Subjective and Objective Cancer-Related Cognitive Impairments Among Systemic and Radiation Therapy-Naïve Female Cancer Patients

IF 3.1 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2025-04-22 DOI:10.1002/cam4.70908

Maria-Chidi C. Onyedibe, Martina E. Schmidt, Pauline Bizer, Philipp Zimmer, Karen Steindorf

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Abstract

Background

Cancer-related cognitive impairment (CRCI) is a frequent and burdensome problem that is still insufficiently understood and managed. We investigated subjective and objective measures of CRCI, as recommended by the International Cancer and Cognition Task Force (ICCTF) in cancer patients prior to systemic or radiation therapy with respect to potential influencing or associated psychosocial, demographic, or lifestyle factors.

Methods

Female patients with breast or gynecological tumors (n = 239, mean age = 55.5, SD = 11.6) prior to any systemic or radiation therapy completed validated subjective (FACT-Cog: perceived cognitive impairment [PCI], perceived cognitive ability [PCA], impact on quality of life [IQoL]) and objective measures of CRCI (Trail Making Test [TMT-A and -B], Controlled Oral Word Association Test [COWA], and Hopkins Verbal Learning Test-Revised [HVLT-R]). Association with cross-sectionally assessed age, body mass index, education, smoking, alcohol intake, sleep problems, social support, anxiety, and pain was investigated using multiple linear regression models.

Results

A quarter (25.1%) of patients showed indication for CRCI based on the PCI score. Subjective and objective CRCI measures showed no or only weak correlations, also when adjusting for age and education (partial Spearman correlations with each other, all |r| ≤ 0.21). Anxiety, sleep problems, and pain were significantly associated with low subjective cognitive function (PCI, PCA, and IQoL). Poor objective cognitive values (TMT, COWA, and HVLT-R) were mainly determined by higher age and lower education.

Conclusions

Cancer-related cognitive impairment is not solely (chemo-)therapy-induced but may be triggered or influenced by anxiety, sleep problems, and pain. Addressing these issues early in the treatment phase could potentially alleviate perceived CRCI. The ICCTF-recommended neuropsychological tests do not adequately capture this CRCI prior to systemic or radiation therapy, but could serve as complementary tools to monitor cognitive changes over time, independent of psychosocial influences.

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全身和放疗女性癌症患者的主观和客观癌症相关认知障碍Therapy-Naïve

癌症相关的认知障碍（CRCI）是一个常见且繁重的问题，但仍未得到充分的理解和管理。根据国际癌症和认知工作组（ICCTF）的建议，我们调查了癌症患者在接受全身或放射治疗前CRCI的主观和客观测量方法，包括潜在的影响或相关的社会心理、人口统计学或生活方式因素。方法女性乳腺或妇科肿瘤患者（n = 239，平均年龄= 55.5,SD = 11.6）在接受任何全身或放射治疗前完成经过验证的主观（FACT-Cog：感知认知障碍[PCI]，感知认知能力[PCA]，对生活质量的影响[ikol]）和客观CRCI测量（Trail Making Test [TMT-A和-B]，对照口语单词联想测试[COWA]和霍普金斯语言学习测试修订[HVLT-R]）。使用多元线性回归模型调查年龄、体重指数、教育程度、吸烟、饮酒、睡眠问题、社会支持、焦虑和疼痛与横断面评估的关系。结果1 / 4（25.1%）的患者显示基于PCI评分的CRCI适应证。主观和客观CRCI测量显示没有或只有弱相关性，在调整年龄和教育程度时也是如此（部分Spearman相关性，所有|或|≤0.21）。焦虑、睡眠问题和疼痛与低主观认知功能（PCI、PCA和iiq）显著相关。客观认知价值差（TMT、COWA、HVLT-R）主要由年龄大、文化程度低决定。结论：癌症相关的认知障碍不仅仅是化疗引起的，还可能由焦虑、睡眠问题和疼痛引发或影响。在治疗早期解决这些问题可能会潜在地减轻CRCI。icctf推荐的神经心理测试不能在全身或放射治疗前充分捕捉到这种CRCI，但可以作为一种辅助工具，监测随时间推移的认知变化，独立于社会心理影响。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.