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化疗相关认知障碍的治疗研究进展
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Abstract:
化疗相关认知障碍(CRCI)是肿瘤患者化疗所引起的常见不良反应,在肿瘤幸存者中,它的发生率非常高,对患者的治疗依从性和生活治疗带来极大影响。目前,CRCI并无明确有效的治疗方法,主要的治疗方法有药物干预和非药物干预。近些年,治疗CRCI的方法层出不穷,也有大量与之相关的随机对照试验和系统综述发表。因此,本文对这些化疗相关认知障碍的治疗方法进展进行综述,以期为临床治疗CRCI提供参考。
Chemotherapy-related cognitive impairment (CRCI) is a common adverse effect of chemotherapy in cancer patients, with a particularly high incidence among cancer survivors. This condition signi- ficantly impacts patients’ treatment adherence and quality of life. Currently, there is no definitive and effective treatment for CRCI; the main therapeutic approaches include pharmacologic and non-pharmacologic interventions. In recent years, there has been a proliferation of treatments for CRCI, and numerous randomized controlled trials and systematic reviews related to these interventions have been published. Therefore, this article reviews the progress of various therapeutic approaches for chemotherapy-related cognitive impairment, aiming to provide a reference for clinical treatment.
[1] | Schrauwen, W., Van de Cavey, J., Vingerhoets, G., Vanheule, S., Van den Broecke, R. and Denys, H. (2020) Heterogeneous Response of Chemotherapy-Related Cognitive Decline in Patients with Breast Cancer: A Prospective Study. Journal of the International Neuropsychological Society, 26, 806-814. https://doi.org/10.1017/s1355617720000296 |
[2] | Loh, K.P., Janelsins, M.C., Mohile, S.G., Holmes, H.M., Hsu, T., Inouye, S.K., et al. (2016) Chemotherapy-Related Cognitive Impairment in Older Patients with Cancer. Journal of Geriatric Oncology, 7, 270-280. https://doi.org/10.1016/j.jgo.2016.04.008 |
[3] | Biglia, N., Bounous, V.E., Malabaila, A., Palmisano, D., Torta, D.M.E., D’alonzo, M., et al. (2011) Objective and Self-Reported Cognitive Dysfunction in Breast Cancer Women Treated with Chemotherapy: A Prospective Study. European Journal of Cancer Care, 21, 485-492. https://doi.org/10.1111/j.1365-2354.2011.01320.x |
[4] | Bender, C.M., Sereika, S.M., Berga, S.L., Vogel, V.G., Brufsky, A.M., Paraska, K.K., et al. (2005) Cognitive Impairment Associated with Adjuvant Therapy in Breast Cancer. Psycho-Oncology, 15, 422-430. https://doi.org/10.1002/pon.964 |
[5] | Amani, O., Mazaheri, M.A., Moghani, M.M., Zarani, F. and Choolabi, R.H. (2024) Chemotherapy-Induced Cognitive Impairment in Breast Cancer Survivors: A Systematic Review of Studies from 2000 to 2021. Cancer Reports, 7, e1989. https://doi.org/10.1002/cnr2.1989 |
[6] | Wefel, J.S., Kesler, S.R., Noll, K.R. and Schagen, S.B. (2014) Clinical Characteristics, Pathophysiology, and Management of Noncentral Nervous System Cancer-Related Cognitive Impairment in Adults. CA: A Cancer Journal for Clinicians, 65, 123-138. https://doi.org/10.3322/caac.21258 |
[7] | Janelsins, M.C., Kohli, S., Mohile, S.G., Usuki, K., Ahles, T.A. and Morrow, G.R. (2011) An Update on Cancer and Chemotherapy-Related Cognitive Dysfunction: Current Status. Seminars in Oncology, 38, 431-438. https://doi.org/10.1053/j.seminoncol.2011.03.014 |
[8] | Koppelmans, V., Breteler, M.M.B., Boogerd, W., Seynaeve, C., Gundy, C. and Schagen, S.B. (2012) Neuropsychological Performance in Survivors of Breast Cancer More than 20 Years after Adjuvant Chemotherapy. Journal of Clinical Oncology, 30, 1080-1086. https://doi.org/10.1200/jco.2011.37.0189 |
[9] | Bai, L. and Yu, E. (2021) A Narrative Review of Risk Factors and Interventions for Cancer-Related Cognitive Impairment. Annals of Translational Medicine, 9, 72-72. https://doi.org/10.21037/atm-20-6443 |
[10] | Boykoff, N., Moieni, M. and Subramanian, S.K. (2009) Confronting Chemobrain: An In-Depth Look at Survivors’ Reports of Impact on Work, Social Networks, and Health Care Response. Journal of Cancer Survivorship, 3, 223-232. https://doi.org/10.1007/s11764-009-0098-x |
[11] | Myers, J.S. (2011) Chemotherapy-Related Cognitive Impairment: The Breast Cancer Experience. Oncology Nursing Forum, 39, E31-E40. https://doi.org/10.1188/12.onf.e31-e40 |
[12] | Bolton, G. and Isaacs, A. (2018) Women’s Experiences of Cancer-Related Cognitive Impairment, Its Impact on Daily Life and Care Received for It Following Treatment for Breast Cancer. Psychology, Health & Medicine, 23, 1261-1274. https://doi.org/10.1080/13548506.2018.1500023 |
[13] | Lv, L., Mao, S., Dong, H., Hu, P. and Dong, R. (2020) Pathogenesis, Assessments, and Management of Chemotherapy-Related Cognitive Impairment (CRCI): An Updated Literature Review. Journal of Oncology, 2020, 1-11. https://doi.org/10.1155/2020/3942439 |
[14] | Lomeli, N., Di, K., Czerniawski, J., Guzowski, J.F. and Bota, D.A. (2017) Cisplatin-Induced Mitochondrial Dysfunction Is Associated with Impaired Cognitive Function in Rats. Free Radical Biology and Medicine, 102, 274-286. https://doi.org/10.1016/j.freeradbiomed.2016.11.046 |
[15] | Sofis, M.J., Jarmolowicz, D.P., Kaplan, S.V., Gehringer, R.C., Lemley, S.M., Garg, G., et al. (2017) KU32 Prevents 5-Fluorouracil Induced Cognitive Impairment. Behavioural Brain Research, 329, 186-190. https://doi.org/10.1016/j.bbr.2017.03.042 |
[16] | Ren, X., St. Clair, D.K. and Butterfield, D.A. (2017) Dysregulation of Cytokine Mediated Chemotherapy Induced Cognitive Impairment. Pharmacological Research, 117, 267-273. https://doi.org/10.1016/j.phrs.2017.01.001 |
[17] | Lange, M., Joly, F., Vardy, J., Ahles, T., Dubois, M., Tron, L., et al. (2019) Cancer-Related Cognitive Impairment: An Update on State of the Art, Detection, and Management Strategies in Cancer Survivors. Annals of Oncology, 30, 1925-1940. https://doi.org/10.1093/annonc/mdz410 |
[18] | Karschnia, P., Parsons, M.W. and Dietrich, J. (2019) Pharmacologic Management of Cognitive Impairment Induced by Cancer Therapy. The Lancet Oncology, 20, e92-e102. https://doi.org/10.1016/s1470-2045(18)30938-0 |
[19] | Miladi, N., Dossa, R., Dogba, M.J., Cléophat-Jolicoeur, M.I.F. and Gagnon, B. (2019) Psychostimulants for Cancer-Related Cognitive Impairment in Adult Cancer Survivors: A Systematic Review and Meta-Analysis. Supportive Care in Cancer, 27, 3717-3727. https://doi.org/10.1007/s00520-019-04907-w |
[20] | Lawrence, J.A., Griffin, L., Balcueva, E.P., Groteluschen, D.L., Samuel, T.A., Lesser, G.J., et al. (2015) A Study of Donepezil in Female Breast Cancer Survivors with Self-Reported Cognitive Dysfunction 1 to 5 Years Following Adjuvant Chemotherapy. Journal of Cancer Survivorship, 10, 176-184. https://doi.org/10.1007/s11764-015-0463-x |
[21] | Rapp, S.R., Dressler, E.V., Brown, W.M., Wade, J.L., Le-Lindqwister, N., King, D., et al. (2024) Phase III Randomized, Placebo-Controlled Clinical Trial of Donepezil for Treatment of Cognitive Impairment in Breast Cancer Survivors after Adjuvant Chemotherapy (WF-97116). Journal of Clinical Oncology, 42, 2546-2557. https://doi.org/10.1200/jco.23.01100 |
[22] | Winocur, G., Binns, M.A. and Tannock, I. (2011) Donepezil Reduces Cognitive Impairment Associated with Anti-Cancer Drugs in a Mouse Model. Neuropharmacology, 61, 1222-1228. https://doi.org/10.1016/j.neuropharm.2011.07.013 |
[23] | Lim, I., Joung, H., Yu, A.R., Shim, I. and Kim, J.S. (2016) PET Evidence of the Effect of Donepezil on Cognitive Performance in an Animal Model of Chemobrain. BioMed Research International, 2016, 1-7. https://doi.org/10.1155/2016/6945415 |
[24] | Sung, P., Chen, P., Yen, C., Shen, M., Chen, C., Tsai, K., et al. (2021) Memantine Protects against Paclitaxel-Induced Cognitive Impairment through Modulation of Neurogenesis and Inflammation in Mice. Cancers, 13, Article 4177. https://doi.org/10.3390/cancers13164177 |
[25] | Nakamura, Z.M., Deal, A.M., Park, E.M., Stanton, K.E., Lopez, Y.E., Quillen, L.J., et al. (2023) A Phase II Single-Arm Trial of Memantine for Prevention of Cognitive Decline during Chemotherapy in Patients with Early Breast Cancer: Feasibility, Tolerability, Acceptability, and Preliminary Effects. Cancer Medicine, 12, 8172-8183. https://doi.org/10.1002/cam4.5619 |
[26] | Mar Fan, H.G., Clemons, M., Xu, W., Chemerynsky, I., Breunis, H., Braganza, S., et al. (2007) A Randomized, Placebo-Controlled, Double-Blind Trial of the Effects of D-Methylphenidate on Fatigue and Cognitive Dysfunction in Women Undergoing Adjuvant Chemotherapy for Breast Cancer. Supportive Care in Cancer, 16, 577-583. https://doi.org/10.1007/s00520-007-0341-9 |
[27] | Kohli, S., Fisher, S.G., Tra, Y., Adams, M.J., Mapstone, M.E., Wesnes, K.A., et al. (2009) The Effect of Modafinil on Cognitive Function in Breast Cancer Survivors. Cancer, 115, 2605-2616. https://doi.org/10.1002/cncr.24287 |
[28] | Attia, A., Rapp, S.R., Case, L.D., D’Agostino, R., Lesser, G., Naughton, M., et al. (2012) Phase II Study of Ginkgo Biloba in Irradiated Brain Tumor Patients: Effect on Cognitive Function, Quality of Life, and Mood. Journal of Neuro-Oncology, 109, 357-363. https://doi.org/10.1007/s11060-012-0901-9 |
[29] | Barton, D.L., Burger, K., Novotny, P.J., Fitch, T.R., Kohli, S., Soori, G., et al. (2012) The Use of Ginkgo Biloba for the Prevention of Chemotherapy-Related Cognitive Dysfunction in Women Receiving Adjuvant Treatment for Breast Cancer, N00c9. Supportive Care in Cancer, 21, 1185-1192. https://doi.org/10.1007/s00520-012-1647-9 |
[30] | Palmer, A.C.S., Zortea, M., Souza, A., Santos, V., Biazús, J.V., Torres, I.L.S., et al. (2020) Clinical Impact of Melatonin on Breast Cancer Patients Undergoing Chemotherapy; Effects on Cognition, Sleep and Depressive Symptoms: A Randomized, Double-Blind, Placebo-Controlled Trial. PLOS ONE, 15, e0231379. https://doi.org/10.1371/journal.pone.0231379 |
[31] | 罗璠, 张晨阳, 袁梦琪, 等. 李佩文从“脏神-脑神”辨治乳腺癌化疗相关认知障碍经验[J]. 中医药导报, 2023, 29(11): 183-185+192. |
[32] | 陈佳静, 刘胜, 秦悦农, 等. 乳腺术后三阴方干预三阴性乳腺癌化疗脑症状临床研究[J]. 世界中医药, 2024, 19(5): 666-671. |
[33] | Chan, R.J., McCarthy, A.L., Devenish, J., Sullivan, K.A. and Chan, A. (2015) Systematic Review of Pharmacologic and Non-Pharmacologic Interventions to Manage Cognitive Alterations after Chemotherapy for Breast Cancer. European Journal of Cancer, 51, 437-450. https://doi.org/10.1016/j.ejca.2014.12.017 |
[34] | Dos Santos, M., Hardy-Léger, I., Rigal, O., Licaj, I., Dauchy, S., Levy, C., et al. (2020) Cognitive Rehabilitation Program to Improve Cognition of Cancer Patients Treated with Chemotherapy: A 3-Arm Randomized Trial. Cancer, 126, 5328-5336. https://doi.org/10.1002/cncr.33186 |
[35] | Zeng, Y., Dong, J., Huang, M., Zhang, J., Zhang, X., Xie, M., et al. (2020) Nonpharmacological Interventions for Cancer-Related Cognitive Impairment in Adult Cancer Patients: A Network Meta-Analysis. International Journal of Nursing Studies, 104, Article 103514. https://doi.org/10.1016/j.ijnurstu.2019.103514 |
[36] | Liu, Y., Liu, J., Chen, S., Zhao, F., Chen, L. and Li, R. (2022) Effectiveness of Nonpharmacologic Interventions for Chemotherapy-Related Cognitive Impairment in Breast Cancer Patients. Cancer Nursing, 46, E305-E319. https://doi.org/10.1097/ncc.0000000000001152 |
[37] | Reid-Arndt, S.A., Matsuda, S. and Cox, C.R. (2012) Tai Chi Effects on Neuropsychological, Emotional, and Physical Functioning Following Cancer Treatment: A Pilot Study. Complementary Therapies in Clinical Practice, 18, 26-30. https://doi.org/10.1016/j.ctcp.2011.02.005 |
[38] | Oberste, M., Schaffrath, N., Schmidt, K., Bloch, W., Jäger, E., Steindorf, K., et al. (2018) Protocol for the “Chemobrain in Motion Study” (CIM-Study): A Randomized Placebo-Controlled Trial of the Impact of a High-Intensity Interval Endurance Training on Cancer Related Cognitive Impairments in Women with Breast Cancer Receiving First-Line Chemotherapy. BMC Cancer, 18, Article No. 1071. https://doi.org/10.1186/s12885-018-4992-3 |
[39] | Kiesl, D., Kuzdas-Sallaberger, M., Fuchs, D., Brunner, S., Kommenda, R., Tischler, C., et al. (2022) Protocol for the Exercise, Cancer and Cognition—The Ecco-Study: A Randomized Controlled Trial of Simultaneous Exercise during Neo-/Adjuvant Chemotherapy in Breast Cancer Patients and Its Effects on Neurocognition. Frontiers in Neurology, 13, Article 777808. https://doi.org/10.3389/fneur.2022.777808 |
[40] | Koevoets, E.W., Schagen, S.B., de Ruiter, M.B., et al. (2022) Effect of Physical Exercise on Cognitive Function after Chemotherapy in Patients with Breast Cancer: A Randomized Controlled Trial (PAM Study). Breast Cancer Research, 24, Article No. 36. |
[41] | 魏小林. 八段锦对化疗期乳腺癌患者认知功能及生活质量的干预效果研究[D]: [硕士学位论文]. 上海: 上海中医药大学, 2021. |
[42] | Reich, R.R., Lengacher, C.A., Alinat, C.B., Kip, K.E., Paterson, C., Ramesar, S., et al. (2017) Mindfulness-Based Stress Reduction in Post-Treatment Breast Cancer Patients: Immediate and Sustained Effects across Multiple Symptom Clusters. Journal of Pain and Symptom Management, 53, 85-95. https://doi.org/10.1016/j.jpainsymman.2016.08.005 |
[43] | Lengacher, C.A., Reich, R.R., Paterson, C.L., Ramesar, S., Park, J.Y., Alinat, C., et al. (2016) Examination of Broad Symptom Improvement Resulting from Mindfulness-Based Stress Reduction in Breast Cancer Survivors: A Randomized Controlled Trial. Journal of Clinical Oncology, 34, 2827-2834. https://doi.org/10.1200/jco.2015.65.7874 |
[44] | Lin, J.G., Kotha, P. and Chen, Y.H. (2022) Understandings of Acupuncture Application and Mechanisms. American Journal of Translational Research, 14, 1469-1481. |
[45] | Zhang, Z., Man, S., Yam, L., Yiu, C.Y., Leung, R.C., Qin, Z., et al. (2020) Electroacupuncture Trigeminal Nerve Stimulation Plus Body Acupuncture for Chemotherapy-Induced Cognitive Impairment in Breast Cancer Patients: An Assessor-Participant Blinded, Randomized Controlled Trial. Brain, Behavior, and Immunity, 88, 88-96. https://doi.org/10.1016/j.bbi.2020.04.035 |
[46] | Zeng, Y., Cheng, A.S.K., Song, T., Sheng, X., Wang, S., Xie, J., et al. (2018) Effects of Acupuncture on Cancer-Related Cognitive Impairment in Chinese Gynecological Cancer Patients: A Pilot Cohort Study. Integrative Cancer Therapies, 17, 737-746. https://doi.org/10.1177/1534735418777109 |