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Liu Y, Liu JE, Shi TY, Bai LX, Yang AL, Li RL, Su YL, Wang PL, Liu J, Zhang L. Factors associated with perceived cognitive function in breast cancer patients treated with chemotherapy: A multicenter cross-sectional study. Eur J Oncol Nurs 2024; 71:102623. [PMID: 38880040 DOI: 10.1016/j.ejon.2024.102623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 05/16/2024] [Accepted: 05/20/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE This study aimed to investigate the factors associated with perceived cognitive function among breast cancer patients treated with chemotherapy in China. METHODS The study was a multicenter cross-sectional design. Data were collected from 10 public hospitals in China between April 2022 and February 2023. A total of 741 participants completed questionnaires assessing sociodemographic and medical characteristics, perceived cognitive function, sleep quality, fatigue, anxiety, and depression. Hierarchical multiple regression analysis was used to assess the determinants of cognitive function. RESULTS The hierarchical multiple regression model accounted for 31.5% of variation in perceived cognitive function (sociodemographic 4.5%; medical 6.6%; exercise frequency 6.6%; sleep quality 2.1%; fatigue 2.8%; anxiety combined with depression 9.0%). Education level, chemotherapy type, number of chemotherapy cycles, and cyclophosphamide drug use were significant predisposing factors of perceived cognitive function (p < 0.001). Exercising ≥3 times/week (p < 0.001) was a significant factor positively influencing perceived cognitive function, meanwhile, anxiety (p < 0.001) and depression (p < 0 0.001) were negative factors. CONCLUSION Our findings suggest that patients with low education levels, postoperative chemotherapy, cyclophosphamide treatment, and a greater number of chemotherapy cycles need more assessment. Sedentary patients, those who have never exercised, and those with anxiety or depression all showed greater cognitive decline. By identifying susceptible populations, encouraging regular exercise, and addressing anxiety and depression, healthcare professionals can contribute significantly to prevent patients' cognitive decline throughout chemotherapy.
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Affiliation(s)
- Yu Liu
- School of Nursing, Capital Medical University, You an Men, Beijing, 100069, PR China
| | - Jun-E Liu
- School of Nursing, Capital Medical University, You an Men, Beijing, 100069, PR China.
| | - Tie-Ying Shi
- Nursing Department, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, PR China
| | - Li-Xiao Bai
- Department of Breast Cancer, The Fifth Medical Centre of Chinese People's Liberation Army (PLA) General Hospital, Beijing, PR China
| | - Ai-Ling Yang
- Department of Breast Cancer, The Fifth Medical Centre of Chinese People's Liberation Army (PLA) General Hospital, Beijing, PR China
| | - Ruo-Lin Li
- School of Nursing, Capital Medical University, You an Men, Beijing, 100069, PR China
| | - Ya-Li Su
- Department of Breast Oncology, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring Road West, Beijing, 100050, PR China
| | - Pi-Lin Wang
- Department of Breast Oncology, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring Road West, Beijing, 100050, PR China
| | - Juan Liu
- Department of Breast Oncology, Beijing Shijitan Hospital, Capital Medical University, 10th Tieyi Road, Beijing, 100038, PR China
| | - Ling Zhang
- School of Public Health, Capital Medical University, You an Men, Beijing, 100069, PR China
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Von Ah D, Rio CJ, Carter A, Perkins SM, Stevens E, Rosko A, Davenport A, Kalady M, Noonan AM, Crouch A, Storey S, Overcash J, Han CJ, Yang Y, Li H, Saligan LN. Association between Cognitive Function and Physical Function, Frailty, and Quality of Life in Older Breast Cancer Survivors. Cancers (Basel) 2024; 16:2718. [PMID: 39123446 PMCID: PMC11311865 DOI: 10.3390/cancers16152718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Older cancer survivors in general are at greater risk for cancer-related cognitive impairment (CRCI), yet few studies have explored its association with health outcomes. This study examined the association between subjective and objective measures of cognitive function and physical function, frailty, and quality of life (QoL) among older breast cancer survivors. MATERIALS AND METHODS Older breast cancer survivors who reported cognitive concerns completed surveys on patient-reported cognitive function, physical function, frailty, and QoL as well as objective tests of visuospatial working memory and sustained attention. Data were analyzed using descriptive statistics and separate linear regression models. RESULTS A total of 219 female breast cancer survivors completed the study. Perceived cognitive abilities were associated with better physical function, frailty, and QoL (p ≤ 0.001) while cognitive concerns were negatively related with these metrics (p ≤ 0.001). Poorer visuospatial working memory and sustained attention were linked to increased frailty (p ≤ 0.001-0.01), whereas poorer sustained attention was associated with poorer physical function (p < 0.01). CONCLUSIONS Older breast cancer survivors with perceived cognitive impairment and poorer cognitive performance reported poorer physical functioning, increased frailty, and poorer QoL. These findings underscore the importance of assessing cognitive concerns and their associated outcomes in older breast cancer survivors.
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Affiliation(s)
- Diane Von Ah
- College of Nursing, The Ohio State University, 394 Newton Hall, 1585 Neil Avenue, Columbus, OH 43210, USA (C.J.H.)
| | - Carielle Joy Rio
- Symptoms Biology Unit, Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, 3 Center Drive, Bethesda, MD 20892, USA
| | - Allie Carter
- Department of Biostatistics and Health Data Science, IU School of Medicine, Richard M. Fairbanks School of Public Health, Indianapolis, IN 46202, USA
| | - Susan M. Perkins
- Department of Biostatistics and Health Data Science, IU School of Medicine, Richard M. Fairbanks School of Public Health, Indianapolis, IN 46202, USA
| | - Erin Stevens
- Division of Palliative Care, Department of Internal Medicine, The Ohio State University, 1581 Dodd Drive, 5th Floor North Columbus, Columbus, OH 43210, USA
| | - Ashley Rosko
- Division of Hematology, James Comprehensive Cancer Center, The Ohio State University, 1150C Lincoln Tower, Columbus, OH 43210, USA
| | - Ashley Davenport
- Division of Medical Oncology, James Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Mathew Kalady
- Division of Colon and Rectal Surgery, Clinical Cancer Genetics Program, The Ohio State University-James: Cancer Treatment and Research Center, Columbus, OH 43210, USA
| | - Anne M. Noonan
- GI Medical Oncology Selection, The Ohio State University-James: Cancer Treatment and Research Center, Columbus, OH 43210, USA
| | - Adele Crouch
- School of Nursing, Indiana University, Indianapolis, IN 46202, USA; (A.C.); (S.S.)
| | - Susan Storey
- School of Nursing, Indiana University, Indianapolis, IN 46202, USA; (A.C.); (S.S.)
| | - Janine Overcash
- College of Nursing, The Ohio State University, 394 Newton Hall, 1585 Neil Avenue, Columbus, OH 43210, USA (C.J.H.)
| | - Claire J. Han
- College of Nursing, The Ohio State University, 394 Newton Hall, 1585 Neil Avenue, Columbus, OH 43210, USA (C.J.H.)
| | - Yesol Yang
- College of Nursing, The Ohio State University, 394 Newton Hall, 1585 Neil Avenue, Columbus, OH 43210, USA (C.J.H.)
| | - Haiying Li
- College of Nursing, The Ohio State University, 394 Newton Hall, 1585 Neil Avenue, Columbus, OH 43210, USA (C.J.H.)
| | - Leorey N. Saligan
- Symptoms Biology Unit, Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, 3 Center Drive, Bethesda, MD 20892, USA
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Parsowith EJ, Stock MS, Kocuba O, Schumpp A, Jackson K, Brooks AM, Larson A, Dixon M, Fairman CM. Impact of Short-Term Creatine Supplementation on Muscular Performance among Breast Cancer Survivors. Nutrients 2024; 16:979. [PMID: 38613014 PMCID: PMC11013276 DOI: 10.3390/nu16070979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/11/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Breast cancer (BC) is one of the most common cancers in the United States. Advances in detection and treatment have resulted in an increased survival rate, meaning an increasing population experiencing declines in muscle mass and strength. Creatine supplementation has consistently demonstrated improvements in strength and muscle performance in older adults, though these findings have not been extended to cancer populations. PURPOSE The purpose of this study was to investigate the effects of short-term creatine supplementation on muscular performance in BC survivors. METHODS Using a double-blind, placebo-controlled, randomized design, 19 female BC survivors (mean ± SD age = 57.63 ± 10.77 years) were assigned to creatine (SUPP) (n = 9) or dextrose placebo (PLA) (n = 10) groups. The participants completed two familiarization sessions, then two test sessions, each separated by 7 days, where the participants supplemented with 5 g of SUPP or PLA 4 times/day between sessions. The testing sessions included sit-to-stand power, isometric/isokinetic peak torque, and upper/lower body strength via 10 repetition maximum (10RM) tests. The interaction between supplement (SUPP vs. PLA) and time (Pre vs. Post) was examined using a group × time ANOVA and effect sizes. RESULTS No significant effects were observed for sit-to-stand power (p = 0.471; ηp2 = 0.031), peak torque at 60°/second (p = 0.533; ηp2 = 0.023), peak torque at 120°/second (p = 0.944; ηp2 < 0.001), isometric peak torque (p = 0.905; ηp2 < 0.001), 10RM chest press (p = 0.407; ηp2 = 0.041), and 10RM leg extension (p = 0.932; ηp2 < 0.001). However, a large effect size for time occurred for the 10RM chest press (ηp2 = 0.531) and leg extension (ηp2 = 0.422). CONCLUSION Seven days of creatine supplementation does not influence muscular performance among BC survivors.
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Affiliation(s)
- Emily J. Parsowith
- Cognition, Neuroplasticity, and Sarcopenia (CNS) Lab, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA; (E.J.P.); (M.S.S.)
| | - Matt S. Stock
- Cognition, Neuroplasticity, and Sarcopenia (CNS) Lab, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA; (E.J.P.); (M.S.S.)
| | - Olivia Kocuba
- Exercise Oncology Lab, University of South Carolina, Columbia, SC 29208, USA
| | - Alec Schumpp
- Exercise Oncology Lab, University of South Carolina, Columbia, SC 29208, USA
| | - Kylah Jackson
- Exercise Oncology Lab, University of South Carolina, Columbia, SC 29208, USA
| | - Alexander M. Brooks
- Exercise Oncology Lab, University of South Carolina, Columbia, SC 29208, USA
| | - Alena Larson
- Exercise Oncology Lab, University of South Carolina, Columbia, SC 29208, USA
| | - Madison Dixon
- Exercise Oncology Lab, University of South Carolina, Columbia, SC 29208, USA
| | - Ciaran M. Fairman
- Exercise Oncology Lab, University of South Carolina, Columbia, SC 29208, USA
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Liu Y, Li RL, Chen L, Zhao FY, Su YL, Jin S, Liu JE. Construction and validation of a risk-prediction model for chemotherapy-related cognitive impairment in patients with breast cancer. J Cancer Surviv 2024:10.1007/s11764-024-01566-7. [PMID: 38512563 DOI: 10.1007/s11764-024-01566-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE To identify risk factors of chemotherapy-related cognitive impairment (CRCI) and construct and validate a visual prediction model of such for patients with breast cancer. METHODS A multicenter, descriptive, and cross-sectional design was adopted. Data were collected from ten public tertiary hospitals in China. Cognitive function was assessed by using Functional Assessment of Cancer Therapy-cognitive function. Socio-demographic, clinical, psychological, and physical indicators were also assessed. The logistic prediction model was constructed by fivefold cross-validation. Then, a nomogram was utilized to visualize the prediction model, which was also evaluated via discrimination, calibration, and decision curve analysis. RESULTS A total of 71 breast cancer patients had CRCI with a prevalence of 9.58%. This visual prediction model was constructed based on education background, exercise frequency, chemotherapy times, and fatigue and demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.882. The calibration curve indicated good agreement between experimental and projected values, and the decision curve proved good clinical applicability. CONCLUSION Education background, exercise frequency, chemotherapy times, and fatigue were associated with high incidence of CRCI. The prediction model exhibits superior performance and has promise as a useful instrument for assessing the likelihood of CRCI in breast cancer patients. IMPLICATIONS FOR CANCER SURVIVORS Our findings could provide breast cancer survivors with risk screening based on CRCI predictors to implement prevention and early intervention, and help patients integrate into society and achieve comprehensive recovery.
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Affiliation(s)
- Yu Liu
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Ruo-Lin Li
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Lu Chen
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Fu-Yun Zhao
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Ya-Li Su
- Department of Breast Oncology, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring Road West, 100050, Beijing, China
| | - Shuai Jin
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Jun-E Liu
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China.
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Dias-Carvalho A, Margarida-Araújo A, Reis-Mendes A, Sequeira CO, Pereira SA, Guedes de Pinho P, Carvalho F, Sá SI, Fernandes E, Costa VM. A Clinically Relevant Dosage of Mitoxantrone Disrupts the Glutathione and Lipid Metabolic Pathways of the CD-1 Mice Brain: A Metabolomics Study. Int J Mol Sci 2023; 24:13126. [PMID: 37685929 PMCID: PMC10488007 DOI: 10.3390/ijms241713126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/26/2023] [Accepted: 08/09/2023] [Indexed: 09/10/2023] Open
Abstract
Long-term cognitive dysfunction, or "chemobrain", has been observed in cancer patients treated with chemotherapy. Mitoxantrone (MTX) is a topoisomerase II inhibitor that binds and intercalates with DNA, being used in the treatment of several cancers and multiple sclerosis. Although MTX can induce chemobrain, its neurotoxic mechanisms are poorly studied. This work aimed to identify the adverse outcome pathways (AOPs) activated in the brain upon the use of a clinically relevant cumulative dose of MTX. Three-month-old male CD-1 mice were given a biweekly intraperitoneal administration of MTX over the course of three weeks until reaching a total cumulative dose of 6 mg/kg. Controls were given sterile saline in the same schedule. Two weeks after the last administration, the mice were euthanized and their brains removed. The left brain hemisphere was used for targeted profiling of the metabolism of glutathione and the right hemisphere for an untargeted metabolomics approach. The obtained results revealed that MTX treatment reduced the availability of cysteine (Cys), cysteinylglycine (CysGly), and reduced glutathione (GSH) suggesting that MTX disrupts glutathione metabolism. The untargeted approach revealed metabolic circuits of phosphatidylethanolamine, catecholamines, unsaturated fatty acids biosynthesis, and glycerolipids as relevant players in AOPs of MTX in our in vivo model. As far as we know, our study was the first to perform such a broad profiling study on pathways that could put patients given MTX at risk of cognitive deficits.
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Affiliation(s)
- Ana Dias-Carvalho
- Associate Laboratory i4HB, Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Ana Margarida-Araújo
- Associate Laboratory i4HB, Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Ana Reis-Mendes
- Associate Laboratory i4HB, Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Catarina Oliveira Sequeira
- iNOVA4Health, LS4Future, NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), Universidade Nova de Lisboa, 1150-082 Lisboa, Portugal
| | - Sofia Azeredo Pereira
- iNOVA4Health, LS4Future, NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), Universidade Nova de Lisboa, 1150-082 Lisboa, Portugal
| | - Paula Guedes de Pinho
- Associate Laboratory i4HB, Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Félix Carvalho
- Associate Laboratory i4HB, Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Susana Isabel Sá
- Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Eduarda Fernandes
- LAQV-REQUIMTE, Laboratory of Applied Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Vera Marisa Costa
- Associate Laboratory i4HB, Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
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Allemann-Su YY, Vetter M, Koechlin H, Conley Y, Paul SM, Cooper BA, Kober KM, Levine JD, Miaskowski C, Katapodi MC. Distinct Cognitive Function Profiles Are Associated With a Higher Presurgery Symptom Burden in Patients With Breast Cancer. Cancer Nurs 2023; 46:E208-E217. [PMID: 35439196 PMCID: PMC11186600 DOI: 10.1097/ncc.0000000000001114] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Cancer-related cognitive impairment (CRCI) is a common symptom in patients with breast cancer. In our previous study of 397 women with breast cancer, we identified 3 groups of patients with distinct CRCI profiles (ie, high, moderate, and low-moderate attentional function). Compared with the other 2 classes, the low-moderate class was younger, had more comorbidities, and with lower functional status. OBJECTIVES In this study, we expand on this work and evaluate for differences among these latent classes in the severity of psychological (depression and anxiety) and physical (fatigue, decrements in energy, sleep disturbance, and pain) symptoms before surgery. METHODS Cancer-related cognitive impairment was assessed using the Attentional Functional Index from before through 6 months after surgery. Lower Attentional Functional Index scores indicate higher levels of CRCI. Psychological and physical symptoms were assessed with valid instruments. Parametric and nonparametric tests were used to evaluate for differences in symptom severity scores among the latent classes. RESULTS Approximately 60% of patients experienced CRCI (ie, moderate and low-moderate classes). Significant differences were found among the 3 classes in the severity of trait and state anxiety, depressive symptoms, fatigue, and sleep disturbance (ie, high < moderate < low-moderate). In addition, compared with the other 2 classes, the low-moderate class reported higher pain interference scores. CONCLUSIONS These findings suggest that women with clinically meaningful levels of persistent CRCI have a relatively high symptom burden before surgery. IMPLICATIONS FOR PRACTICE Clinicians need to routinely perform preoperative assessments of CRCI and associated symptoms and initiate therapeutic interventions.
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Affiliation(s)
- Yu-Yin Allemann-Su
- Author Affiliations: Department of Clinical Research, University of Basel (Ms Alleman-Su and Dr Katapodi); Department of Oncology, Cantonal Hospital Basel-Land (Dr Vetter), Liestal; Faculty of Psychology, University of Basel (Dr Koechlin), Switzerland; Department of Anaesthesiology, Boston Children's Hospital, Harvard Medical School (Dr Koechlin), Boston, Massachusetts; School of Nursing, University of Pittsburgh (Dr Conley), Pennsylvania; School of Nursing (Drs Paul, Cooper, Kober, and Miaskowski), and School of Medicine (Drs Levine and Miaskowski), University of California, San Francisco
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García-Torres F, Tejero-Perea A, Gómez-Solís Á, Castillo-Mayén R, Jaén-Moreno MJ, Luque B, Gálvez-Lara M, Sánchez-Raya A, Jablonski M, Rodríguez-Alonso B, Aranda E. Effectiveness of the Unified Barlow Protocol (UP) and neuropsychological treatment in cancer survivors for cognitive impairments: study protocol for a randomized controlled trial. Trials 2022; 23:819. [PMID: 36175973 PMCID: PMC9524048 DOI: 10.1186/s13063-022-06731-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022] Open
Abstract
Background Cancer survivors frequently develop cognitive impairment, which negatively affects their quality of life and emotional well-being. This study compares the effectiveness of a well-established treatment (neuropsychological treatment) with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) to reduce these cognitive deficits and evaluate the effect of both treatments on anxiety-depressive symptoms and the quality of life of cancer survivors. Methods A three-arm, randomized superiority clinical trial with a pre-post and repeated follow-up measures intergroup design using a 1:1:1 allocation ratio will be performed. One hundred and twenty-three cancer survivors with mild to moderate cognitive impairment will be randomly assigned to one of the study interventions: a cognitive rehabilitation intervention group, an intervention group with UP intervention, or a control group on the waiting list. The primary outcome is to observe a significant improvement in cognitive function in both intervention groups and a significant decrease in emotional impairments in comparison with the waitlist group. Improvements in anxiety, depression, and quality of life are also expected as secondary outcomes. These results will be maintained at 6 months of follow-up. Discussion The aim of this trial is to test the efficacy of the UP intervention in reducing cognitive deficits in breast cancer survivors. The results of this trial may be useful in reducing the presence of cognitive problems in cancer survivors and improving their emotional state and quality of life. Trial registration ClinicalTrials.gov NCT05289258. Registered 12 March 2022, v01. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06731-w.
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Affiliation(s)
- Francisco García-Torres
- Department of Psychology, University of Cordoba, Cordoba, Spain. .,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.
| | - Adrián Tejero-Perea
- Department of Psychology, University of Cordoba, Cordoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.,Reina Sofía University Hospital of Cordoba, Cordoba, Spain
| | | | - Rosario Castillo-Mayén
- Department of Psychology, University of Cordoba, Cordoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
| | - Maria José Jaén-Moreno
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.,Department of Social Health Sciences, Radiology and Physical Medicine, University of Córdoba, Córdoba, Spain
| | - Bárbara Luque
- Department of Psychology, University of Cordoba, Cordoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
| | - Mario Gálvez-Lara
- Department of Psychology, University of Cordoba, Cordoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
| | - Araceli Sánchez-Raya
- Department of Psychology, University of Cordoba, Cordoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
| | - Marcin Jablonski
- Collegium Medicum Jan Kochanowski, University in Kielce, Kielce, Poland
| | - Beatriz Rodríguez-Alonso
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.,Reina Sofía University Hospital of Cordoba, Cordoba, Spain
| | - Enrique Aranda
- Medical Oncology Department, Reina Sofía University Hospital, Córdoba, Spain
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8
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Konopka-Filippow M, Hempel D, Sierko E. Actual, Personalized Approaches to Preserve Cognitive Functions in Brain Metastases Breast Cancer Patients. Cancers (Basel) 2022; 14:cancers14133119. [PMID: 35804894 PMCID: PMC9265102 DOI: 10.3390/cancers14133119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 11/24/2022] Open
Abstract
Simple Summary Breast cancer is the one of most common causes of brain metastases among solid malignancies, being responsible for 10–16% of all brain metastases in oncological patients. Brain metastases in the course of breast cancer significantly worsen quality of life of patients, especially in the aspect of neurocognitive domains. The review aims to summarize and integrate the current knowledge about breast cancer brain metastases, focusing on indications of certain types of treatment, and with special attention to the role of hippocampus sparing in preserving neurocognitive functions in irradiated patients. Abstract Breast cancer (BC) is the most often diagnosed cancer among women worldwide and second most common cause of brain metastases (BMs) among solid malignancies being responsible for 10–16% of all BMs in oncological patients. Moreover, BMs are associated with worse prognosis than systemic metastases. The quality of life (QoL) among brain metastases breast cancer (BMBC) patients is significantly influenced by cognitive functions. Cancer-related cognitive deficits and the underlying neural deficits in BMBC patients can be caused via BMs per se, chemotherapy administration, brain irradiation, postmenopausal status, or comorbidities. Brain RT often leads to cognitive function impairment by damage of neural progenitor cells of the hippocampus and hence decreased QoL. Sparing the hippocampal region of the brain during RT provides protective covering of the centrally located hippocampi according to the patient’s clinical requirements. This article discusses the personalized strategies for treatment options to protect cognitive functions in BMBC patients, with special emphasis on the innovative techniques of radiation therapy.
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Affiliation(s)
- Monika Konopka-Filippow
- Department of Oncology, Medical University of Bialystok, 15-274 Bialystok, Poland; (M.K.-F.); (D.H.)
- Department of Radiotherapy I, Maria Sklodowska-Curie Bialystok Oncology Centre, 15-027 Bialystok, Poland
| | - Dominika Hempel
- Department of Oncology, Medical University of Bialystok, 15-274 Bialystok, Poland; (M.K.-F.); (D.H.)
- Department of Radiotherapy I, Maria Sklodowska-Curie Bialystok Oncology Centre, 15-027 Bialystok, Poland
| | - Ewa Sierko
- Department of Oncology, Medical University of Bialystok, 15-274 Bialystok, Poland; (M.K.-F.); (D.H.)
- Department of Radiotherapy I, Maria Sklodowska-Curie Bialystok Oncology Centre, 15-027 Bialystok, Poland
- Correspondence: ; Tel.: +48-85-664-6734; Fax: +48-66-46-783
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A Telehealth-Based Cognitive-Adaptive Training (e-OTCAT) to Prevent Cancer and Chemotherapy-Related Cognitive Impairment in Women with Breast Cancer: Protocol for a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127147. [PMID: 35742400 PMCID: PMC9222777 DOI: 10.3390/ijerph19127147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/02/2022] [Accepted: 06/08/2022] [Indexed: 12/24/2022]
Abstract
Background: Many women with breast cancer experience a great number of side effects, such as cognitive impairment, during and after chemotherapy that reduces their quality of life. Currently, research focusing on the use of non-pharmacological, and specifically telehealth interventions to prevent or mitigate them has been insufficient. Methods: This protocol describes a randomized controlled trial aimed at studying the preventive effects of a videoconferenced cognitive-adaptive training (e-OTCAT) program (ClinicalTrials.gov NCT04783402). A number of 98 eligible participants will be randomized to one of the following groups: (a) the experimental group receiving the e-OTCAT program during 12 consecutive weeks since the beginning of chemotherapy; and (b) the control group receiving and educational handbook and usual care. The primary outcome will be the cognitive function. Secondary measures will be psychological distress, fatigue, sleep disturbance, quality of life and occupational performance. The time-points for these measures will be placed at baseline, after 12 weeks and six months of post-randomization. Conclusion: This trial may support the inclusion of multidimensional interventions through a telehealth approach in a worldwide growing population suffering from breast cancer, emphasizing the prevention of cognitive impairment as one of the side effects of cancer and its treatments.
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Effects of Baduanjin exercise on cognitive function and cancer-related symptoms in women with breast cancer receiving chemotherapy: a randomized controlled trial. Support Care Cancer 2022; 30:6079-6091. [PMID: 35416502 DOI: 10.1007/s00520-022-07015-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/25/2022] [Indexed: 12/17/2022]
Abstract
PURPOSE Cognitive decline is one of the main side effects of breast cancer patients after relevant treatment, but there is a lack of clear measures for prevention and management without definite mechanism. Moreover, postoperative patients also have a need for limb rehabilitation. Whether the cognitive benefits of Baduanjin exercise can improve the overall well-being of breast cancer patients remains unknown. METHODS This randomized controlled trial was conducted on 70 patients with breast cancer receiving chemotherapy who were randomly assigned and allocated to (1:1) a supervised Baduanjin intervention group (5 times/week, 30 min each time) or a control group for 3 months. The effects of Baduanjin exercise intervention were evaluated by outcome measures including subjective cognitive function, symptoms (fatigue, depression, and anxiety), and health-related quality of life at pre-intervention (T0), 4 weeks (T1), 8 weeks (T2), and 12 weeks (T3). The collected data were analyzed by using an intention-to-treat principle and linear mixed-effects modeling. RESULTS Participants in the Baduanjin intervention group had a significantly greater improvement in terms of FACT-Cog (F = 14.511; p < 0.001), PCI (F = 15.789; p < 0.001), PCA (F = 6.261; p = 0.015), and FACT-B scores (F = 8.900; p = 0.004) compared with the control group over the time. The exercise-cognition relationship was significantly mediated through the reduction of fatigue (indirect effect: β = 0.132; 95% CI 0.046 to 0.237) and the improvement of anxiety (indirect effect: β = - 0.075; 95% CI - 0.165 to -0.004). CONCLUSIONS This pilot study revealed the benefits of Baduanjin exercise for subjective cognition and health-related quality of life of Chinese breast cancer patients receiving chemotherapy and outlined the underlying mediating mechanism of exercise-cognition. The findings provided insights into the development of public health initiatives to promote brain health and improve quality of life among breast cancer patients. TRIAL REGISTRATION NUMBER ChiCTR 2,000,033,152.
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Cui H, Shi X, Song X, Zhang W. Changes and Influencing Factors of Cognitive Impairment in Patients with Breast Cancer. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:7278853. [PMID: 34745299 PMCID: PMC8568554 DOI: 10.1155/2021/7278853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the changes in cognitive function and its influencing factors in patients with breast cancer after chemotherapy, to provide a scientific basis for further cognitive correction therapy. METHODS In this study, general information on age, marital status, and chemotherapy regimen was collected from 172 breast cancer chemotherapy patients. 172 patients with breast cancer undergoing chemotherapy were investigated by convenience sampling method, and the subjects were tested one-on-one using the Chinese version of the MATRICS Consensus Cognitive Battery (MCCB) computer system. RESULTS The mean value of standardized t-value of cognitive function and its abnormal dimensions in breast cancer patients undergoing chemotherapy were MCCB total cognition (66.3%, 36.99 ± 13.06, abnormal), working memory (73.3%, 36.84 ± 10.25), attention and alertness (70.3%, 37.20 ± 12.50), social cognition (65.1%, 39.54 ± 10.17), and visual memory (61.6%, 42.19 ± 9.38). A comparison of cognitive function among breast cancer chemotherapy patients with different demographic characteristics showed that differences in place of residence, educational level, monthly income, timing of chemotherapy, chemotherapy regimen, and chemotherapy times may be associated with abnormal cognitive function. Further multiple linear regression analysis was performed and the results showed that there was a linear regression between literacy, number of chemotherapy sessions, monthly personal income, and cognitive function. CONCLUSION Cognitive impairment is common in patients with breast cancer after chemotherapy. Nurses should pay attention to the cognitive function changes and intervention of patients with breast cancer after chemotherapy, to prevent the changes of cognitive function and promote the rehabilitation of patients.
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Affiliation(s)
- Huixia Cui
- College of Nursing, Jinzhou Medical University, Jinzhou, Liaoning 121001, China
| | - Xusheng Shi
- Department of Intensive Care Medicine, Liaocheng People's Hospital, Liaocheng, Shandong 252000, China
| | - Xiaoxiu Song
- College of Nursing, Jinzhou Medical University, Jinzhou, Liaoning 121001, China
| | - Wenlu Zhang
- Department of Radiation Oncology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning 121001, China
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