title: Neuropsychological function in high-risk breast cancer survivors after stem-cell supported high-dose therapy versus standard-dose chemotherapy: evaluation of long-term treatment effects.
abstract: BACKGROUND
  Studies on cognitive functioning in breast cancer patients point out that a subset of women exhibit chemotherapy-related neuropsychological impairment. Thereby, high-dose therapy may elevate the risk of cognitive dysfunctions. The primary purpose of the study was to evaluate the impact of high-dose versus standard-dose chemotherapy on the late neuropsychological outcome in randomized assigned high-risk breast cancer survivors. Next to focusing prevalence, function specificity and extent of cognitive impairment, the question as to whether doses-dependent group differences occur was investigated.
  
  
  METHODS
  Twenty-four high-dose and 23 standard-dose patients 5 years, on average, after treatment underwent a comprehensive neuropsychological assessment. In addition, 29 early-stage breast cancer patients matched for age, education and time since treatment were recruited as a comparison group.
  
  
  RESULTS
  Global cognitive impairment was observed in 8% of high-dose versus 13% of standard-dose compared with 3% of early-stage breast cancer patients. Compared with normative data, all patient groups performed worse on one attention subtest measuring the simple reaction time (P < 0.001 in each case). By contrast, no significant between-group differences on the late neuropsychological outcome were found.
  
  
  CONCLUSIONS
  Five years after treatment, standard-dose patients were slightly, but not significantly, more impaired in cognitive performance than high-dose patients.
authors.affiliation: Institute of Medical Psychology, Hamburg-Eppendorf University Medical Center, Hamburg, Germany. a.scherwath@uke.uni-hamburg.de
authors.forename: A
authors.initials: A
authors.lastname: Scherwath
authors.forename: A
authors.initials: A
authors.lastname: Mehnert
authors.forename: B
authors.initials: B
authors.lastname: Schleimer
authors.forename: L
authors.initials: L
authors.lastname: Schirmer
authors.forename: F
authors.initials: F
authors.lastname: Fehlauer
authors.forename: R
authors.initials: R
authors.lastname: Kreienberg
authors.forename: B
authors.initials: B
authors.lastname: Metzner
authors.forename: E
authors.initials: E
authors.lastname: Thiel
authors.forename: A R
authors.initials: AR
authors.lastname: Zander
authors.forename: F
authors.initials: F
authors.lastname: Schulz-Kindermann
authors.forename: U
authors.initials: U
authors.lastname: Koch
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000523:psychology* / Q000628:therapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D009483:Neuropsychological Tests; D033581:Stem Cell Transplantation
chemical_list: D000970:Antineoplastic Agents