A meta-analysis of the neuropsychological effects of adjuvant chemotherapy treatment in women treated for breast cancer.
Given the improvement in mortality rates associated with breast cancer, the importance of understanding the long-term neuropsychological consequences of chemotherapy is becoming increasingly vital. This study applies meta-analytic techniques to the scant literature on the relationship between contemporary adjuvant chemotherapy treatment for breast cancer and cognitive dysfunction as examined through neuropsychological indices. Seven studies (involving more than 300 participants) were selected from over 200 potential articles, based on three inclusion criteria: presence of breast cancer, administration of chemotherapy treatment, and use of neuropsychological tests. From these, nine treatment-control comparisons were used to generate 129 Hedge's d effect sizes across the cognitive domains of simple attention, working memory short- and long-term memory, speed of processing, language, spatial abilities, and motor function. Small to medium cumulative effect sizes, showing diminished cognitive function for chemotherapy treatment groups compared to control groups, were obtained for each of the eight cognitive domains. Overall, these results suggest that women who undergo adjuvant chemotherapy as treatment for breast cancer may experience subtle yet consequential cognitive decline.
Stewart
Angela
A
School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.
Bielajew
Catherine
C
Collins
Barbara
B
Parkinson
Matthew
M
Tomiak
Eva
E
D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D008569:Memory Disorders / Q000175:diagnosis* / Q000209:etiology*; D009483:Neuropsychological Tests; D011930:Reaction Time; D012720:Severity of Illness Index; D013997:Time Factors