Persistent neurocognitive problems after adjuvant chemotherapy for breast cancer.
BACKGROUND
Neurocognitive problems have been observed in a number of women previously treated with adjuvant chemotherapy for breast cancer. The present study aims to combine the results of neuropsychological and electrophysiological techniques collected in patients with breast cancer treated with cyclophosphamide/methotrexate/5-fluorouracil (CMF) at different time points.


METHODS
Patients with breast cancer treated with adjuvant CMF chemotherapy (n = 63) were examined with neuropsychological tests 1 year after treatment and compared with healthy women (n = 60; T1 portion of the study). Based on neuropsychological test performance, patients were classified as cognitively impaired or unimpaired. Four years later, behavioral and neurophysiological measures (T2 portion of the study) were collected during an information-processing task in a subgroup of patients (n = 26). At T2, we compared the results of cognitively impaired patients (n = 8) with those of patients classified as cognitively unimpaired at T1 (n = 18).


RESULTS
In the initial neuropsychological assessment, 33.3% of the patients were classified as cognitively impaired, compared with 10% of healthy women. At T2, impaired patients who received CMF showed longer P3 latencies, lower P3 amplitudes, longer reaction times, and made more errors in an information processing task compared with unimpaired patients who received CMF.


CONCLUSIONS
The results indicate the persistence of neurocognitive problems < or = 5 years after completion of chemotherapy and consistency across different assessment techniques.
Kreukels
Baudewijntje P C
BP
Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
van Dam
Frits Sam
FS
Ridderinkhof
K Richard
KR
Boogerd
Willem
W
Schagen
Sanne B
SB
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects*; D003071:Cognition / Q000187:drug effects; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009483:Neuropsychological Tests; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate