title: Cognitive functioning after cancer treatment: a 3-year longitudinal comparison of breast cancer survivors treated with chemotherapy or radiation and noncancer controls.
abstract: BACKGROUND
  This study examined the influence of prior treatment on the course of cognitive functioning in breast cancer survivors. Changes in cognitive functioning over time were compared in breast cancer survivors treated with chemotherapy plus radiotherapy, breast cancer survivors treated with radiotherapy only, and women with no history of cancer.
  
  
  METHODS
  Stage 0-II breast cancer patients treated with chemotherapy plus radiotherapy (CT group; n = 62) or radiotherapy only (RT group; n = 67) completed neuropsychological assessments 6 months after completing treatment and again 36 months later. Women with no history of cancer (NC group; n = 184) were assessed over a similar interval.
  
  
  RESULTS
  A significant group × time effect was found for processing speed (P = .009) that reflected a tendency for the NC group but not the RT and CT groups to improve over time. There was also a significant group effect for executive functioning (P = .006) that reflected the NC group performing better than the CT and RT groups. Additional analyses found the administration of hormonal therapy was not associated with change over time in cognitive performance.
  
  
  CONCLUSIONS
  Findings provide limited support for the view that changes in cognitive functioning in cancer survivors are attributable to chemotherapy administration and illustrate the importance of including a radiotherapy comparison group. Future research should seek to examine possible mechanisms that could explain the apparent prolonged impact of both chemotherapy and radiotherapy on cognitive functioning in breast cancer survivors.
authors.affiliation: Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida 33612, USA.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Phillips
authors.forename: Heather S
authors.initials: HS
authors.lastname: Jim
authors.forename: Brent J
authors.initials: BJ
authors.lastname: Small
authors.forename: Christine
authors.initials: C
authors.lastname: Laronga
authors.forename: Michael A
authors.initials: MA
authors.lastname: Andrykowski
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D016022:Case-Control Studies; D003071:Cognition / Q000187:drug effects* / Q000528:radiation effects*; D003131:Combined Modality Therapy; D005260:Female; D006727:Hormone Antagonists / Q000627:therapeutic use; D006728:Hormones; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009483:Neuropsychological Tests; D017741:Survivors
chemical_list: D006727:Hormone Antagonists; D006728:Hormones