title: Lack of a chemobrain effect for adjuvant FOLFOX chemotherapy in colon cancer patients. A pilot study.
abstract: OBJECTIVE
  Chemotherapy improves the survival rate of stage III colon cancer patients. The combination of oxaliplatin, 5-fluorouracil, and leucovorin (the FOLFOX4 regimen) has emerged as the standard of care. This prospective study evaluates potential alterations in cognitive function in FOLFOX4-treated patients.
  
  
  METHODS
  We evaluated 57 consecutive colorectal cancer patients who received adjuvant chemotherapy with FOLFOX4. Patients underwent a complete battery of neuropsychological tests at three different times: before (T0), at the end (T1), and 6 months after treatment (T2).
  
  
  RESULTS
  We have analyzed cognitive impairment (Mini Mental State Examination, MMSE), visuo-spatial memory (Clock Drawing Test, CDT, Rey Complex Figure, copy and recall), information processing speed (Trial Making Test-A, TMT-A, and Trial Making Test-B, TMT-B), verbal memory (Rey Auditory Verbal Learning Test, call and recall), emotional distress (Psychological Distress Inventory, PDI), anxiety (State and Trait Anxiety Inventory, STAI-Y1 and Y2), and depression (Beck Depression Inventory, BDI). Then we have calculated, for each test and for each interval of time, mean ± standard deviation for the mean. In a subsequent phase, we tested the significance of different results through the ANOVA analysis for repeated measures. In this case, we could not find any statistically significant modification in cognitive function, but we could notice an improvement in emotional performance, anxiety and depression a short time after chemotherapy administration.
  
  
  CONCLUSIONS
  We found no effect on cognitive function related to chemotherapy, the only little modification is about some emotional performance during chemotherapy. These findings may be explained by the central role of the psychological adaptation process, which occurs during the period from diagnosis to completion of treatment and is characterized by anxiety and adjustment depression. Our results seem to rule out any significant cognitive impairment due to adjuvant FOLFOX4 chemotherapy in colon cancer patients.
authors.affiliation: Department of Medical Oncology, Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Andreis
authors.forename: Marco
authors.initials: M
authors.lastname: Ferri
authors.forename: Maria
authors.initials: M
authors.lastname: Mazzocchi
authors.forename: Fausto
authors.initials: F
authors.lastname: Meriggi
authors.forename: Anna
authors.initials: A
authors.lastname: Rizzi
authors.forename: Luigina
authors.initials: L
authors.lastname: Rota
authors.forename: Brunella
authors.initials: B
authors.lastname: Di Biasi
authors.forename: Chiara
authors.initials: C
authors.lastname: Abeni
authors.forename: Claudio
authors.initials: C
authors.lastname: Codignola
authors.forename: Renzo
authors.initials: R
authors.lastname: Rozzini
authors.forename: Alberto
authors.initials: A
authors.lastname: Zaniboni
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000139:chemically induced / Q000175:diagnosis; D003110:Colonic Neoplasms / Q000188:drug therapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D010865:Pilot Projects; D011446:Prospective Studies
chemical_list: D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil