title: A prospective study of cognitive function in men with non-seminomatous germ cell tumors.
abstract: OBJECTIVE
  Longitudinal neuropsychological assessments were performed to determine if adjuvant chemotherapy was associated with cognitive dysfunction in men with non-seminomatous germ cell tumors (NSGCT).
  
  
  METHODS
  Patients with NSGCT status post-orchiectomy that either received adjuvant chemotherapy (n = 55) or did not (n = 14) were recruited. Patients were tested before chemotherapy, 1 week post-chemotherapy (or 3 months later in the surveillance group) and 12 months after the baseline evaluation.
  
  
  RESULTS
  Compared with the surveillance group, patients treated with chemotherapy had higher rates of cognitive decline at 12 months (overall cognitive decline: 0%, 52%, and 67% in the surveillance, low exposure (LE), and high exposure (HE) group, respectively), greater number of tests that declined (mean of 0.1, 1.4, and 2.0 in the surveillance, LE, and HE group, respectively), and more frequent worsening in motor dexterity (0%, 48%, and 46% in the surveillance, LE, and HE group, respectively). Compared with the surveillance group, patients receiving more cycles of chemotherapy demonstrated worse psychomotor speed and learning and memory. Younger age was associated with greater incidence of overall cognitive decline at 12-month follow-up.
  
  
  CONCLUSIONS
  Men with NSGCT that received chemotherapy demonstrated greater rates of cognitive decline in a dose-response manner. Reductions in motor dexterity were most common. Decline in learning and memory also was evident particularly at later follow-up time points and in men receiving more chemotherapy. Men that receive chemotherapy for NSGCT are at risk for cognitive decline and may benefit from monitoring and referral for psychosocial care.
authors: Department of Neuro-Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors: Jeffrey S
authors: JS
authors: Wefel
authors: Damon J
authors: DJ
authors: Vidrine
authors: Salma K
authors: SK
authors: Marani
authors: Richard J
authors: RJ
authors: Swartz
authors: Tracy L
authors: TL
authors: Veramonti
authors: Christina A
authors: CA
authors: Meyers
authors: Harald J
authors: HJ
authors: Hoekstra
authors: Josette E H M
authors: JE
authors: Hoekstra-Weebers
authors: Ellen R
authors: ER
authors: Gritz
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D003072:Cognition Disorders / Q000523:psychology*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000523:psychology / Q000628:therapy*; D009483:Neuropsychological Tests; D009919:Orchiectomy; D011446:Prospective Studies; D013736:Testicular Neoplasms / Q000523:psychology / Q000628:therapy*; D055815:Young Adult
keywords: chemotherapy; cognitive function; neurotoxicity; oncology; quality of life; testicular cancer