title: Is there a relationship between objectively measured cognitive changes in patients with solid tumours undergoing chemotherapy treatment and their health-related quality of life outcomes? A systematic review.
abstract: BACKGROUND
  This systematic review examines whether there is a relationship between objective measures of chemotherapy-related cognitive impairment in patients with solid cancer tumours and health-related quality of life (HRQoL).
  
  
  METHODS
  Multiple online databases were searched (including Ovid MEDLINE, EMBASE, PsycINFO, PsycARTICLES, CINAHL, PubMed, and Web of Science) to identify articles published between 1980 and 2016 examining the extent of chemotherapy-related cognitive deficit and its relationship with HRQoL in cancer patients. Of 2769 potentially relevant articles, 17 studies met the inclusion criteria for the current review.
  
  
  RESULTS
  Evidence for the presence of cognitive impairment in patients treated with chemotherapy was found in 15 of the 17 studies. Of the 15 studies finding some sort of cognitive impairment, 12 were in female breast cancer patients, 2 in bowel cancer, and 1 each in ovarian and lung cancer. Three of the 15 studies found a significant relationship between various objectively measured cognitively impaired domains and specific HRQoL outcomes. There was, however, only limited testing of the relationships between quantifiable cognitive dysfunction and HRQoL domains.
  
  
  CONCLUSIONS
  This review suggests that in patients with solid tumours, where there is a relationship between chemotherapy treatment and cognitive impairment, the type and level of cognitive decline does not consistently appear to affect such patients' HRQoL. This could be partly explained by variations in study design, measures used, definitions of cognitive impairment, varying measurement time frames, small sample sizes, and differences in disease severity and type of treatment regimes.
authors.affiliation: School of Health Sciences, City, University London, London, UK.
authors.forename: Marie-Rose
authors.initials: MR
authors.lastname: Dwek
authors.affiliation: School of Health Sciences, City, University London, London, UK.
authors.forename: Lorna
authors.initials: L
authors.lastname: Rixon
authors.affiliation: School of Health Sciences, City, University London, London, UK.
authors.forename: Catherine
authors.identifier: http://orcid.org/0000-0003-1571-0040
authors.initials: C
authors.lastname: Hurt
authors.affiliation: Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Alice
authors.initials: A
authors.lastname: Simon
authors.affiliation: School of Health Sciences, City, University London, London, UK.
authors.forename: Stanton
authors.initials: S
authors.lastname: Newman
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology; D060825:Cognitive Dysfunction; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy* / Q000523:psychology*; D011788:Quality of Life
chemical_list: D000970:Antineoplastic Agents
keywords: cancer; chemotherapy; cognition; cognitive impairment; health-related quality of life; oncology