“化疗脑”对乳腺癌存活者认知能力的影响 [美国媒体]

‘Chemobrain’ Study Examines Effects of Chemotherapies on Cognition in Breast Cancer Survivors

“化疗脑”对乳腺癌存活者认知能力的影响

Cancer-related cognitive impairment is often referred to as ‘chemobrain’ and anthracycline-based chemotherapy may have greater negative effects on particular cognitive domains and brain network connections than nonanthracycline-based regimens, according to an article published online by JAMA Oncology.

与癌症相关的认知能力损伤一般被称为“化疗脑”，而蒽环类化疗药与非蒽环类化疗药相比，会对某些认知领域以及脑部网络连接产生更为严重的负面影响，据《JAMA肿瘤学》杂志在线发表的一篇文章称。

Chemotherapy for breast cancer is often associated with cognitive problems in patients. However, it is unclear whether certain regimens are associated with greater cognitive difficulties than others.

对乳腺癌的化疗经常会导致患者的认知障碍。但是却不清楚到底哪种化疗药造成的负面影响更大。

Shelli R. Kesler, Ph.D., of the University of Texas MD Anderson Cancer Center, Houston, and Douglas W. Blayney, M.D., of the Stanford University School of Medicine, California, compared the effects of anthracycline and nonanthracycline chemotherapy regimens on cognitive status and functional brain connectivity in a small study.

休斯顿德州大学MD Anderson癌症中心的Shelli R. Kesler博士以及加州斯坦福大学医学院的Douglas W. Blayney医学博士，在一个小型研究中比较了蒽环类和非蒽环类化疗药对认知功能和功能性脑连通性的影响。



Patient-reported outcomes of cognitive dysfunction and psychological distress were elevated in both groups of women treated with chemotherapy compared with patients treated without chemotherapy, the results indicate. Credit: PRONicki Dugan Pogue.

结果指示，在接受化疗和接受非化疗治疗的两组女性中，患者报告的认知失衡和心理不适都增加了。来源：PRONicki Dugan Pogue

The authors used cognitive tests and imaging data from 62 primary breast cancer survivors (average age nearly 55) who were, on average, more than two years off therapy to examine cognitive status and functional brain connectivity. Of the women, 20 received anthracycline-based chemotherapy as part of their primary treatment, 19 received nonanthracycline regimens and 23 did not receive any chemotherapy.

论文作者使用了认知测试和62位原发乳腺癌存活者（平均年龄接近55岁）的影像学数据来考察她们的认知能力以及功能性脑连接性。这62人脱离治疗的平均时间为2年，其中20人接受了蒽环类化疗药作为她们主要治疗方法的一部分，19人接受了非蒽环类化疗药，另外23人没有接受过化疗。

Women treated with anthracycline-based chemotherapy had lower verbal memory, including immediate recall and delayed recall, compared with the other two groups of women. The anthracycline regimens also were associated with lower default mode brain network connectivity, suggesting a decreased efficiency of information processing, according to the study.

与另外两组相比较，接受蒽环类化疗药的女性的语言记忆能力更弱，包括即刻回想和延迟回想能力。另外还发现蒽环类的化疗药与降低脑部默认模式网络连接性有关，意即减弱了学习过程中的信息处理效率。

Patient-reported outcomes of cognitive dysfunction and psychological distress were elevated in both groups of women treated with chemotherapy compared with patients treated without chemotherapy, the results indicate.

结果还显示出，在接受化疗和接受非化疗治疗的两组女性中，患者报告的认知失衡和心理不适都增加了。

“These results should be considered preliminary given the study limitations of small sample size and retrospective, cross-sectional design, Larger, prospective studies are needed that include pretreatment and posttreatment assessments so that patients’ individual cognitive and neurobiologic trajectories can be evaluated with respect to potential ANTHR [anthracycline]-related neurotoxic effects,” the study concludes.

“本研究得到的结果首先应考虑到受小样本、回顾性研究和跨学科实验设计的局限性的影响。我们以后必须开展更大规模的研究，包括治疗前和治疗后的评估，这样才能将患者个体的认知能力和神经生物学状况的评估与蒽环类化疗药潜在的神经毒性影响联系起来，”该研究得到如此结论。