Changes of Cognitive Function and Fatigue following Chemotherapy in Patients with Gastrointestinal Cancer: A Prospective Controlled Study
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Purpose: This study was to identify changes in cognitive function and fatigue following chemotherapy in patients with stomach or colorectal cancer. Methods: Of the participants, 67 underwent adjuvant chemotherapy, while 66 healthy participants made up the comparison group. Three assessment tools were used: 1) the Korean Mini-Mental State Examination; 2) Everyday Cognition; 3) Functional Assessment of Chronic Illness Therapy-Fatigue. The questionnaires were administered in three stages, before chemotherapy, towards the end of chemotherapy, and 6 months after the final chemotherapy session. Data were analyzed using descriptive statistics and repeated measures analysis of variance (RM ANOVA). Results: At the post-chemotherapy stage, 38.8% of the patients who underwent adjuvant chemotherapy complained of subjective cognitive impairment and reported greater difficulty in the cognitive domains of attention and concentration, memory, and executive function. RM ANOVA revealed a significant decline in cognitive function after chemotherapy. However, improvement was observed six months after the completion of chemotherapy (F=42.68, p< .001). Cancer-related fatigue also showed similar patterns as observed in the case of cognitive function (F=44.76, p< .001). Conclusion: Chemotherapy was associated with increased cognitive decline and fatigue in cancer patients with cancer. Nursing intervention programs need to be developed to counteract cognitive decline and fatigue in patients undergoing chemotherapy.
Abstract
Purpose: This study was to identify changes in cognitive function and fatigue following chemotherapy in patients with stomach or colorectal cancer. Methods: Of the participants, 67 underwent adjuvant chemotherapy, while 66 healthy participants made up the comparison group. Three assessment tools were used: 1) the Korean Mini-Mental State Examination; 2) Everyday Cognition; 3) Functional Assessment of Chronic Illness Therapy-Fatigue. The questionnaires were administered in three stages, before chemotherapy, towards the end of chemotherapy, and 6 months after the final chemotherapy session. Data were analyzed using descriptive statistics and repeated measures analysis of variance (RM ANOVA). Results: At the post-chemotherapy stage, 38.8% of the patients who underwent adjuvant chemotherapy complained of subjective cognitive impairment and reported greater difficulty in the cognitive domains of attention and concentration, memory, and executive function. RM ANOVA revealed a significant decline in cognitive function after chemotherapy. However, improvement was observed six months after the completion of chemotherapy (F=42.68, p< .001). Cancer-related fatigue also showed similar patterns as observed in the case of cognitive function (F=44.76, p< .001). Conclusion: Chemotherapy was associated with increased cognitive decline and fatigue in cancer patients with cancer. Nursing intervention programs need to be developed to counteract cognitive decline and fatigue in patients undergoing chemotherapy.
참고문헌 (29)
- Hutchinson AD, "Objective and subjective cognitive impairment following chemotherapy for cancer: a systematic review", Cancer Treat Rev, 38, pp.926~934 (2012)
- Gehring K, "Review of recent studies on interventions for cognitive deficits in patients with cancer", Expert Rev Anticancer Ther, 12, pp.255~269 (2012)
- Ahles TA, "Neuropsychologic impact of standard-dose systemic chemotherapy in long-term survivors of breast cancer and lymphoma", J Clin Oncol, 20, pp.485~493 (2002)
- Wefel JS, "Chemotherapy-related cognitive dysfunction", Curr Neurol Neurosci Rep, 12, pp.267~275 (2012)
- de Ruiter MB, "Late effects of high-dose adjuvant chemotherapy on white and gray matter in breast cancer survivors: converging results from multimodal magnetic resonance imaging", Hum Brain Mapp, 33, pp.2971~2983 (2012)
- Lange M, "Cognitive dysfunctions in elderly cancer patients: a new challenge for oncologists", Cancer Treat Rev, 40, pp.810~817 (2014)
- Kwon JS, "Cognitive rehabilitation", pp.282~ (2008), Pacific Books
- Hyrien O, "Mathematical and experimental approaches to identify and predict the effects of chemotherapy on neuroglial precursors", Cancer Res, 70, pp.10051~10059 (2010)
- Verstappen CC, "Neurotoxic complications of chemotherapy in patients with cancer: clinical signs and optimal management", Drugs, 63, pp.1549~1563 (2003)
- Nelson CJ, "Chemotherapy and cognitive deficits:mechanisms, findings, and potential interventions", Palliat Support Care, 5, pp.273~280 (2007)
- 정복례, "화학요법을 받는 유방암 환자의 인지기능장애 관련 요인", Asian Oncology Nursing, 12(3), pp.221~229 (2012), 대한종양간호학회
- 박진희, "유방암 환자에서 화학요법관련 인지기능저하의 발생률과 발생양상", Journal of Korean Academy of Nursing, 45(1), pp.118~128 (2015), 한국간호과학회
- Krynetskiy E, "Establishing a model for assessing DNA damage in murine brain cells as a molecular marker of chemotherapy-associated cognitive impairment", Life Sci, 93, pp.605~610 (2013)
- Kaiser J, "Neural correlates of chemotherapy-related cognitive impairment", Cortex, 54, pp.33~50 (2014)
- Vardy J, "Cognitive function after chemotherapy in adults with solid tumours", Crit Rev Oncol Hematol, 63, pp.183~202 (2007)
- 오복자, "대장암 ․ 위암 환자의 항암화학요법 시기에 따른 암 증상, 우울 및 삶의 질의 변화: 전향적 종단 연구", 성인간호학회지, 29(3), pp.313~322 (2017), 한국성인간호학회[DOI]
- Faul F, "G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences", Behav Res Methods, 39, pp.175~191 (2007)
- 박진희, "유방암 환자에서 화학요법이 인지기능에 미치는 영향에 대한 메타분석", Journal of Korean Academy of Nursing, 42(5), pp.644~658 (2012), 한국간호과학회
- Tomaszewski Farias S, "The measurement of everyday cognition: development and validation of a short form of the Everyday Cognition scales", Alzheimers Dement, 7, pp.593~601 (2011)
- 강연욱, "K-MMSE(Korean-Mini Mental State Examination)의 노인 규준 연구", 한국심리학회지:일반, 25(2), pp.1~12 (2006), 한국심리학회
- Folstein MF, "“Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician", J Psychiatr Res, 12, pp.189~198 (1975)
- Prabhu RS, "Effect of the addition of chemotherapy to radiotherapy on cognitive function in patients with low-grade glioma: secondary analysis of RTOG 98-02", J Clin Oncol, 32, pp.535~541 (2014)
- Yellen SB, "Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system", J Pain Symptom Manage, 13, pp.63~74 (1997)
- Chaiy SI, "Social science research methodology", pp.82~ (2000), Hakhyunsa
- Jansen CE, "A prospective longitudinal study of chemotherapy-induced cognitive changes in breast cancer patients", Support Care Cancer, 19, pp.1647~1656 (2011)
- Tager FA, "The cognitive effects of chemotherapy in post-menopausal breast cancer patients: a controlled longitudinal study", Breast Cancer Res Treat, 123, pp.25~34 (2010)
- Lindner OC, "A meta-analysis of cognitive impairment following adult cancer chemotherapy", Neuropsychology, 28, pp.726~740 (2014)
- Myers JS, "Chemotherapy-related cognitive impairment: the breast cancer experience", Oncol Nurs Forum, 39, pp.E31~E40 (2012)
- 강미애, "주관적 기억 장애와 경도 인지 장애의 신경인지기능 특성 비교", Annals of geriatric medicine and research, 18(1), pp.7~15 (2014), 대한노인병학회[DOI]