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A meta-analysis of cognitive impairment and decline associated with adjuvant chemotherapy in women with breast cancer
Ono, Miyuki Ogilvie, James M. Wilson, Jennifer Green, Heather Chambers, Suzanne Ownsworth, Tamara Shum, David
Ono, Miyuki
Ogilvie, James M.
Wilson, Jennifer
Green, Heather
Chambers, Suzanne
Ownsworth, Tamara
Shum, David
Abstract
A meta-analysis was performed to quantify the magnitude and nature of the association between adjuvant chemotherapy and performance on a range of cognitive domains among breast cancer patients. A total of 27 studies (14 cross-sectional, 8 both cross-sectional and prospective, and 5 prospective) were included in the analyses, involving 1562 breast cancer patients who had undergone adjuvant chemotherapy and 2799 controls that included breast cancer patients who did not receive adjuvant chemotherapy. A total of 737 effect sizes (Cohen’s d) were calculated for cross-sectional and prospective longitudinal studies separately and classified into eight cognitive domains. The mean effect sizes varied across cross-sectional and prospective longitudinal studies (ranging from −1.12 to 0.62 and −0.29 to 1.12, respectively). Each cognitive domain produced small effect sizes for cross-sectional and prospective longitudinal studies (ranging from −0.25 to 0.41). Results from cross-sectional studies indicated a significant association between adjuvant chemotherapy and cognitive impairment that held across studies with varied methodological approaches. For prospective studies, results generally indicated that cognitive functioning improved over time after receiving adjuvant chemotherapy. Greater cognitive impairment was reported in cross-sectional studies comparing chemotherapy groups with healthy control groups. Results suggested that cognitive impairment is present among breast cancer patients irrespective of a history of chemotherapy. Prospective longitudinal research is warranted to examine the degree and persisting nature of cognitive impairment present both before and after chemotherapy, with comparisons made to participants’ cognitive function prior to diagnosis. Accurate understanding of the effects of chemotherapy is essential to enable informed decisions regarding treatment and to improve quality of life among breast cancer patients.
Keywords
breast cancer, adjuvant chemotherapy, meta-analysis, cognitive functioning, moderators
Date
2015
Type
Journal article
Journal
Book
Volume
5
Issue
Page Range
1-19
Article Number
ACU Department
Faculty of Health Sciences
Collections
Relation URI
Event URL
Open Access Status
Open access
License
CC BY 4.0
File Access
Open
Notes
© 2015 Ono, Ogilvie, Wilson, Green, Chambers, Ownsworth and Shum.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).