Cognitive impairment after cytotoxic chemotherapy.

Area of Science:

• Oncology
• Neuroscience
• Pharmacology

Background:

• Cytotoxic chemotherapy frequently causes neurotoxicity, impacting many patients.
• Postchemotherapy cognitive impairment (PCCI) remains under-researched, with limited understanding of differential drug effects.
• This review focuses on PCCI from cytotoxic agents, excluding neurotoxicity from targeted therapies or immunotherapies.

Purpose of the Study:

• To systematically review the existing literature on postchemotherapy cognitive impairment (PCCI).
• To investigate whether individual cytotoxic chemotherapy drugs or regimens have differential effects on cognitive function.
• To identify potential risk factors associated with PCCI.

Main Methods:

• A comprehensive literature search was performed in the PubMed database.
• 1215 articles were initially screened based on predefined inclusion and exclusion criteria.
• 30 studies were ultimately included in this systematic review.

Main Results:

• 25 out of 30 studies reported significant cognitive impairment in patients undergoing chemotherapy.
• Breast cancer patients receiving FEC-T regimens showed a higher incidence of PCCI.
• Colon cancer patients on FOLFOX regimens demonstrated less significant cognitive impairment.
• Independent risk factors identified include patient age, mood alterations, cognitive reserve, and APOE e4 allele presence.

Conclusions:

• Evidence suggests that specific chemotherapy regimens, particularly FEC-T, are more frequently associated with PCCI than others, such as FOLFOX.
• Further research is required to precisely define patient cohorts by treatment protocol and cancer type to elucidate individual cytotoxic drug effects on cognition.