Evidence-Based Strategies for Addressing Cancer- and Treatment-Related Cognitive Impairment: A Review

Cancer-related cognitive impairment (CRCI) has become a notable long-term consequence for cancer survivors, especially among those receiving chemotherapy, radiotherapy, or targeted treatments. Despite the advances in the treatment of cancer, CRCI still disrupts the quality of life of patients, daily activities, and work performance, as well as emotional well-being. This review provides a summary of the existing information on the neurobiological basis of CRCI, including neuroinflammation, disturbed neuroplasticity, oxidative stress, and tumour-related factors. It analyses diagnostic methods, from cognitive screening to high-level neuroimaging, and reviews evidence-based interventions that play a significant role in providing highly disciplined, personalized care. The ongoing constraints on advancing machine learning-based CRCI interventions include persistent obstacles, a lack of long-term trials, and difficulties accessing data and achieving interpretability, among others. Other important risk factors are also identified in this review, as are the performance of different predictive models with respect to accuracy, generalization ability, and clinical utility. Moreover, it addresses the challenges of validating these models and biomarkers across different populations, as well as the need for further studies to enhance their validity and enable personalized interventions.