Systematic review of pharmacologic and non-pharmacologic interventions to manage cognitive alterations after chemotherapy for breast cancer

Chan, Raymond J., McCarthy, Alexandra L., Devenish, Jackie, Sullivan, Karen A. and Chan, Alexandre (2015) Systematic review of pharmacologic and non-pharmacologic interventions to manage cognitive alterations after chemotherapy for breast cancer. European Journal of Cancer, 51 4: 437-450. doi:10.1016/j.ejca.2014.12.017


Author Chan, Raymond J.
McCarthy, Alexandra L.
Devenish, Jackie
Sullivan, Karen A.
Chan, Alexandre
Title Systematic review of pharmacologic and non-pharmacologic interventions to manage cognitive alterations after chemotherapy for breast cancer
Journal name European Journal of Cancer   Check publisher's open access policy
ISSN 0959-8049
1879-0852
Publication date 2015-03
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.ejca.2014.12.017
Open Access Status DOI
Volume 51
Issue 4
Start page 437
End page 450
Total pages 14
Place of publication Kidlington, Oxford, United Kingdom
Publisher Pergamon Press [Elsevier]
Collection year 2015
Language eng
Formatted abstract
Purpose
Cognitive alterations are reported in breast cancer patients receiving chemotherapy. This has adverse effects on patients’ quality of life and function. This systematic review investigates the effectiveness of pharmacologic and non-pharmacologic interventions to manage cognitive alterations associated with breast cancer treatment.

Methods
Medline via EBSCO host, CINAHL and Cochrane CENTRAL were searched for the period January 1999–May 2014 for prospective randomised controlled trials related to the management of chemotherapy-associated cognitive alterations. Included studies investigated the management of chemotherapy-associated cognitive alterations and used subjective or objective measures in patients with breast cancer during or after chemotherapy. Two authors independently extracted data and assessed the risk of bias.

Results
Thirteen studies involving 1138 participants were included. Overall, the risk of bias for the 13 studies was either high (n = 11) or unclear (n = 2). Pharmacologic interventions included psychostimulants (n = 4), epoetin alfa (n = 1) and Ginkgo biloba (n = 1). Non-pharmacologic interventions were cognitive training (n = 5) and physical activity (n = 2). Pharmacologic agents were ineffective except for self-reported cognitive function in an epoetin alfa study. Cognitive training interventions demonstrated benefits in self-reported cognitive function, memory, verbal function and language and orientation/attention. Physical activity interventions were effective in improving executive function and self-reported concentration.

Conclusion
Current evidence does not favour the pharmacologic management of cognitive alterations associated with breast cancer treatment. Cognitive training and physical activity interventions appear promising, but additional studies are required to establish their efficacy. Further research is needed to overcome methodological shortfalls such as heterogeneity in participant characteristics and non-standardised neuropsychological outcome measures.
Keyword Breast cancer
Chemotherapy
Cognitive function
Cognitive training
Physical activity
Psychostimulants
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

 
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Created: Tue, 03 Feb 2015, 10:24:50 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work