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Systematic review of self-reported cognitive function in cancer patients following chemotherapy treatment

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Abstract

Purpose

Cognitive symptoms are common in cancer patients, with up to 70% reporting cognitive symptoms following chemotherapy. These symptoms can have a major impact on how an individual functions in all aspects of their lives. This review evaluates self-reported cognitive function and its associations with neuropsychological tests and patient-reported outcomes in adult cancer patients who received chemotherapy treatment for a solid cancer.

Methods

A search of multiple databases (Medline, Ovid at Nursing, PsycINFO, Allied and Complementary Medicine) from 1936 to 2017 was conducted, identifying 1563 unique articles, of which 101 met inclusion criteria.

Results

Of the 101 included studies, 48 (47%) were cross-sectional and 38 (38%) longitudinal in design, with 12 (12%) randomised controlled trials. A minority (26%) incorporated a healthy control arm in the study design, whilst the majority (79%) were in women with breast cancer. There was diversity in the assessment of self-reported cognitive symptoms. A total of 43 of 44 studies that sought an association between self-reported cognitive function and patient-reported outcomes found a moderate to strong association. Overall, 31 studies showed a lack of association between self-reported cognitive symptoms and neuropsychological results, whilst 14 studies reported a significant association between the two, but the association was often restricted to limited cognitive domains.

Conclusion

The review found widespread heterogeneity in the assessment of self-reported cognitive symptoms and consistently absent or weak association with neuropsychological test scores.

Implications for Cancer Survivors

This research highlights the need for a standardised approach to measurement of self-reported cognitive symptoms in cancer patients.

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Acknowledgements

We acknowledge the following members of the research team for their contribution in data abstraction: Corrinne Renton (research officer); Doug Williams (research assistant); and undergraduate psychology students, Liam Darby, Charlotte Emily Davies, Christopher Mo, Pranathi Suryaprakash, Emily Jane Coombs Tidball and Maria Truasheim. We acknowledge Erika Jungfer (volunteer) for her contribution to obtaining articles and compilation of the endnote library.

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Authors and Affiliations

  1. Department of Medical Oncology, Liverpool Hospital, Liverpool, NSW, 2170, Australia

    Victoria J. Bray

  2. Centre for Medical Psychology & Evidence-based Decision-making, University of Sydney, Level 6, The Chris O’Brien Lifehouse, Sydney, NSW, 2006, Australia

    Haryana M. Dhillon

  3. Department of Medical Oncology, Concord Cancer Centre, Concord Repatriation General Hospital, Concord, NSW, 2139, Australia

    Janette L. Vardy

  4. Sydney Medical School, University of Sydney, Sydney, NSW, 2006, Australia

    Janette L. Vardy

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  1. Victoria J. Bray
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  2. Haryana M. Dhillon
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  3. Janette L. Vardy
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Correspondence to Janette L. Vardy.

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This review does not contain any studies with human participants performed by any of the authors.

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Quality assessment

Table 2 Checklist for assessing the quality of quantitative studies
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Bray, V.J., Dhillon, H.M. & Vardy, J.L. Systematic review of self-reported cognitive function in cancer patients following chemotherapy treatment. J Cancer Surviv 12, 537–559 (2018). https://doi.org/10.1007/s11764-018-0692-x

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