Journal of Neuro-Oncology

, Volume 51, Issue 2, pp 159–165 | Cite as

Neurophysiological Evaluation of Late Effects of Adjuvant High-dose Chemotherapy on Cognitive Function

  • Sanne B. Schagen
  • Hans L. Hamburger
  • Martin J. Muller
  • Willem Boogerd
  • Frits S.A.M. van Dam
Article

Abstract

Objectives: To evaluate late neurotoxicity of adjuvant high-dose (HD) chemotherapy versus standard-dose (SD) chemotherapy by event-related potentials (ERP) and quantitative electroencephalography (qEEG).

Patients and methods: From a randomized study in high-risk breast cancer patients on the efficacy of high-dose versus standard-dose adjuvant chemotherapy, late effects on cognitive functioning were analyzed by neuropsychological tests. Cognitive impairment was found in 32% of the HD group, 17% of the SD group and in 9% of a control group of stage I breast cancer patients not treated with chemotherapy. In 17 consecutive patients in the HD group and 16 consecutive patients in the SD group neurophysiological tests were performed, consisting of P300 and qEEG. Results of patients treated with chemotherapy were compared with results of 14 control patients not treated with chemotherapy. All patients were tested two years after treatment.

Results: Asymmetry of the alpha rhythm of ≥0.5 Hz was found in 7 HD patients, 2 SD patients and in none of the control patients (p = 0.01). No differences were found between the groups with regard to frequency of alpha rhythm, alpha blocking and latency of P300. No correlation was found between neurophysiological parameters and neuropsychological performance, except for an overall relation between the P300 latencies and the total number of deviant test scores.

Conclusion: Although the neurophysiological differences are subtle and the relation with the cognitive functioning in individual patients as measured by the neuropsychological examination is equivocal, the results suggest that there is neurophysiological support for cognitive dysfunction as a late complication of high-dose systemic chemotherapy in breast cancer.

breast cancer chemotherapy cognitive impairment ERP late effects qEEG 

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References

  1. 1.
    Rodenhuis S, Huitema AD, van Dam FS, de Vries EG, Beijnen JH: High-dose chemotherapy with peripheral blood progenitor cell transplantation in the adjuvant treatment of breast cancer. Cancer J Sci Am 6: 125–130, 2000Google Scholar
  2. 2.
    van Dam FS, Schagen SB, Muller MJ, Boogerd W, v d Wall E, Droogleever Fortuyn ME, Rodenhuis S: Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy. J Natl Cancer Inst 4: 210–218, 1998Google Scholar
  3. 3.
    Dropcho EJ: Central nervous system injury by therapeutic irradiation. Ed. Neurologic Complications of Systemic Cancer. Neurol Clin 9: 969–988, 1991Google Scholar
  4. 4.
    Roman DD, Sperduto PW: Neuropsychological effects of cranial radiation: current knowledge and future directions. Int J Radiat Oncol Biol Phys 31: 983–998, 1995PubMedGoogle Scholar
  5. 5.
    Boogerd W. Neurological complications of chemotherapy. In: Vinken, Bruyn (eds) Handbook of Clinical Neurology: Intoxications of the Nervous System. Part II. Elsevier Science, Amsterdam, 1995, pp 527–546Google Scholar
  6. 6.
    De Angelis LM, Shapiro WR: Drug/radiation interactions and central nervous system injury. In: Gutin PH, Leibel SA, Sheline GE (eds) Radiation Injury of the Nervous System. Raven Press, New York, 1991, pp 361–382Google Scholar
  7. 7.
    Meyers CA: Neurocognitive dysfunction in cancer patients. Oncology 14(1): 75–79, 2000Google Scholar
  8. 8.
    Bio-logic System Corp. Brain Atlas III, Mundelein, IlliniosGoogle Scholar
  9. 9.
    Hamburger HL, Brugt v d MAG: Global field power measurement versus classical method in the determination of the latency of evoked potential components. Brain Topography 3: 391–396, 1991PubMedGoogle Scholar
  10. 10.
    de Jonghe F, Huyser J, Swinkels J, Sno H, Schalken H: Depressie en Angstlijst, 1990Google Scholar
  11. 11.
    Aaronson NK, Ahmedzi S, Bergman B, Bullinger M, Cull A: The EORTC QLQ-C30: a quality of life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85: 365–376, 1993PubMedGoogle Scholar
  12. 12.
    Ibbotson T, Maguire P, Selby P, Priestman T, Wallace L: Screening for anxiety and depression in cancer patients: the effects of disease and treatment. Eur J Cancer 30a: 37–40, 1994PubMedGoogle Scholar
  13. 13.
    SPSS Benelux B.V. Gorichem, The Netherlands.Google Scholar
  14. 14.
    Schmand B, Lindeboom J, van Harskamp F: De Nederlandse Leestest voor Volwassenen. Swets & Zeitlinger, Lisse, 1992Google Scholar
  15. 15.
    Meyers CA, Abbruzzese JL: Cognitive functioning in cancer patients: effect of previous treatment. Neurology 42(2): 434–436, 1992PubMedGoogle Scholar
  16. 16.
    Van Oosterhout AG, Ganzevles PG, Wilmink JT, De Geus BW, Van Vonderen RG, Twijnstra A: Sequelae in long-term survivors of small cell lung cancer. Int J Radiat Oncol Biol Phys 34(5): 1037–1044, 1996PubMedGoogle Scholar
  17. 17.
    Stemmer SM, Stears JC, Burton BS, Jones RB, Simon JH: White matter changes in patients with breast cancer treated with high-dose chemotherapy and autologous bone marrow support. Am J Neuroradiol 15(7): 1267–1273, 1994PubMedGoogle Scholar
  18. 18.
    Brown MS, Stemmer SM, Simon JH, Stears JC, Jones RB, Cagnoni PJ, Sheeder JL: White matter disease induced by high-dose chemotherapy: longitudinal study with MR imaging and proton spectroscopy. Am J Neuroradiol 19(2): 217–221, 1998PubMedGoogle Scholar
  19. 19.
    Jonkman EJ, van Huffelen AC, Pfurtscheller G: Quantitative EEG and cerebral ischemia. In: Lopes da Silva FH, Storm van Leeuwen W, Remond A (eds) Handbook of Electroencephalography and Clinical Neurophysiology. Elsevier, Amsterdam, 1986, pp 205–237Google Scholar
  20. 20.
    Viggiano MP: Event-related potentials in brain-injured patients with neuropsychological disorders: a review. J Clin Exp Neuropsychol 18(5): 631–647, 1996PubMedGoogle Scholar
  21. 21.
    Cohen RA, O'Donnell BF, Meadows ME, Moonis M, Stone WF, Drachman DA: ERP indices and neuropsychological performance as predictors of functional outcome in dementia. J Geriatr Psychiatry Neurol 8(4): 217–225, 1995PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 2001

Authors and Affiliations

  • Sanne B. Schagen
    • 1
  • Hans L. Hamburger
    • 2
  • Martin J. Muller
    • 1
  • Willem Boogerd
    • 2
    • 3
  • Frits S.A.M. van Dam
    • 4
    • 5
  1. 1.Department of Psychosocial research and EpidemiologyThe Netherlands Cancer Institute/Antoni van Leeuwenhoek HospitalNetherlands
  2. 2.Department of Neurology and Clinical NeurophysiologyMunicipal Hospital SlotervaartThe Netherlands
  3. 3.Department of Neuro-OncologyThe Netherlands Cancer Institute/Antoni van Leeuwenhoek HospitalThe Netherlands
  4. 4.Department of Psychosocial research and EpidemiologyThe Netherlands Cancer Institute/Antoni van Leeuwenhoek HospitalThe Netherlands
  5. 5.Department of Clinical PsychologyUniversity of AmsterdamAmsterdamThe Netherlands

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