Abstract
Purpose
The aim of this review is to provide an updated overview of chemotherapy-related cognitive impairment (CRCI) in patients with cancer outside central nervous system (CNS), its incidence and prevalence, the cognitive pattern in neuropsychological studies, neuroimaging findings, and the relationship between chemobrain and aging. Methodological limitations of studies are also discussed.
Methods
This review was guided by the PRISMA statement. The MEDLINE and Scopus databases were employed to search articles about CRCI in non-CNS cancer patients published from January 2004 to September 2019. Two types of research were reviewed: prospective studies addressing the effects of chemotherapy on cognition and systematic reviews about factors related with CRCI, also as neuroimaging findings and current available treatments.
Results
Fifty-nine studies meeting the criteria were analyzed: 47 were longitudinal studies on cancer and cognition and 12 were reviews on risk factors, neuroimaging, and treatment. The majority of studies find cognitive impairment in patients with cancer treated with chemotherapy. The body of the literature on breast cancer is the most abundant, but there are also studies on colorectal, testicular, and lung cancer. Neuroimaging studies show changes in structure and activation in patients undergoing chemotherapy. Non-pharmacological treatment is effective for improving cognition and quality of life.
Conclusions
The occurrence of CRCI during the course of treatment in people with different types of cancer is frequent. Some risk factors have been identified, but CRCI is a complex phenomenon, with mediating factors related to cancer and treatment and moderating factors related with lifestyle and health.
Implications for Cancer Survivors
This review highlights the importance of recognizing that this cognitive dysfunction is frequent, mild to moderate in nature but with great impact on quality of life.
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References
Harrington CB, Hansen JA, Moskowitz M, Todd BL, Feuerstein M. It’s not over when it’s over: long-term symptoms in cancer survivors—a systematic review. Int J Psychiatry Med. 2010;40:163–81.
Duijts SFA, van der Beek AJ, Boelhouwer IG, Schagen SB. Cancer-related cognitive impairment and patients’ ability to work. Curr Opin Support Palliat Care. 2016;11:1.
Bolton G, Isaacs A. Women’s experiences of cancer-related cognitive impairment, its impact on daily life and care received for it following treatment for breast cancer. Psychol Health Med. 2018;23:1261–74.
Hutchinson AD, Hosking JR, Kichenadasse G, Mattiske JK, Wilson C. Objective and subjective cognitive impairment following chemotherapy for cancer: a systematic review. Cancer Treat Rev. 2012;38:926–34.
Joly F, Giffard B, Rigal O, et al. Impact of cancer and its treatments on cognitive function: advances in research from the Paris International Cognition and Cancer Task Force symposium and update since 2012. J Pain Symptom Manag. 2015;50:830–41.
Cruzado JA, López-Santiago S, Martínez-Marín V, José-Moreno G, Custodio AB, Feliu J. Longitudinal study of cognitive dysfunctions induced by adjuvant chemotherapy in colon cancer patients. Support Care Cancer. 2014;22:1815–23.
Vardy JL, Dhillon HM, Pond GR, Rourke SB, Bekele T, Renton C, et al. Cognitive function in patients with colorectal cancer who do and do not receive chemotherapy: a prospective, longitudinal, controlled study. J Clin Oncol. 2015;33:4085–92.
Gehring K, Roukema JA, Sitskoorn MM. Review of recent studies on interventions for cognitive deficits in patients with cancer. Expert Rev Anticancer Ther. 2012;12:255–69.
Simó M, Root JC, Vaquero L, Ripollés P, Jové J, Ahles T, et al. Cognitive and brain structural changes in a lung cancer population. J Thorac Oncol. 2015;10:38–45.
Ahles TA, Root JC. Cognitive effects of cancer and cancer treatments. Annu Rev Clin Psychol. 2018;14:425–51.
Levine PM, Silberfarb PM, Lipowski ZJ. Mental disorders in cancer patients: a study of 100 psychiatric referrals. Cancer. 1978;42:1385–91.
Ahles TA, Saykin AJ, McDonald BC, et al. Cognitive function in breast cancer patients prior to adjuvant treatment. Breast Cancer Res Treat. 2008;110:143–52.
Hermelink K, Untch M, Lux MP, et al. Cognitive function during neoadjuvant chemotherapy for breast cancer. Cancer. 2007;109:1905–13.
Schilder SC, Linn SC, et al. Cognitive functioning of postmenopausal breast cancer patients before adjuvant systemic therapy, and its association with medical and psychological factors. Crit Rev Oncol Hematol. 2010;76:133–41.
Vardy JL, Dhillon HM, Pond GR, et al. Cognitive function and fatigue after diagnosis of colorectal cancer. Ann Oncol. 2014;25(12):2404–12.
Lange M, Joly F. How to identify and manage cognitive dysfunction after breast cancer treatment. J Oncol Pract. 2017;13:784–90.
Lange M, Rigal O, Clarisse B, et al. Cognitive dysfunctions in elderly cancer patients: a new challenge for oncologists. Cancer Treat Rev. 2014;40:810–7.
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6:7.
Wefel JS, Lenzi R, Theriault RL, Davis RN, Meyers CA. The cognitive sequelae of standard-dose adjuvant chemotherapy in women with breast carcinoma: results of a prospective, randomized, longitudinal trial. Cancer. 2004;100:2292–9.
Shilling V, Jenkins V, Morris R, Deutsch G, Bloomfield D. The effects of adjuvant chemotherapy on cognition in women with breast cancer-preliminary results of an observational longitudinal study. Breast. 2005;14:142–50.
Bender CM, Sereika SM, Berga SL, Vogel VG, Brufsky AM, Paraska KK, et al. Cognitive impairment associated with adjuvant therapy in breast cancer. Psychooncology. 2006;15:422–30.
Hurria A, Rosen C, Hudis C, Zuckerman E, Panageas KS, Lachs MS, et al. Cognitive function of older patients receiving adjuvant chemotherapy for breast cancer: a pilot prospective longitudinal study. J Am Geriatr Soc. 2006;54:925–31.
Jenkins V, Shilling V, Deutsch G, Bloomfield D, Morris R, Allan S, et al. A 3-year prospective study of the effects of adjuvant treatments on cognition in women with early stage breast cancer. Br J Cancer. 2006;94:828–34.
Schagen SB, Muller MJ, Boogerd W, Mellenbergh GJ, van Dam FSAM. Change in cognitive function after chemotherapy: a prospective longitudinal study in breast cancer patients. J Natl Cancer Inst. 2006;98:1742–5.
Ruzich M, Ryan B, Owen C, Delahunty A, Stuart-Harris R. Prospective evaluation of cognitive function in patients with early breast cancer receiving adjuvant chemotherapy. Asia Pac J Clin Oncol. 2007;3:125–33.
Hermelink K, Henschel V, Untch M, Bauerfeind I, Lux MP, Munzel K. Short-term effects of treatment-induced hormonal changes on cognitive function in breast cancer patients: results of a multicenter, prospective, longitudinal study. Cancer. 2008;113:2431–9.
Jansen CE, Dodd MJ, Miaskowski CA, Dowling GA, Kramer J. Preliminary results of a longitudinal study of changes in cognitive function in breast cancer patients undergoing chemotherapy with doxorubicin and cyclophosphamide. Psycho-Oncology. 2008;17(12):1189–95.
Stewart A, Collins B, Mackenzie J, Tomiak E, Verma S, Bielajew C. The cognitive effects of adjuvant chemotherapy in early stage breast cancer: a prospective study. Psycho-Oncology. 2008;17(2):122–30.
Collins B, Mackenzie J, Stewart A, Bielajew C, Verma S. Cognitive effects of chemotherapy in post-menopausal breast cancer patients 1 year after treatment. Psychooncology. 2009;18:134–43.
Mehlsen M, Pedersen AD, Jensen AB, Zachariae R. No indications of cognitive side-effects in a prospective study of breast cancer patients receiving adjuvant chemotherapy. Psychooncology. 2009;18:248–57.
Quesnel C, Savard J, Ivers H. Cognitive impairments associated with breast cancer treatments: results from a longitudinal study. Breast Cancer Res Treat. 2009;116:113–23.
Vearncombe KJ, Rolfe M, Wright M, Pachana NA, Andrew B, Beadle G. Predictors of cognitive decline after chemotherapy in breast cancer patients. Journal of the International Neuropsychological Society. 2009;15(6):951–62.
Ahles TA, Saykin AJ, McDonald BC, Li Y, Furstenberg CT, Hanscom BS, et al. Longitudinal assessment of cognitive changes associated with adjuvant treatment for breast cancer: impact of age and cognitive reserve. J Clin Oncol. 2010;28:4434–40.
Biglia N, Moggio G, Peano E, et al. Effects of surgical and adjuvant therapies for breast cancer on sexuality, cognitive functions, and body weight. J Sex Med. 2010;7:1891–900.
Debess J, Riis JØ, Engebjerg MC, Ewertz M. Cognitive function after adjuvant treatment for early breast cancer: a population-based longitudinal study. Breast Cancer Res Treat. 2010;121:91–100.
Tager FA, McKinley PS, Schnabel FR, el-Tamer M, Cheung YK, Fang Y, et al. The cognitive effects of chemotherapy in post-menopausal breast cancer patients: a controlled longitudinal study. Breast Cancer Res Treat. 2010;123:25–34.
Wefel JS, Saleeba AK, Buzdar AU, Meyers CA. Acute and late onset cognitive dysfunction associated with chemotherapy in women with breast cancer. Cancer. 2010;116:3348–56.
Jansen CE, Cooper BA, Dodd MJ, Miaskowski CA. A prospective longitudinal study of chemotherapy-induced cognitive changes in breast cancer patients. Support Care Cancer. 2011;19:1647–56.
Skaali T, Fosså SD, Andersson S, Cvancarova M, Langberg CW, Lehne G, et al. A prospective study of neuropsychological functioning in testicular cancer patients. Ann Oncol. 2011;22:1062–70.
Biglia N, Bounous VE, Malabaila A, Palmisano D, Torta DM, D’Alonzo M, et al. Objective and self-reported cognitive dysfunction in breast cancer women treated with chemotherapy: a prospective study. Eur J Cancer Care. 2012;21:485–92.
Hedayati E, Alinaghizadeh H, Schedin A, Nyman H, Albertsson M. Effects of adjuvant treatment on cognitive function in women with early breast cancer. Eur J Oncol Nurs. 2012;16:315–22.
Andreis F, Ferri M, Mazzocchi M, Meriggi F, Rizzi A, Rota L, et al. Lack of a chemobrain effect for adjuvant FOLFOX chemotherapy in colon cancer patients. A pilot study. Support Care Cancer. 2013;21:583–90.
Collins B, MacKenzie J, Tasca GA, Scherling C, Smith A. Cognitive effects of chemotherapy in breast cancer patients: a dose-response study. Psychooncology. 2013;22:1517–27.
Ando-Tanabe N, Iwamitsu Y, Kuranami M, et al. Cognitive function in women with breast cancer receiving adjuvant chemotherapy and healthy controls. Breast Cancer. 2014;21:453–62.
Collins B, Mackenzie J, Tasca GA, Scherling C, Smith A. Persistent cognitive changes in breast cancer patients 1 year following completion of chemotherapy. J Int Neuropsychol Soc. 2014:1–10.
Lepage C, Smith AM, Moreau J, et al. A prospective study of grey matter and cognitive function alterations in chemotherapy-treated breast cancer patients. Springerplus. 2014;3:444.
Wefel JS, Vidrine DJ, Marani SK, et al. A prospective study of cognitive function in men with non-seminomatous germ cell tumors. Psychooncology. 2014;23:6.
Lange M, Heutte N, Rigal O, Noal S, Kurtz JE, Lévy C, et al. Decline in cognitive function in older adults with early-stage breast cancer after adjuvant treatment. Oncologist. 2016;21:1337–48.
Lyon DE, Cohen R, Chen H, Kelly DL, Starkweather A, Ahn HC, et al. The relationship of cognitive performance to concurrent symptoms, cancer- and cancer-treatment-related variables in women with early-stage breast cancer: a 2-year longitudinal study. J Cancer Res Clin Oncol. 2016;142:1461–74.
Menning S, De Ruiter MB, Kieffer JM, et al. Cognitive impairment in a subset of breast cancer patients after systemic therapy. Results from a longitudinal study. J Pain Symptom Manag. 2016;52.
Amidi A, Hosseini SMH, Leemans A, et al. Changes in brain structural networks and cognitive functions in testicular cancer patients receiving cisplatin-based chemotherapy. J Natl Cancer Inst. 2017;109:1–7.
Andryszak P, Wiłkość M, Żurawski B, Izdebski P. Verbal fluency in breast cancer patients treated with chemotherapy. Breast Cancer. 2017;24:376–83.
Cerulla N, Arcusa À, Navarro J-B, Garolera M, Enero C, Chico G, et al. Role of taxanes in chemotherapy-related cognitive impairment: a prospective longitudinal study. Breast Cancer Res Treat. 2017;164:179–87.
Yao C, Rich JB, Tirona K, Bernstein LJ. Intraindividual variability in reaction time before and after neoadjuvant chemotherapy in women diagnosed with breast cancer. Psychooncology. 2017;26:2261–8.
Chen BT, Ghassaban K, Jin T, et al. Subcortical brain iron deposition and cognitive performance in older women with or without breast cancer receiving adjuvant chemotherapy: a pilot MRI study. Magn Reson Imaging. 2018;54:218–24.
Hermelink K, Bühner M, Sckopke P, et al. Chemotherapy and post-traumatic stress in the causation of cognitive dysfunction in breast cancer patients. J Natl Cancer Inst. 2017;109:1–2.
Janelsins MC, Heckler CE, Peppone LJ, et al. Longitudinal trajectory and characterization of cancer-related cognitive impairment in a nationwide cohort study. J Clin Oncol. 2018;36:JCO.2018.78.662.
Klemp JR, Myers JS, Fabian CJ, Kimler BF, Khan QJ, Sereika SM, et al. Cognitive functioning and quality of life following chemotherapy in pre- and peri-menopausal women with breast cancer. Support Care Cancer. 2018;26:575–83.
Lange M, Heutte N, Noal S, et al. Cognitive changes after adjuvant treatment in older adults with early-stage breast cancer. Oncologist. 2018; theoncologist.2017-0570.
Ng T, Phey XY, Yeo HL, Shwe M, Gan YX, Ng R, et al. Impact of adjuvant anthracycline-based and taxane-based chemotherapy on plasma VEGF levels and cognitive function in breast cancer patients: a longitudinal study. Clin Breast Cancer. 2018;18:e927–37.
Sales MVC, Suemoto CK, Apolinazrio D, Serrao VT, Andrade CS, Conceição DM, et al. The effects of adjuvant chemotherapy on the cognitive function of patients with early stage colorectal cancer. Clin Colorectal Cancer. 2018:1–9.
Vardy JL, Bray VJ, Dhillon HM. Cancer-induced cognitive impairment: practical solutions to reduce and manage the challenge. Future Oncol. 2017;13:767–71.
Jean-Pierre P, McDonald BC. Neuroepidemiology of cancer and treatment-related neurocognitive dysfunction in adult-onset cancer patients and survivors. In: Handb. Clin. Neurol. 1st ed. Amsterdam: Elsevier B.V.; 2016.
Bray VJ, Dhillon HM, Bell ML, et al. Evaluation of a web-based cognitive rehabilitation program in cancer survivors reporting cognitive symptoms after chemotherapy. J Clin Oncol. 2017;35:217–25.
Janelsins MC, Kesler SR, Ahles TA, Morrow GR. Prevalence, mechanisms, and management of cancer-related cognitive impairment. Int Rev Psychiatry. 2014;26:102–13.
Vannorsdall TD. Cognitive changes related to cancer therapy. Med Clin North Am. 2017;101:1115–34.
Janelsins MC, Kohli S, Mohile SG, Usuki K, Ahles T, Morrow GR. An update on cancer and chemotherapy related cognitive dysfunction: current status. Semin Oncol. 2011;38:431–8.
Kayl AE, Wefel JS, Meyers CA. Chemotherapy and cognition: effects, potential mechanisms, and management. Am J Ther. 2006;13:362–9.
Kesler SR, Blayney DW. Neurotoxic effects of anthracycline- vs nonanthracycline-based chemotherapy on cognition in breast cancer survivors. JAMA Oncol. 2016;2:185–92.
Simó M, Rifà-Ros X, Rodriguez-Fornells A, Bruna J. Chemobrain: a systematic review of structural and functional neuroimaging studies. Neurosci Biobehav Rev. 2013;37:1311–21.
Schagen SB, Wefel JS. Chemotherapy-related changes in cognitive functioning. Eur J Cancer Suppl. 2013;11:225–32.
Vega JN, Dumas J, Newhouse PA. Cognitive effects of chemotherapy and cancer-related treatments in older adults. Am J Geriatr Psychiatry. 2016:1–12.
Myers JS. Chemotherapy-related cognitive impairment: the breast cancer experience. Oncol Nurs Forum. 2012;39:E31–40.
Myers JS. Cancer- and chemotherapy-related cognitive changes: the patient experience. Semin Oncol Nurs. 2013;29:300–7.
Selamat MH, Loh SY, Mackenzie L, Vardy J. Chemobrain experienced by breast cancer survivors: a meta-ethnography study investigating research and care implications. PLoS One. 2014;9:e108002.
Van Dam FSAM, Schagen SB, Muller MJ, et al. Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy. J Natl Cancer Inst. 1998;90:210–8.
Ahles TA, Saykin AJ. Candidate mechanisms for chemotherapy-induced cognitive changes. Nat Rev Cancer. 2007;7:192–201.
Wefel JS, Vardy J, Ahles T, Schagen SB. International Cognition and Cancer Task Force recommendations to harmonise studies of cognitive function in patients with cancer. Lancet Oncol. 2011;12:703–8.
Vardy JL, Wefel JS, Ahles T, Tannock IF, Schagen SB. Cancer and cancer-therapy related cognitive dysfunction: an international perspective from the Venice cognitive workshop. Ann Oncol. 2007;19:623–9.
Schagen S, Vardy J. Cognitive dysfunction in people with cancer. Lancet Oncol. 2007;8:852–3.
The Adjutant General’s Office, Staff, Personnel Research Section C and RB. The new Army Individual Test of general mental ability. Psychol Bull. 1944;41:532–8.
Benedict RHB, Schretlen D, Groninger L, Brandt J. Hopkins Verbal Learning Test Revised: normative data and analysis of inter-form and test-retest reliability. Clin Neuropsychol (Neuropsychology, Dev Cogn Sect D). 1998;12:43–55.
Benton AL, Hamsher DS, Sivan AB. Multilingual aphasia examination. Iowa City: AJA Associates; 1994.
Folstein M, Folstein S, Mc Hugh PR. Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.
Cheung YT, Tan EHJ, Chan A. An evaluation on the neuropsychological tests used in the assessment of postchemotherapy cognitive changes in breast cancer survivors. Support Care Cancer. 2012:1361–75.
Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695–9.
Lange M, Heutte N, Noal S, et al. Cognitive changes after adjuvant treatment in oder adults with early-stage breast cancer. Oncologist. 2018; theoncologist.2017-0570.
Vardy JL, Dhillon HM. Survivors of cancer need support managing cancer-related cognitive impairment. J Oncol Pract. 2017;13:791–3.
Myers JS. Chemotherapy-related cognitive impairment: neuroimaging, neuropsychological testing, and the neuropsychologist. Clin J Oncol Nurs. 2009;13:413–21.
Bray VJ, Dhillon HM, Vardy J. Cancer-related cognitive impairment in adult cancer survivors: a review of the literature. Cancer Forum. 2017;41:46.
Collins B, Mackenzie J, Kyeremanteng C. Study of the cognitive effects of chemotherapy: considerations in selection of a control group. J Clin Exp Neuropsychol. 2013;35:435–44.
Duff K. Current topics in science and practice evidence-based indicators of neuropsychological change in the individual patient: relevant concepts and methods. Arch Clin Neuropsychol. 2012;27:248–61.
Cheung YT, Chui WK, Chan A. Neuro-cognitive impairment in breast cancer patients: pharmacological considerations. Crit Rev Oncol Hematol. 2012;83:99–111.
Schilder CM, Seynaeve C, Linn SC, et al. The impact of different definitions and reference groups on the prevalence of cognitive impairment: a study in postmenopausal breast cancer patients before the start of adjuvant systemic therapy. Psychooncology. 2010;19:415–22.
Anderson-Hanley C, Sherman ML, Riggs R. Neuropsychological effects of treatments for adults with cancer: a meta-analysis and review of the literature. J Int Neuropsychol Soc. 2003;9:967–82.
Van Dyk K, Ganz PA, Ercoli L, Petersen L, Crespi CM. Measuring cognitive complaints in breast cancer survivors: psychometric properties of the patient’s assessment of own functioning inventory. Support Care Cancer. 2016;24:4939–49.
Bartels C, Wegrzyn M, Wiedl A, Ackermann V, Ehrenreich H. Practice effects in healthy adults: a longitudinal study on frequent repetitive cognitive testing. BMC Neurosci. 2010;11:118.
Heilbronner RL, Sweet JJ, Attix DK, Krull KR, Henry GK, Hart RP. Official position of the American Academy of Clinical Neuropsychology on serial neuropsychological assessments: the utility and challenges of repeat test administrations in clinical and forensic contexts. Clin Neuropsychol. 2010;24:1267–78.
Chelune GJ, Naugle RI, Lüders H, Jeffery S, Awad IA. Individual change after epilepsy surgery: practice effects and base-rate information. Neuropsychology. 1993;7:41–52.
McSweeny AJ, Naugle RI, Chelune GJ, Lüders H. “T Scores for Change”: an illustration of a regression approach to depicting change in clinical neuropsychology. Clin Neuropsychol. 1993;7:300–12.
Cerulla N, Arcusa À, Navarro J-B, et al. Cognitive impairment following chemotherapy for breast cancer: the impact of practice effect on results. J Clin Exp Neuropsychol. 2007;41:290–9.
Lindner OC, Phillips B, McCabe MG, et al. A meta-analysis of cognitive impairment following adult cancer chemotherapy. Neuropsychology. 2014;28:726–40.
Ono M, Ogilvie JM, Wilson JS, et al. A meta-analysis of cognitive impairment and decline associated with adjuvant chemotherapy in women with breast cancer. Front Oncol. 2015;5:59.
Morse R, Rodgers J, Verrill M, Kendell K. Neuropsychological functioning following systemic treatment in women treated for breast cancer: a review. Eur J Cancer. 2003;39:2288–97.
Amidi A, Wu LM. Structural brain alterations following adult non-CNS cancers: a systematic review of the neuroimaging literature. Acta Oncol. 2019:1–15.
Koppelmans V, de Groot M, de Ruiter MB, et al. Global and focal white matter integrity in breast cancer survivors 20 years after adjuvant chemotherapy. Hum Brain Mapp. 2014;35:889–99.
Kaiser J, Bledowski C, Dietrich J. Neural correlates of chemotherapy-related cognitive impairment. Cortex. 2014;54:33–50.
Deprez S, Kesler SR, Saykin AJ, Silverman DHS, de Ruiter MB, McDonald BC. International Cognition and Cancer Task Force recommendations for neuroimaging methods in the study of cognitive impairment in non-CNS cancer patients. JNCI J Natl Cancer Inst. 2018;110:1–9.
Karschnia P, Parsons MW, Dietrich J. Pharmacologic management of cognitive impairment induced by cancer therapy. Lancet Oncol. 2019;20:e92–e102.
Morean DF, O’Dwyer L, Cherney LR. Therapies for cognitive deficits associated with chemotherapy for breast cancer: a systematic review of objective outcomes. Arch Phys Med Rehabil. 2015;96:1880–97.
Allen DH, Myers JS, Jansen CE, Merriman JD, Von Ah D. Assessment and management of cancer- and cancer treatment-related cognitive impairment. J Nurse Pract. 2018;14:217–224.e5.
Ferguson RJ, McDonald BC, Rocque MA, et al. Development of CBT for chemotherapy-related cognitive change: results of a waitlist control trial. Psychooncology. 2012;21:176–86.
Ferguson RJ, Sigmon ST, Pritchard AJ, et al. A randomized trial of videoconference-delivered cognitive behavioral therapy for survivors of breast cancer with self-reported cognitive dysfunction. Cancer. 2016;122:1782–91.
Mandelblatt JS, Hurria A, McDonald BC, et al. Cognitive effects of cancer and its treatments at the intersection of aging: what do we know; what do we need to know? Semin Oncol. 2013;40:709–25.
Loh KP, Janelsins MC, Mohile SG, et al. Chemotherapy-related cognitive impairment in older patients with cancer. J Geriatr Oncol. 2016;7:270–80.
Mandelblatt JS, Clapp JD, Luta G, et al. Long-term trajectories of self-reported cognitive function in a cohort of older survivors of breast cancer: CALGB 369901 (Alliance). Cancer. 2016;122:3555–63.
Hardy SJ, Krull KR, Wefel JS, Janelsins M. Cognitive changes in cancer survivors. ASCO educational book; 2019.
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Idea for the article: JBNP and NOC; literature research and data analysis: NCT; draft: NCT; review: JBNP and NOC.
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Cerulla Torrente, N., Navarro Pastor, JB. & de la Osa Chaparro, N. Systematic review of cognitive sequelae of non-central nervous system cancer and cancer therapy. J Cancer Surviv 14, 464–482 (2020). https://doi.org/10.1007/s11764-020-00870-2
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DOI: https://doi.org/10.1007/s11764-020-00870-2