Innovations In Clinical Neuroscience

JAN-FEB 2018

A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience

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R E V I E W 42 ICNS Innovations in Clinical Neuroscience • January–February 2018 • Volume 15 • Number 1–2 although the data come from small studies and must be interpreted with caution. 108–111 A recent pilot trial of 15 patients with brain tumor(s) revealed significant post-baseline improvement in attention, graphomotor speed, visual memory, and self-reported quality of life after receiving a daily dose of donepezil for 24 weeks. 111 Lawrence et al 110 reported improved delayed verbal memory following donepezil treatment in patients with breast cancer, with self-reported cognitive impairments 1 to 5 years following adjuvant chemotherapy. Wefel et al 112 reported a delayed time to cognitive decline in patients with brain metastases undergoing WBRT who received memantine treatment compared to placebo. CONCLUSION Cognitive impairment can affect daily functioning, quality of life, and capacity to work in patients with cancer and those in remission. Consequently, cognitive assessment is now an important and necessary part of a comprehensive oncological care plan. Cancer-related cognitive impairment might be due to the direct effects of the cancer itself, nonspecific factors, or comorbid conditions that are independent of the disease and/or due to the adverse effects of the treatment or combination of treatments given for the disease. The prevalence and extent of cognitive impairment associated with cancer is recognized but not well understood due, in part, to marked differences in the research methods and definitions used for evaluating cognitive functioning in these patients. Most studies have identified attention, memory, and information processing as the most frequent cognitive domains impacted by cancer and cancer-related treatments, but further research clearly is needed. Recent efforts have been made to develop common definitions to define cognitive impairment in cancer patients and to suggest guidelines for the most appropriate cognitive tests to be used. Cognitive function has increasingly been recognized as a requisite therapeutic target in many diseases, including cancer. The extent of cognitive impairment that is observed in patients with cancer and those in remission make cognitive functioning a particularly important target for clinical trials and clinical practice in oncology. REFERENCES 1. Weiss B. Chemobrain: a translational challenge for neurotoxicology. Neurotoxicology. 2008;29:891– 898. 2. Hodgson K, Hutchinson A, Wilson C, Nettelbeck T. A meta-analysis of the effects of chemotherapy on cognition in patients with cancer. Cancer Treat Rev. 2013;39:297–304. 3. Wefel J, Vardy J, Ahles T, Schagen SB. International Cognition and Cancer Task Force recommendations to harmonise studies of cognitive function in patients with cancer. 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