Abstract
Objective
To systematically review evidence of treatments for cognitive impairments experienced
by at least 20% of all women who undergo chemotherapy for breast cancer.
Data Sources
Searches of 5 databases (PubMed, Embase, Cochrane CENTRAL, PsycINFO, CINAHL), with
no date or language restrictions, identified 1701 unique results. Search terms included
breast cancer, chemotherapy, chemobrain, chemofog, and terms on cognition and language
deficits.
Study Selection
Included only peer-reviewed journal articles that described therapies for cognitive
dysfunction in women undergoing (or who had undergone) chemotherapy for breast cancer
and provided objective measurements of cognition or language.
Data Extraction
Data were extracted according to Cochrane recommendations, including characteristics
of participants, interventions, outcomes, and studies. Quality assessment of all 12
eligible studies was performed using the Physiotherapy Evidence Database scale and
treatment fidelity criteria. Screening, data extraction, and quality assessment reliability
were performed.
Data Synthesis
Six articles described interventions for cognition that took place during cancer treatment;
6, afterward. Five interventions were medical (including a strength-training program),
2 were restorative, and 5 were cognitive. Medicinal treatments were ineffective; restorative
and exercise treatments had mixed results; cognitive therapy had success in varying
cognitive domains. The domains most tested and most successfully treated were verbal
memory, attention, and processing speed.
Conclusions
Cognitive therapy protocols delivered after chemotherapy and aimed at improving verbal
memory, attention, and processing speed hold the most promise. Future research is
needed to clarify whether computerized cognitive training can be effective in treating
this population, and to identify objective assessment tools that are sensitive to
this disorder.
Keywords
List of abbreviations:
HVLT-R (Hopkins Verbal Learning Test–Revised), PEDro (Physiotherapy Evidence Database)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 27, 2015
Footnotes
Supported by an Advanced Rehabilitation Research Training Award: Interventions for Neurologic Communication Disorders (award no. H133P120013) from the National Institute on Disability and Rehabilitation Research within the Department of Education; the Northwestern University Clinical and Translational Science Institute; and the National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award (grant no. UL1TR000150). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Clinical and Translational Science Award is a registered trademark of the U.S. Department of Health and Human Services.
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
