Table 1.
Summary of Reviewed Studies
| First Author, y | Tumor | CTx Patients, No. | Cytotoxic Drugs | Control Group No. and Treatment | Second Control Group No. and Treatment | Timepoints of Assessment | Examined Cognitive Domains | Cognitive Deficits Observed (Yes or No) |
|---|---|---|---|---|---|---|---|---|
| Ahles, 2010, 2014 | Breast cancer | 60 | DXR+CP (+PTX, 5-FU or DTX) 5-FU+EPR+CP CP+MTX+5-FU |
72 Local treatment | 45 Healthy women | Prior to CTx; 1, 6, and 18 mos after CTx | Verbal and visuospatial memory, working memory, processing speed, concentration, reaction time, premorbid intelligence level | Yes |
| Ando-Tanabe, 2014 | Breast cancer | 18 | DXR+CP/EPR+CP followed by PTX/DTX | 20 Healthy women | – | Prior to CTx; 1 and 6 mos after CTx | Verbal and visuospatial memory, concentration, information processing, executive function | No |
| Andreis, 2013 | Colon cancer | 57 | 5-FU+OX+LV (FOLFOX4) | – | – | Prior to CTx; directly and 6 mos after CTx | Global cognitive function, visuospatial memory, processing speed, verbal memory | No |
| Biglia, 2012 | Breast cancer | 40 | CP+EPR+5-FU (+DTX) (FEC/FEC-T) DXR+PTX | – | – | Prior to CTx; 1, 3 and 6 mos after baseline | Global cognitive function, visual attention, processing speed, short-term memory, verbal learning, intelligence level | Yes |
| Chen, 2014 | Breast cancer | 42 | Not described | 37 Local treatment | 37 Healthy women | Prior to CTx; after CTx | Not described | Yes |
| Cheung, 2015 | Breast cancer | 99 | DXR+CP DTX+CP | – | – | Prior to CTx; 6 wks after baseline and at end of CTx | Processing speed, reaction time, memory, attention | Yes |
| Collins, 2013 | Breast cancer | 28 | Not described | 28 Antihormonal treatment | 28 Healthy volunteers | Prior to CTx; 1 mo after CTx | Executive function, speech, processing speed, verbal and visuospatial memory and function, working memory | Yes |
| Collins, 2013 | Breast cancer | 60 | CP+EPR+5-FU +DTX (FEC-T) (and more) | 60 Healthy women | – | Prior to CTx; after every CTx cycle | Processing speed, working memory, verbal and visual memory | Yes |
| Collins, 2009 | Breast cancer | 53 | CP+EPR+5-FU (FEC) DXR+CP (and more) | 40 Antihormonal therapy | – | Prior to CTx; 1 and 12 mos after CTx | Executive function, speech, processing speed, verbal learning and memory, visuospatial function, working memory, motor function | Yes |
| Cruzado, 2014 | Colon cancer | 81 | 5-FU+OX +LV (FOLFOX4) | – | – | Prior to CTx; prior to last CTx cycle and 6 mos after CTx | Attention, visuomotor function, executive function, verbal learning and memory | Yes |
| Debess, 2010 | Breast cancer | 75 | CP+EPR+5-FU (FEC) | 45 No treatment or antihormonal | 208 Healthy women | Prior to CTx; 1 mo after CTx | Concentration, episodic memory, attention, awareness and flexibility, visual scanning, executive function | Yes |
| Deprez, 2010 | Breast cancer | 34 | CP+EPR+5-FU (+PTX) (FEC/FEC-T) | 16 Local treatment | 19 Healthy women | Prior to CTx; 3-5 mos after CTx | Attention, concentration, memory, executive function, motor processing speed | Yes |
| Hedayati, 2012 | Breast cancer | 18 | CP+EPR+5-FU (FEC) DTX+DXR +CP | 59 No treatment or antihormonal | 69 Healthy women | Prior to surgery; prior to CTx; 1 and 3 mos after CTx | Processing speed, reaction time, memory, attention | Yes |
| Hermelink, 2007, 2008, 2010 | Breast cancer | 101 | EPR+CP+PTX/EPR+PTX+CP+MTX+5-FU | – | – | Prior to CTx; prior to last CT cycle | Verbal memory, attention, working memory, psychomotor function, processing speed, cognitive flexibility, executive function, intelligence | Yes |
| Hess, 2010 | Ovarian cancer | 27 | Not specified | – | – | Prior to CTx; after 3 and 6 cycles of CTx | Attention, processing speed, reaction time | Yes |
| Hess, 2015 | Cancer of ovaries, tubes or peritoneum | 231 | Not specified | – | – | Prior to CTx; after 3 and 6 cycles of CTx; 6 mos after CTx | Processing speed, reaction time, memory, attention | Yes |
| Jansen, 2011 | Breast cancer | 71 | DXR+CP (+DTX) | – | – | Prior to CTx; after 4 cycles, 1 wk and 6 mos after CTx | Short-term and long-term memory, visuospatial function, speech, attention, global cognitive function | Yes |
| Koleck, 2014 | Breast cancer | 37 | Not specified | 41 Antihormonal treatment | 50 Healthy women | Prior to CTx; 6 and 12 mos after baseline | Attention, learning and memory, motor speed, cognitive flexibility, executive function, visuospatial function | Yes |
| Mehlsen, 2009 | Breast cancer | 36 | CP+EPR +5-FU (FEC) | 14 Cardiologic patients | 17 Healthy volunteers | CT group: prior to CTx; 4-6 wks after CTxControls: upon hospitalization; 3 mos after baseline | Processing speed, working memory, visuospatial function, verbal and visual memory, semantic fluidity, reaction inhibition | Yes |
| Quesnel, 2009 | Breast cancer | 41 | DXR+CP(+DTX) CP+EPR+5-FU (FEC) | 40 Radiation | 45 Healthy women | Prior to CTx; directly and 3 mos after CTx (controls only once) | Verbal and visual memory, attention, concentration, executive function, processing speed, semantic fluidity | Yes |
| Stewart, 2008 | Breast cancer | 61 | CP+EPR+5-FU (FEC) DXR+CP (and more) | 51 Antihormonal treatment | – | Prior to CTx; directly after CTx | Executive function, speech, motor speed, processing speed, verbal and visual learning and memory, visuospatial function, working memory | Yes |
| Tager, 2010 | Breast cancer | 30 | DXR+CP (+DTX/PTX) CP+MTX+5-FU | 31 Other adjuvant therapies | – | Prior to CTx; 1 and 7 mos after CTx | Motor speed, speech, attention, concentration, working memory, visuospatial function, verbal and visual memory | Yes |
| Vardy, 2015 | Colorectal cancer | 173 | 5-FU+OX | 116 Surgery only | 72 Healthy volunteers | Prior to CTx; 6, 12, and 24 mos after baseline | Memory, attention, executive function, decision making | No |
| Vearncombe, 2009 | Breast cancer | 136 | Not specified | – | – | Prior to CTx; 1 mo after CTx | Verbal learning and memory, abstraction, motor coordination | Yes |
| Wefel, 2010 | Breast cancer | 42 | CP+EPR+5-FU (+PTX) (FEC/FEC-T) | – | – | Prior to CTx; 3, 7, and 13 mos after baseline | Attention, processing speed, learning and memory | Yes |
| Wefel, 2014 | Germ cell tumors | 55 | Several treatment protocols | 12 Surgery only | – | Prior to CTx; 1 week after CTx; 1 y after baseline | Attention, motor speed, learning and memory, speech, executive function, motor function | Yes |
| Whitney, 2008 | Non–small cell lung cancer | 14 | Not specified | – | – | Prior to CTx; 1 and 7 mos after CTx | Not specified | Yes |
Abbreviations: CP, cyclophosphamide; CTx, chemotherapy; DTX, docetaxel; DXR, doxorubicin; EPR, epirubicin; FEC/FEC-T, 5-fluorouracil, epirubicin, cyclophosphamide, doxorubicin, and taxanes; 5-FU, 5-fluorouracil; LV, leucovorin; MTX, methotrexate; OX, oxaliplatin; PTX, paclitaxel.