Effects of Adjuvant Chemotherapy on Cognitive Function of Patients With Early-stage Colorectal Cancer

Sales, Manuela; Suemoto, Cláudia Kimie; Apolinário, Daniel; Serrao, ValeriaT.; Andrade, Celi Santos; Conceição, David M.; Amaro, Edson; Melo, Brian Alvarez Ribeiro de; Riechelmann, Rachel P.

doi:10.1016/j.clcc.2018.09.002

Cited by 30 publications

(19 citation statements)

References 62 publications

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“…There is also a notion that self-initiated retrieval processes rather than encoding are implicated in prospective memory impairment among breast cancer survivors [11]. The recent study of patients with colorectal carcinoma treated with 5-fluorouracil with or without oxaliplatin confirmed the presence of a decline in executive function at 12 month time point comparing to patients, who had not received chemotherapy due to localized character of the disease [12].…”

Section: Chemobrainmentioning

confidence: 99%

Chemobrain as a Product of Growing Success in Chemotherapy - Focus On Glia As Both A Victim And A Cure

Walczak¹,

Janowski²

2019

Neuropsychiatry

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Chemotherapy-induced cognitive impairment or chemobrain is a frequent consequence of cancer treatment with many psychiatric features. Ironically, the increasing efficacy of chemotherapy leaves growing number of patients alive with chemobrain. Therefore, there is an urgent need for strategies capable of returning cancer survivors back to their pre-morbid quality of life. Molecular mechanisms of chemobrain are largely unknown. Over the last decade there was a lot of emphasis in preclinical research on inflammatory consequences of chemotherapy and oxidative stress but so far none of these approaches were translated into clinical scenario. The co-administration of chemotherapy with protective agents was evaluated preclinically but it should be introduced with caution as potential interference was not yet studied and that could blunt therapeutic efficacy. Stem cell-based regenerative medicine approach has so far been exploited very sparsely in the context of chemobrain and the focus was on indirect mechanisms or neuronal replacement in the hippocampus. However, there is evidence for widespread white matter abnormalities in patients with chemobrain. This is quite logical considering life-long proliferation and turnover of glial cells, which makes them vulnerable to chemotherapeutic agents. Feasibility of glia replacement has been established in mice with global dysmyelination where profound therapeutic effect has been observed but only in case of global cell engraftment (across the entire brain). While global glia replacement has been achieved in mice translation to clinical setting might be challenging due to much larger brain size. Therefore, a lot of attention should be directed towards the route of administration to accomplish widespread cell delivery. Techniques facilitating that broad cell distribution including intra-arterial and intrathecal methods should be considered as very compelling options. Summarizing, chemobrain is a rapidly growing medical problem and global glia replacement should be considered as worthwhile therapeutic strategy.

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Section: Chemobrainmentioning

confidence: 99%

Chemobrain as a Product of Growing Success in Chemotherapy - Focus On Glia As Both A Victim And A Cure

Walczak¹,

Janowski²

2019

Neuropsychiatry

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“…Chemotherapy-induced peripheral neuropathy (CIPN) and cognitive impairments (CICI) affect up to 75% of patients receiving chemotherapy and can last for months and even years after treatment completion. 51 , 53 Common symptoms of CIPN include persistent shooting or burning pain in the absence of noxious stimuli, tingling, and loss of sensation, which typically present in a “stocking and glove” distribution. 20 In CICI, patients experience deficits in memory, attention, information processing, and executive functioning.…”

Section: Introductionmentioning

confidence: 99%

“… 20 In CICI, patients experience deficits in memory, attention, information processing, and executive functioning. 51 As there are no Food and Drug Administration-approved agents that prevent or treat these disorders, CIPN and CICI can greatly impair quality of life of patients and sometimes even lead to delay or discontinuation of cancer treatment. 24 …”

Section: Introductionmentioning

confidence: 99%

Inhibition of dual leucine zipper kinase prevents chemotherapy-induced peripheral neuropathy and cognitive impairments

Goodwani

Acton

et al. 2021

Pain

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“…In the only study to date examining CRCD and brain structural changes in colorectal cancer, Sales et al [78] found reductions in executive function in colorectal patients from pre-to post-chemotherapy relative to patients not treated with chemotherapy; however, they did not find significant differences in DTI metrics (FA, mean, radial, or axial diffusivity) in a subset of participants who completed neuroimaging. Likewise, in contrast to the cross-sectional analysis [32] described above showing differences in DTI metrics relative to healthy controls in small-cell lung cancer patients after chemotherapy and non-small-cell lung cancer patients not yet treated with chemotherapy, in a longitudinal design following the same cohorts Simó et al [56] did not identify white matter changes in the non-small-cell lung cancer group from pre-to post-chemotherapy relative to controls.…”

Section: Longitudinal Examination Of Whole-brain and Regional Structu...mentioning

confidence: 93%

Structural Neuroimaging Findings Related to Adult Non-CNS Cancer and Treatment: Review, Integration, and Implications for Treatment of Cognitive Dysfunction

McDonald

2021

Neurotherapeutics

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Cancer-and treatment-related cognitive dysfunction (CRCD) is a common challenge faced by patients diagnosed with noncentral nervous system (CNS) cancer. It has become increasingly recognized that multiple factors likely play a role in these symptoms, including the cancer disease process, systemic treatments (e.g., chemotherapy and endocrine therapies), and risk factors that may predispose an individual to both cancer and cognitive dysfunction. As the field has evolved, advanced neuroimaging techniques have been applied to better understand the neural correlates of CRCD. This review focuses on structural neuroimaging findings related to CRCD in adult non-CNS cancer populations, including examination of gray matter volume/density and white matter integrity differences between cancer patients and comparison groups, as well as emerging findings regarding structural network abnormalities. Overall, this literature has demonstrated consistent findings of reduced gray matter volume/density and white matter integrity in cancer patients relative to comparison groups. These are most prominent in individuals treated with chemotherapy, though alterations have also been noted in those treated with anti-estrogen and androgen-deprivation therapies. Alterations in gray and white matter structural network connectivity have also been identified. These structural abnormalities have been observed most prominently in frontal and temporal brain regions, and have been shown to correlate with subjective and objective cognitive function, as well as with physiological and clinical variables, helping to inform understanding of CRCD mechanisms. To date, however, structural neuroimaging techniques have not been utilized in systematic studies of potential CRCD treatments, suggesting a potentially fruitful avenue for future research.

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Effects of Adjuvant Chemotherapy on Cognitive Function of Patients With Early-stage Colorectal Cancer

Cited by 30 publications

References 62 publications

Chemobrain as a Product of Growing Success in Chemotherapy - Focus On Glia As Both A Victim And A Cure

Chemobrain as a Product of Growing Success in Chemotherapy - Focus On Glia As Both A Victim And A Cure

Inhibition of dual leucine zipper kinase prevents chemotherapy-induced peripheral neuropathy and cognitive impairments

Structural Neuroimaging Findings Related to Adult Non-CNS Cancer and Treatment: Review, Integration, and Implications for Treatment of Cognitive Dysfunction

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