Systematic Review of Cognitive Impairment in Colorectal Cancer Survivors Who Received Chemotherapy.
Ya-Ning Chan, Ashley Leak Bryant, Jamie L Conklin and 3 others
PMID 34673756WHAT IT FOUND
After chemotherapy started, reported cognitive impairment ranged from 13.3% to 57% at different time points.
Objective tests did not show change, while patient-reported concerns were mixed. Ask about memory and concentration.
Key findings
01After chemotherapy initiation, the prevalence of cognitive impairment ranged from 13.3% to 57% at different time points during treatment.
02Objective neuropsychological assessments did not show significant changes during treatment or significant differences between survivors who did and did not receive chemotherapy, whereas patient-reported questionnaires showed mixed findings.
03Potential physiologic correlates such as FOLFOX treatment, higher toxicity grade, surgery, and chemotherapy with radiation were reported, but none was prominent across studies.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included observational studies and excluded interventional studies, so it reports associations and prevalence, not a tested effect of chemotherapy. Studies used many different cognitive tests, definitions, and time points, so the results could not be combined into one reliable estimate. Most studies relied on two quality-of-life items about concentration and memory, which may miss other cognitive problems. Study quality varied widely, from 25% to 100% of appraisal criteria met. Correlate findings were mostly from one or two studies and were not consistent across the review. No gray literature was searched, so negative results may be missing.
The easy way to misread this
Do not read the 13.3% to 57% range as one stable rate of chemotherapy-caused cognitive decline. The studies used different definitions and measures, patient-reported findings were mixed, and objective neuropsychological tests did not show significant change.