Breast Cancer Regimen Linked to Cognitive Decline

NEW YORK DEC 08, 2006 (Reuters Health) - As a treatment for high-risk breast cancer patients, high-dose cyclophosphamide, thiotepa, and carboplatin (CTC) is associated with a drop in cognitive performance over time, new research shows.

Previous reports have shown a drop in cognitive performance among breast cancer survivors treated with cytotoxic therapy, the researchers note in the Journal of the National Cancer Institute for December 6. However, there was a need to verify this observation in longitudinal studies and to clarify which regimens produced the greatest cognitive deficits.

Dr. Sanne B. Schagen, from the Netherlands Cancer Institute in Amsterdam, and colleagues used standard neuropsychological tests to compare cognitive function in 28 patients treated with CTC, 39 patients treated with standard-dose 5-FU, epirubicin, and cyclophosphamide (FEC), 57 stage I breast cancer patients treated with no systemic therapy, and 60 healthy control subjects.

Cognitive function was assessed in cancer patients before and 6 months after treatment (12-month interval) and in control subjects at a 6-month interval.

At baseline, cognitive function was comparable in the four groups, the report indicates. At follow-up, however, 25% of CTC patients showed worsening cognitive function compared with 6.7% of healthy controls (p = 0.02). The other breast cancer groups were not significantly more likely than controls to experience cognitive decline.

"Our results confirm the findings of our earlier cross-sectional study," the researchers note. They "also show that analyses of cognitive change that correct for the effects of repeated testing are essential for an accurate interpretation of cognitive performance in studies with a longitudinal design."

SOURCE:

• J Natl Cancer Inst 2006;98:1742-1745.