The Impact of Cognitive Impairment on Treatment Toxicity, Treatment Completion, and Survival among Older Adults Receiving Chemotherapy: A Systematic Review

Cancers

Schroder Sattar¹  Caroline Mariano²  Isabel Tejero³  Shabbir Alibhai⁴  Eitan Amir⁵  Heather Kilgour⁶  Kristen Haase⁶  Cara Bradley⁷  Ridhi Verma⁸ 

[1] College of Nursing, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada;Department of Medical Oncology, BC Cancer Vancouver Centre, Vancouver, BC V5Z 4E6, Canada;Division of Geriatric Medicine and General Internal Medicine, Department of Medicine, Sinai Health System, Toronto, ON M5G 1X5, Canada;Division of Geriatric Medicine and General Internal Medicine, Department of Medicine, University Health Network, Toronto, ON M5G 2C4, Canada;Division of Medical Oncology and Hematology, University Health Network, Toronto, ON M5G 2C1, Canada;Faculty of Applied Science, School of Nursing, University of British Columbia, Vancouver, BC V6T 2B5, Canada;Library, University of Regina, Regina, SK S4S 0A2, Canada;School of Healthcare Sciences, Cardiff University, Wales CF14 4XN, UK;

关键词: cognitive impairment;    chemotherapy;    treatment toxicity;    survival;    treatment completion;    clinical endpoints;   

DOI  :  10.3390/cancers14061582

来源: DOAJ

【 摘 要 】

Cognitive impairment (CI) is common among older adults with cancer, but its effect on cancer outcomes is not known. This systematic review sought to identify research investigating clinical endpoints (toxicity risk, treatment completion, and survival) of chemotherapy treatment in those with baseline CI. A systematic search of five databases (inception to March 2021) was conducted. Eligible studies included randomized trials, prospective studies, and retrospective studies in which the sample or a subgroup were older adults (aged ≥ 65) screened positive for CI prior to receiving chemotherapy. Risk of bias assessment was performed using the Quality in Prognosis Studies (QUIPS) tool. Twenty-three articles were included. Sample sizes ranged from n = 31 to 703. There was heterogeneity of cancer sites, screening tools and cut-offs used to ascertain CI, and proportion of patients with CI within study samples. Severity of CI and corresponding proportion of each level within study samples were unclear in all but one study. Among studies investigating CI in a qualified multivariable model, statistically significant findings were found in 4/6 studies on survival and in 1/1 study on nonhematological toxicity. The lack of robust evidence indicates a need for further research on the role of CI in predicting survival, treatment completion, and toxicity among older adults receiving chemotherapy, and the potential implications that could shape treatment decisions.

【 授权许可】

Unknown