Chemobrain and Cancer Survivorship: A Scoping Review of the Literature

化疗脑与癌症生存:文献范围综述

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Abstract

BACKGROUND: Cancer-related cognitive impairment (CRCI), commonly known as chemobrain, is characterized by deficits in memory, processing speed, and executive function. While traditionally linked to chemotherapy, emerging evidence suggests that hormone and radiation therapies may also contribute. Despite its high prevalence, CRCI remains underrecognized in oncology research and clinical practice, limiting the development of targeted interventions. Estimates suggest that up to 75% of cancer patients experience cognitive impairment during treatment, with approximately 35% reporting persistent symptoms months or even years post-treatment. However, much of the existing literature has focused on breast cancer, leaving a critical gap in understanding CRCI in other cancer populations. AIMS: This scoping review systematically analyzed research on CRCI across various malignancies, excluding breast cancer, to provide a broader perspective. MATERIALS & METHODS: A comprehensive literature search identified 29 studies examining cognitive impairment in patients with colorectal, testicular, lung, prostate, and hematological cancers. RESULTS: Findings suggest that the severity and duration of cognitive decline vary depending on cancer type and treatment modality, with some therapies inducing transient symptoms and others contributing to prolonged deficits. Existing cognitive assessment tools, such as the Mini-Mental State Examination (MMSE), often lack the sensitivity to detect subtle neurocognitive changes, highlighting the need for more precise diagnostic measures. Methodological challenges, including small sample sizes and reliance on self-reported cognitive symptoms, further hinder the characterization of CRCI in non-breast cancer populations. DISCUSSION: Given the increasing recognition of CRCI across diverse malignancies, future research should prioritize longitudinal studies, advanced neuroimaging techniques, and targeted interventions to mitigate cognitive impairment. A more comprehensive understanding of CRCI in various cancer populations is essential for refining clinical guidelines, improving cognitive assessments, and enhancing survivorship care. CONCLUSION: Expanding research efforts beyond breast cancer will help optimize supportive care strategies and improve the quality of life for individuals affected by cancer-related cognitive dysfunction.

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