Comparative Analysis of the Chemotherapy-related Cognition Impairments in Patients with Breast Cancer: a Community-based Research

Owrangi, M.; Gholamzadeh, M. J.; Vasaghi Gharamaleki, M.; Mousavi, S. Z.; Kamali, A.-M.; Dehghani, M.; Nami, M.; Chakrabarti, P.

Purpose: With increasing breast cancer (BC) survival rates, the survivors quality of life (QoL) has become an important issue. Chemotherapy-induced cognitive impairment, known as chemobrain has been addressed recently. Therefore, cognitive function as one of the determinants of QoL should be considered while prescribing chemotherapeutics. In this study, we aimed to evaluate the effects of two common chemotherapy regimens on BC survivors cognition. Methods: The participants comprised 35 BC patients who underwent two common chemotherapy regimens, AC-T and TAC, and 24 matched healthy volunteers. The participants were assessed regarding anxiety, depression, general health status, and cognitive function including aspects of concentration, verbal ability, reasoning, memory, and visuospatial skill through Addenbrookes Cognitive Examination (ACE-P) and Cambridge Brain Science (CBS) tests. Results: Regarding depression and anxiety, there were no significant differences between the three groups. However, BC patients significantly complained of chronic fatigue compared to healthy volunteers (P-value = 0.027). Besides, ACE-P revealed the language domain to be affected in the AC-T group in comparison with the TAC-treated cases (P-value = 0.036). Moreover, the patients receiving the AC-T regimen had worse performance in visuospatial working memory and attention domains compared to the TAC group considering CBS tests (P-value = 0.031 and 0.008, respectively). Conclusion: The results represent the AC-T regimen to be more toxic than the TAC in domains of language, concentration, and visuospatial working memory. Implications for cancer survivors: The AC-T regimen should be prescribed with caution in BC patients suffering from baseline cognitive impairments to improve post-chemotherapy QoL.