Marie Lange1, Bénédicte Giffard2, Sabine Noal3, Olivier Rigal4, Jean-Emmanuel Kurtz5, Natacha Heutte6, Christelle Lévy7, Djelila Allouache8, Chantal Rieux9, Johan Le Fel10, Aurélie Daireaux11, Bénédicte Clarisse12, Corinne Veyret13, Philippe Barthélémy14, Nadine Longato15, Francis Eustache16, Florence Joly17. 1. INSERM, U1077, Caen, France; Normandie Université, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France; INSERM, U1086, Caen, France; Unité de Recherche Clinique, Centre François Baclesse, Caen, France. Electronic address: m.lange@baclesse.fr. 2. INSERM, U1077, Caen, France; Normandie Université, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France. Electronic address: benedicte.giffard@unicaen.fr. 3. Unité de Recherche Clinique, Centre François Baclesse, Caen, France; Comité Sein, Centre François Baclesse, Caen, France. Electronic address: s.noal@baclesse.fr. 4. Service des soins de support, Centre Henri-Becquerel, Rouen, France; Département d'Oncologie médicale, Centre Henri-Becquerel, Rouen, France. Electronic address: olivier.rigal@chb.unicancer.fr. 5. Département d'hématologie et d'oncologie, Hôpitaux universitaires de Strasbourg, Strasbourg, France. Electronic address: J-Emmanuel.KURTZ@chru-strasbourg.fr. 6. INSERM, U1086, Caen, France; Unité de Recherche Clinique, Centre François Baclesse, Caen, France; UFR des sciences pharmaceutiques, Université de Caen Basse-Normandie, Caen, France. Electronic address: n.heutte@baclesse.fr. 7. Comité Sein, Centre François Baclesse, Caen, France. Electronic address: c.levy@baclesse.fr. 8. Comité Sein, Centre François Baclesse, Caen, France. Electronic address: d.allouache@baclesse.fr. 9. Unité de Recherche Clinique, Centre François Baclesse, Caen, France. Electronic address: c.rieux@baclesse.fr. 10. Service des soins de support, Centre Henri-Becquerel, Rouen, France. Electronic address: johan.lefel@chb.unicancer.fr. 11. Unité de Recherche Clinique, Centre François Baclesse, Caen, France. Electronic address: aurelie.daireaux@neuf.fr. 12. Unité de Recherche Clinique, Centre François Baclesse, Caen, France. Electronic address: b.clarisse@baclesse.fr. 13. Département d'Oncologie médicale, Centre Henri-Becquerel, Rouen, France. Electronic address: corinne.veyret@chb.unicancer.fr. 14. Département d'hématologie et d'oncologie, Hôpitaux universitaires de Strasbourg, Strasbourg, France. Electronic address: philippe.barthelemy@chru-strasbourg.fr. 15. Département d'hématologie et d'oncologie, Hôpitaux universitaires de Strasbourg, Strasbourg, France. Electronic address: nadine.longato@chru-strasbourg.fr. 16. INSERM, U1077, Caen, France; Normandie Université, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France. Electronic address: neuropsycho@chu-caen.fr. 17. Normandie Université, UMR-S1077, Caen, France; INSERM, U1086, Caen, France; Unité de Recherche Clinique, Centre François Baclesse, Caen, France; CHU de Caen, Service d'Oncologie, Caen, France. Electronic address: f.joly@baclesse.fr.
Abstract
PURPOSE: Cognitive deficits (CD) are reported among cancer patients receiving chemotherapy, but may also be observed before treatment. Though elderly patients are expected to be more prone to present age-related CD, poor information is available regarding the impact of cancer and chemotherapy on this population. This study assessed baseline cognitive functions (before adjuvant treatment) in elderly early stage breast cancer (EBC) patients. METHODS: Women >65years-old with newly diagnosed EBC were included in this prospective study. Episodic memory, working memory, executive functions and information processing speed were assessed by neuropsychological tests. Questionnaires were used to assess subjective CD, anxiety, depression, fatigue, quality of life and geriatric profile. Objective CD were defined using International Cognition and Cancer Task Force criteria. A group of elderly women without cancer coupled with published data related to healthy women were used for comparison (respectively to subjective and objective CD). RESULTS: Among the 123 elderly EBC patients (70±4years) included, 41% presented objective CD, which is greater than expected in healthy population norms (binomial test P<.0001). Verbal episodic memory was mainly impaired (21% of patients). No correlation was observed between objective CD and cancer stage or geriatric assessment. Subjective CD only correlated with verbal episodic memory (P=.01). CONCLUSIONS: This is the first large series assessing baseline cognitive functions in elderly EBC patients. More than 40% presented objective CD before any adjuvant therapy, which is higher than what is reported among younger patients. Our results reinforce the hypothesis that age is a risk factor for CD in EBC patients.
PURPOSE:Cognitive deficits (CD) are reported among cancerpatients receiving chemotherapy, but may also be observed before treatment. Though elderly patients are expected to be more prone to present age-related CD, poor information is available regarding the impact of cancer and chemotherapy on this population. This study assessed baseline cognitive functions (before adjuvant treatment) in elderly early stage breast cancer (EBC) patients. METHODS:Women >65years-old with newly diagnosed EBC were included in this prospective study. Episodic memory, working memory, executive functions and information processing speed were assessed by neuropsychological tests. Questionnaires were used to assess subjective CD, anxiety, depression, fatigue, quality of life and geriatric profile. Objective CD were defined using International Cognition and Cancer Task Force criteria. A group of elderly women without cancer coupled with published data related to healthy women were used for comparison (respectively to subjective and objective CD). RESULTS: Among the 123 elderly EBC patients (70±4years) included, 41% presented objective CD, which is greater than expected in healthy population norms (binomial test P<.0001). Verbal episodic memory was mainly impaired (21% of patients). No correlation was observed between objective CD and cancer stage or geriatric assessment. Subjective CD only correlated with verbal episodic memory (P=.01). CONCLUSIONS: This is the first large series assessing baseline cognitive functions in elderly EBC patients. More than 40% presented objective CD before any adjuvant therapy, which is higher than what is reported among younger patients. Our results reinforce the hypothesis that age is a risk factor for CD in EBC patients.
Authors: Nabiel Mir; Paul MacLennan; Mustafa Al-Obaidi; Donna Murdaugh; Kelly M Kenzik; Andrew McDonald; Noha Sharafeldin; Crystal Young-Smith; Ravi Paluri; Olumide Gbolahan; Lakshmin Nandagopal; Smita Bhatia; Grant R Williams Journal: J Geriatr Oncol Date: 2020-03-13 Impact factor: 3.599
Authors: John E Schmidt; Ellen Beckjord; Dana H Bovbjerg; Carissa A Low; Donna M Posluszny; Amy E Lowery; Mary Amanda Dew; Stephanie Nutt; Sarah R Arvey; Ruth Rechis Journal: J Cancer Surviv Date: 2015-08-04 Impact factor: 4.442