Chemo-related cognitive deficits: computer-based rehab shows promise

  • Dos Santos M & al.
  • Cancer
  • 30.09.2020

  • von Susan London
  • Clinical Essentials
Der Zugang zum gesamten Inhalt dieser Seite ist nur Angehörigen medizinischer Fachkreise vorbehalten. Der Zugang zum gesamten Inhalt dieser Seite ist nur Angehörigen medizinischer Fachkreise vorbehalten.

Takeaway

  • Cancer patients with chemotherapy-related cognitive difficulties saw greater improvement with a computer-assisted cognitive rehabilitation program supervised by a neuropsychologist than with home cognitive self-exercises or simple telephone follow-up.

Why this matters

  • Effective treatments for cancer-related cognitive impairment are lacking.

Key results

  • Proportion of patients with 7-point improvement in perceived cognitive impairment score:
    • 75.0% with computer-assisted cognitive rehabilitation (P=.12 and P=.09, respectively);
    • 59.1% with home cognitive self-exercise control; and
    • 56.9% with telephone follow-up control.
  • Vs controls, computer-assisted cognitive rehabilitation netted greater mean changes in:
    • perceived cognitive impairment (16.3 vs 11.1 and 9.1; P=.02);
    • perceived cognitive abilities (5.3 vs 1.8 and 2.7; P<.01>
    • working memory (1.3 vs 1.1 and 0.4; P=.03);
    • cognition-related QoL (5.1 vs 2.6 and 3.8; P=.01); and
    • depression symptoms (−6.5 vs −1.7 and −2.3; P=.03).

Study design

  • French multicenter, randomized controlled trial among 167 patients with cancer (median age, 51 years) with cognitive complaints during/within 5 years of completing chemotherapy.
  • Three 12-week cognitive rehabilitation programs:
    • computer-assisted cognitive rehabilitation with neuropsychologist,
    • home cognitive self-exercises (control), and
    • telephone follow-ups (control).
  • Main outcome: 7-point improvement in Functional Assessment of Cancer Therapy-Cognitive Function perceived cognitive impairment score.
  • Funding: Ligue Nationale Contre le Cancer.

Limitations

  • No long-term follow-up.
  • Majority had breast cancer and received hormone therapy.
  • Multiple testing.