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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2020.1191    [Accepted]
Neurocognitive Effects of Chemotherapy for Colorectal Cancer: A Systematic Review and a Meta-Analysis of 11 Studies
Soo Young Hwang1, Kwanghyun Kim2, Byeonggwan Ha1, Dongkyu Lee1, Seonung Kim1, Seongjun Ryu1, Jisu Yang3, Sun Jae Jung2,4
1Yonsei University College of Medicine, Seoul, Korea
2Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
3Department of Public Health, Yonsei University, Seoul, Korea
4Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
Correspondence  Sun Jae Jung ,Tel: 82-2-2228-1573, Fax: 82-2-392-8133, Email: sunjaejung@yuhs.ac
Received: November 30, 2020;  Accepted: March 16, 2021.  Published online: March 17, 2021.
*Soo Young Hwang and Kwanghyun Kim contributed equally to this work.
ABSTRACT
Purpose
Chemotherapy-related cognitive impairment (CRCI) is a controversial concept not much explored on colorectal cancer patients.
Materials and Methods
We identified eleven prospective studies: eight studies on 696 colorectal cancer patients who received chemotherapy and three studies on 346 rectal cancer patients who received neoadjuvant chemoradiotherapy. Standardized mean differences (SMDs) of neuropsychological test results and the cognitive quality-of-life scale were calculated using random effect models. A meta-regression was conducted to investigate the association between mean study population age and effect sizes.
Results
The association between chemotherapy and cognitive impairment was not clear in colorectal cancer patients (SMD, 0.003; 95% confidence interval, ‒0.080 to 0.086). However, a meta-regression showed that older patients are more vulnerable to CRCI than younger patients (β=‒0.016, p < 0.001).
Conclusion
Chemotherapy has an overall positive negligible effect size on the cognitive function of colorectal patients. Age is a significant moderator of CRCI.
Key words: Cognitive dysfunction, Colorectal neoplasms, Drug therapy, Meta-analysis
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