Factores de riesgo de deterioro cognitivo asociado a cáncer en pacientes con carcinoma de mama y colon que reciben tratamiento con quimioterapia Translated title: Risk factors for cancer-related cognitive impairment in breast and colorectal cancer patients who undergo chemotherapy

RESUMEN

Fundamento:

Nuestro estudio se plantea con el objetivo de evaluar el impacto de diferentes factores individuales sobre el deterioro cognitivo relacionado con el cáncer en pacientes tratados con quimioterapia.

Material y métodos:

Estudio unicéntrico longitudinal prospectivo. Incluyó pacientes con carcinoma de mama y colon tratados con quimioterapia. Se recogieron variables clínicas y genéticas del paciente (polimorfismos de nucleótido simple, SNP). Los pacientes fueron evaluados neurocognitivamente con once test validados, en tres momentos: basal previo a quimioterapia (M0), entre una y cuatro semanas tras finalizar quimioterapia (M1) y entre 24-30 semanas tras finalizar quimioterapia (M2).

Resultados:

Se incluyeron 62 pacientes, 82% mujeres, con mediana de edad de 56 años (rango 30-74), un 64,5% con cáncer de mama. La edad <55 años, tener estudios superiores, ausencia de comorbilidades y presencia de la variante CC de rs471692 (TOP2A) se asociaron, en general, con mejores resultados cognitivos en M0. Se observó un empeoramiento significativo de M0 a M1 en los test RAVLT y Letras y números, y recuperación en M2 respecto a M0 en los test de memoria visual, FAST, clave de números, y cubos. La edad ≥55 años, la quimioterapia adyuvante, las comorbilidades, el consumo de tabaco y de alcohol y la variante GT de rs1800795 se relacionaron con el deterioro entre M0 y M1 en el modelo multivariante.

Conclusiones:

La edad mayor de 55 años, el sexo femenino, la presencia de comorbilidades y el nivel básico de estudios se relacionan con un mayor riesgo de deterioro cognitivo tras el tratamiento con quimioterapia.

ABSTRACT

Background:

Our study aims to evaluate the impact of different factors on cancer-related cognitive impairment in patients who undergo chemotherapy.

Methodology:

Prospective longitudinal single-centre study that included patients with breast and colon carcinoma who underwent chemotherapy as part of their treatment. Clinical and genetic characteristics of the patients (single nucleotide polymorphisms, SNPs) were collected. Patients’ neurocognitive status was assessed using eleven validated tests at three time points: before chemotherapy (M0 - baseline), between one and four weeks after completing chemotherapy (M1), and between 24-30 weeks after completing chemotherapy (M2).

Results:

Sixty-two patients were included in this study; 82% were female, median age was 56 years (range 30-74), and 64.5% had been diagnosed with breast cancer. Overall, better cognitive results at M0 were associated with age < 55 years, higher educational level, absence of comorbidities, and the CC variant rs471692 (TOP2A). Significant decline was found between M0 to M1 in the Rey Auditory Verbal Learning Test and the Letter and Number test, with evidence of recovery in M2 compared to M0 regarding the following test: Visual Memory, Functioning Assessment Short Test (FAST), Digit Symbol Substitution and Cube. In the multivariate analysis, being ≥55 years of age, adjuvant chemotherapy, presence of comorbidities, tobacco and alcohol use, and GT variant rs1800795 were associated with cognitive decline between M0 and M1.

Conclusion:

Being ≥55 years of age, female, presence of comorbidities and basic education level are related to a higher risk of cognitive impairment after chemotherapy.