|Table of Contents|

Effect of neoadjuvant chemotherapy on perioperative neurocognitive disorders in patients with malignant tumors

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 15
Page:
2820-2825
Research Field:
Publishing date:

Info

Title:
Effect of neoadjuvant chemotherapy on perioperative neurocognitive disorders in patients with malignant tumors
Author(s):
QIAO Limei; CHEN Cheng; WANG Zhonghui; XIA Liang; LIU Jianyun; WANG Xiaoyan
Department of Anesthesiology,Yunnan Cancer Hospital(the Third Affiliated Hospital of Kunming Medical University),Yunnan Kunming 650118,China.
Keywords:
neoadjuvant chemotherapy; perioperative neurocognitive disorders; neuropsychological test
PACS:
R730.5
DOI:
10.3969/j.issn.1672-4992.2024.15.020
Abstract:
Objective:To investigate the effect of neoadjuvant chemotherapy on perioperative neurocognitive disorders(PND) in patients with malignant tumors,and analyze the risk factors of PND,in order to provide reference and effective clinical guidance for reducing postoperative cognitive impairment in this population.Methods:A total of 105 patients with malignant tumors who underwent elective surgery in this hospital from July 2022 to March 2023 were selected as the study objects.According to whether they received neoadjuvant chemotherapy before surgery,all patients were divided into neoadjuvant chemotherapy group(group N) and control group(group C).The patients received MMSE and neuropsychological tests to evaluate the changes in cognitive function at 1 day before surgery and 7 days after surgery,respectively.The occurrence of PND was determined by Z-value method.Results:47 cases in group N and 58 cases in group C successfully completed the neuropsychological tests.In both groups,the age of patients in group N was lower than that in group C,and the intraoperative blood loss was significantly higher than that in group C(P＜0.05).There were no significant differences in other variables(P＞0.05).There was no significant difference in preoperative MMSE scores and neuropsychological tests between the two groups(P＞0.05).The number symbol conversion and number breadth in group N decreased significantly more than that in group C at 7 days after surgery(P＜0.05).PND occurred in 12 patients(25.5%) in group N and 6 patients(10.3%) in group C at 7 days after surgery,and the difference was statistically significant(χ2=4.216,P=0.040).Age was an independent risk factor for PND.Conclusion:Neoadjuvant chemotherapy can aggravate early postoperative cognitive function impairment and significantly increase the incidence of early postoperative PND in patients with malignant tumors.

References:

［1］EVERED L,SCOTT DA,SILBERT B.Cognitive decline associated with anesthesia and surgery in the elderly:Does this contribute to dementia prevalence［J］.Curr Opin Psychiatry,2017,30(3):220-226.
［2］EVERED L,SILBERT B,KNOPMAN DS,et al.Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018［J］.Br J Anaesth,2018,121(5):1005-1012.
［3］BEAR HD,ANDERSON S,SMITH RE,et al.Sequential preoperative or postoperative docetaxel added to preoperative doxorubicin plus cyclophosphamide for operable breast cancer:National Surgical Adjuvant Breast and Bowel Project Protocol B-27［J］.J Clin Oncol,2006,24(13):2019-2027.
［4］CHEANG MC,CHIA SK,VODUC D,et al.Ki-67 index,HER-2 status,and prognosis of patients with luminal B breast cancer［J］.J Natl Cancer Inst,2009,101(10):736-750.
［5］FANG J,CAI SN,JIANG HF,et al.Effect of chemotherapy preoperatively upon early postoperative cognitive dysfunction in eldly tumor patients［J］.National Medical Journal of China,2009,89(33):2319-2323.
［6］王凯元,刘玲,李锦成,等.新辅助化疗对老年患者单肺通气手术后认知功能障碍的影响［J］.中国肿瘤临床,2014,41(12):801-805. WANG KY,LIU L,LI JC,et al.Effect of neoadjuvant chemotherapy on cognitive dysfunction inelderly patients after single lung ventilation operation［J］.Chinese Oncology,2014,41(12):801-805.
［7］谈诚,徐晶晶,王蕊,等.肺移植患者围手术期神经认知障碍发生率及危险因素分析［J］.国际麻醉学与复苏杂志,2021,42(4):344-350. TAN C,XU JJ,WANG R,et al.Incidence and risk factors of perioperative neurocognitive impairment in lung transplantation patients［J］.International Journal of Anesthesiology and Resuscitation,2021,42(4):344-350.
［8］VAN SK,SCHWARTE LA,SCHOBER P.Diagnostic citeria of postoperative cognitive dysfunction:A focused systematic review［J］.Anesthesiol Res Pract,2020,2020:7384394.
［9］DIETRICH J,MONJE M,WEFEL J,et al.Clinical patterns and biological correlates of cognitive dysfunction associated with cancer therapy［J］.Oncologist,2008,13(12):1285-1295.
［10］EBATA Y,NAKANISHI R,TANAKA Y,et al.Neoadjuvant chemotherapy in patients with T4b or obstructive colon cancer:A single center retrospective cohort study［J］.Anticancer Res,2024,44(3):1281-1287.
［11］JANELSINS MC,KOHLI S,MOHILE SG,et al.An update on cancer- and chemotherapy-related cognitive dysfunction:Current status［J］.Semin Oncol,2011,38(3):431-438.
［12］姜远旭,程静,张雪萍.右美托咪定对新辅助化疗结肠癌手术患者术后认知功能障碍的影响［J］.浙江医学,2023,45(12):1287-1291,1303. JIANG YX,CHENG J,ZHANG XP.Effects of dexmedetomidine on postoperative cognitive dysfunction in patients undergoing neoadjuvant chemotherapy for colon cancer［J］.Zhejiang Medical Journal,2023,45(12):1287-1291,1303.
［13］HURRIA A,ROSEN C,HUDIS C,et al.Cognitive function of older patients receiving adjuvant chemotherapy for breast cancer:A pilot prospective longitudinal study［J］.J Am Geriatr Soc,2006,54(6):925-931.
［14］EVENDEN J.Cognitive impairments and cancer chemotherapy:Translational research at a crossroads［J］.Life Sci,2013,93(17):589-595.
［15］乔丽梅,李亚雄,王小燕,等.全主动脉弓置换并支架象鼻术患者rScO2及S100β蛋白和NSE与围手术期神经认知障碍的关系［J］.西安交通大学学报(医学版),2023,44(1):107-114. QIAO LM,LI YX,WANG XY,et al.Relationship between rScO2,S100β protein and NSE and perioperative neurocognitive impairment in patients undergoing total aortic arch replacement and stenting［J］.Journal of Xi'an Jiaotong University(Medical Edition),2023,44(1):107-114.
［16］MONK TG,WELDON BC,GARVAN CW,et al.Predictors of cognitive dysfunction after major noncardiac surgery［J］.Anesthesiology,2008,108(1):18-30.
［17］NEGRINI D,WU A,OBA A,et al.Incidence of postoperative cognitive dysfunction following inhalational vs total intravenous general anesthesia:A systematic review and Meta-analysis［J］.Neuropsychiatr Dis Treat,2022,18:1455-1467.

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Last Update: 2024-06-28