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Preliminary comparison of neuropsychological performance in patients with non-small-cell lung cancer treated with chemotherapy or targeted therapy

Authors Kang HL, Chen VCH, Hung WL, Hsiao HP, Wang WH

Received 14 November 2018

Accepted for publication 13 February 2019

Published 28 March 2019 Volume 2019:15 Pages 753—761


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Yuping Ning

Hsiu-Ling Kang,1,* Vincent Chin-Hung Chen,2,3,* Wei-Lin Hung,4 Han-Pin Hsiao,2 Wei-Han Wang4,5

1Department of Nursing, Chang Gung Memorial Hospital, Chiayi, Taiwan; 2Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Taiwan; 3School of Medicine, Chang Gung University, Taoyuan, Taiwan; 4Department of Psychology, Chung Shan Medical University, Taichung, Taiwan; 5Room of Clinical Neuropsychology, Department of Neurology, Chung Shan Medical University Hospital, Taichung, Taiwan

*These authors contributed equally to this work

Purpose: This cross-sectional pilot study aimed to compare the effects of chemotherapy and targeted therapy on neuropsychological performance and psychiatric symptoms in patients with non-small-cell lung cancer (NSCLC).
Patients and methods: A total of 113 patients with NSCLC were recruited. According to their type of cancer treatment, the patients were classified into chemotherapy (n=40), targeted therapy (n=33), and untreated control (n=40) groups. All participants completed five objective tests measuring various domains of cognitive function, a subjective cognitive functioning scale (Functional Assessment of Cancer Therapy–Cognitive Function; FACT-cog), and the Hospital Anxiety and Depression Scale (HADS) either within 6 months after diagnosis (for the untreated group) or about 18 months after treatment.
Results: Overall, there were no significant intergroup differences in the proportions of patients with abnormal cognitive performance and psychiatric disturbances. Among the untreated NSCLC patients, 35% had impaired performance in at least one cognitive domain, and a comparable finding (30%–35%) was made for the other two treatment groups. The proportion of patients with impaired psychomotor speed was the highest (10%–15%) across various cognitive domains. Moreover, a significant proportion of NSCLC patients (15%–20%) exhibited HADS-defined anxiety and depression disorder. Finally, significant correlations were found between FACT-cog total scores and the HADS Depression subscale across all three groups.
Conclusion: This study demonstrated that 1) a substantial proportion of NSCLC patients exhibited cognitive impairments (especially regarding psychomotor speed) and psychiatric disturbances; 2) no significant differences were observed among the three patient groups for any subjective or objective measure of cognitive deficit; and 3) perceived cognitive impairment was significantly associated with depression or anxiety. Prompt treatment of psychiatric disorders to minimize their impact is therefore recommended.

Keywords: non-small-cell lung cancer, neuropsychological performance, psychomotor speed, anxiety, depression

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