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Lack of a chemobrain effect for adjuvant FOLFOX chemotherapy in colon cancer patients. A pilot study

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Abstract

Purpose

Chemotherapy improves the survival rate of stage III colon cancer patients. The combination of oxaliplatin, 5-fluorouracil, and leucovorin (the FOLFOX4 regimen) has emerged as the standard of care. This prospective study evaluates potential alterations in cognitive function in FOLFOX4-treated patients.

Methods

We evaluated 57 consecutive colorectal cancer patients who received adjuvant chemotherapy with FOLFOX4. Patients underwent a complete battery of neuropsychological tests at three different times: before (T0), at the end (T1), and 6 months after treatment (T2).

Results

We have analyzed cognitive impairment (Mini Mental State Examination, MMSE), visuo-spatial memory (Clock Drawing Test, CDT, Rey Complex Figure, copy and recall), information processing speed (Trial Making Test-A, TMT-A, and Trial Making Test-B, TMT-B), verbal memory (Rey Auditory Verbal Learning Test, call and recall), emotional distress (Psychological Distress Inventory, PDI), anxiety (State and Trait Anxiety Inventory, STAI-Y1 and Y2), and depression (Beck Depression Inventory, BDI). Then we have calculated, for each test and for each interval of time, mean ± standard deviation for the mean. In a subsequent phase, we tested the significance of different results through the ANOVA analysis for repeated measures. In this case, we could not find any statistically significant modification in cognitive function, but we could notice an improvement in emotional performance, anxiety and depression a short time after chemotherapy administration.

Conclusions

We found no effect on cognitive function related to chemotherapy, the only little modification is about some emotional performance during chemotherapy. These findings may be explained by the central role of the psychological adaptation process, which occurs during the period from diagnosis to completion of treatment and is characterized by anxiety and adjustment depression. Our results seem to rule out any significant cognitive impairment due to adjuvant FOLFOX4 chemotherapy in colon cancer patients.

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Acknowledgments

All co-authors have seen and agree with the contents of the manuscript and there is no financial interest to report. We certify that the submission is not under review at any other publication

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Authors and Affiliations

  1. Department of Medical Oncology, Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy

    Federica Andreis, Maria Mazzocchi, Fausto Meriggi, Anna Rizzi, Luigina Rota, Brunella Di Biasi, Chiara Abeni & Alberto Zaniboni

  2. Department of Geriatry, Fondazione Poliambulanza, Brescia, Italy

    Marco Ferri & Renzo Rozzini

  3. Department of Surgery, Fondazione Poliambulanza, Brescia, Italy

    Claudio Codignola

Authors
  1. Federica Andreis
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  2. Marco Ferri
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  3. Maria Mazzocchi
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  4. Fausto Meriggi
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  5. Anna Rizzi
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  7. Brunella Di Biasi
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  8. Chiara Abeni
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  9. Claudio Codignola
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  10. Renzo Rozzini
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  11. Alberto Zaniboni
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Correspondence to Alberto Zaniboni.

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Andreis, F., Ferri, M., Mazzocchi, M. et al. Lack of a chemobrain effect for adjuvant FOLFOX chemotherapy in colon cancer patients. A pilot study. Support Care Cancer 21, 583–590 (2013). https://doi.org/10.1007/s00520-012-1560-2

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  • DOI: https://doi.org/10.1007/s00520-012-1560-2

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