Neuroprotective interventions to prevent chemotherapy-related cognitive impairment in breast cancer survivors: A systematic review.

IF 1.5 4区心理学 Q4 CLINICAL NEUROLOGY

Applied Neuropsychology-Adult Pub Date : 2025-09-23 DOI:10.1080/23279095.2025.2553713

Heather Shelton, Marie Bakitas, Pamela G Bowen, Chisom O Odii, Ellen M Lavoie Smith, Hsiao-Lan Wang, Rebecca Billings, David E Vance

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Abstract

Background: Chemotherapy-related cognitive impairment (CRCI) is common among breast cancer survivors (BCS). While numerous rehabilitation interventions exist, these typically occur post-CRCI. Preventive neuroprotective interventions during chemotherapy may improve cognitive outcomes.

Objective: To investigate the efficacy of neuroprotective interventions delivered during initial chemotherapy on CRCI in breast cancer (BC) patients.

Methods: A systematic review following PRISMA-S identified studies implementing interventions during chemotherapy to prevent CRCI in BC patients. In June 2024, CINAHL, CENTRAL, Embase, OvidMedline, and Web of Science were searched for English-language RCTs or quasi-experimental studies (1990-June 2024) involving interventions initiated during chemotherapy. Reviews, case reports, and non-human studies were excluded.

Results: Five studies met inclusion criteria, highlighting limited research in this area. Findings suggest physical exercise, compensatory cognitive training, memantine, and probiotic supplements during chemotherapy are linked to positive cognitive outcomes in BCS. However, small sample sizes, lack of randomization, and absence of blinding limit generalizability.

Discussion: Neuroprotective interventions are established in healthy and non-cancer populations. Implementing such interventions during chemotherapy may yield improved cognitive outcomes. Future studies should develop CRCI-specific prevention strategies for BCS.

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神经保护干预预防乳腺癌幸存者化疗相关认知障碍：系统综述

背景：化疗相关认知障碍（CRCI）在乳腺癌幸存者（BCS）中很常见。虽然存在许多康复干预措施，但这些干预措施通常发生在crci后。化疗期间的预防性神经保护干预可能改善认知结果。目的：探讨在乳腺癌（BC）患者初始化疗期间给予神经保护干预对CRCI的疗效。方法：系统回顾PRISMA-S确定的在化疗期间实施干预措施以预防BC患者CRCI的研究。2024年6月，检索了CINAHL、CENTRAL、Embase、OvidMedline和Web of Science，检索了涉及化疗期间干预措施的英语rct或准实验研究（1990- 2024年6月）。综述、病例报告和非人类研究被排除在外。结果：5项研究符合纳入标准，突出了该领域研究的局限性。研究结果表明，化疗期间的体育锻炼、代偿性认知训练、美金刚和益生菌补充剂与BCS患者的积极认知结果有关。然而，小样本量、缺乏随机化和缺乏盲法限制了通用性。讨论：在健康和非癌症人群中建立了神经保护干预。在化疗期间实施这些干预措施可能会改善认知结果。未来的研究应制定针对crci的BCS预防策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Applied Neuropsychology-Adult CLINICAL NEUROLOGY-PSYCHOLOGY

CiteScore

4.50

自引率

11.80%

发文量

134

期刊介绍： pplied Neuropsychology-Adult publishes clinical neuropsychological articles concerning assessment, brain functioning and neuroimaging, neuropsychological treatment, and rehabilitation in adults. Full-length articles and brief communications are included. Case studies of adult patients carefully assessing the nature, course, or treatment of clinical neuropsychological dysfunctions in the context of scientific literature, are suitable. Review manuscripts addressing critical issues are encouraged. Preference is given to papers of clinical relevance to others in the field. All submitted manuscripts are subject to initial appraisal by the Editor-in-Chief, and, if found suitable for further considerations are peer reviewed by independent, anonymous expert referees. All peer review is single-blind and submission is online via ScholarOne Manuscripts.