Celia Sánchez-Gómez, Eduardo José Fernández-Rodríguez, Samuel Jiménez-Sánchez, Emilio Fonseca-Sánchez, Jesus Perez, Víctor Navarro-López, Sara Jiménez García-Tizón, Juan Luis Sánchez-González
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引用次数: 0
摘要
背景：乳腺癌患者与化疗相关的癌症相关认知障碍（CRCI）是癌症治疗的一个具有挑战性的后遗症。认知训练（CT）显示出改善CRCI的潜力。目的：本系统综述结合荟萃分析，旨在评价CT改善乳腺癌患者CRCI的疗效。方法：系统回顾PubMed、Web of Science、Scopus、Embase、Cochrane Library、PsycInfo、CINAHL Complete、ClinicalTrials.gov和Psicodoc数据库中截至2025年1月发表的研究。采用PRISMA、RoB 2和PEDro量表评估方法学质量。该协议已在PROSPERO （CRD42025636745）中注册。结果：在7751项研究中，11项符合纳入标准，9项纳入meta分析。8项研究评估了CT对FACT-Cog量表整体评分的影响，显示出显著的影响(SMD = 0.2；IC del 95%: -0.39 a -0.01；p = 0.04)，异质性低（I2 = 0%）。7项研究分析了感知认知障碍（PCI）、感知认知能力（PCA）和对生活质量（QOL）的影响，而6项研究包括了他人的评论（OTH），显示出显著的总体效果(SMD = 0.39；IC del 95%: -0.58 a -0.19；结论：CT可有效改善乳腺癌患者的CRCI。然而，现有的证据质量较低，因此，仍有必要进行更大样本的高质量研究。
Effect of Cognitive Training on Cancer-Related Cognitive Impairment in Patients With Breast Cancer: A Systematic Review and Meta-Analysis.
Background: Cancer-related cognitive impairment (CRCI) associated with chemotherapy ('chemobrain') in patiens with breast cancer represents a challenging sequelae of cancer treatment. Cognitive training (CT) has shown potential to improve CRCI.
Aim: This systematic review with meta-analysis aimed to evaluate the efficacy of CT in improving CRCI in patients with breast cancer.
Methods: A systematic literature review was conducted in PubMed, Web of Science, Scopus, Embase, Cochrane Library, PsycInfo, CINAHL Complete, ClinicalTrials.gov and Psicodoc databases for studies published up to January 2025. Methodological quality was assessed using PRISMA, RoB 2 and the PEDro Scale. The protocol was registered in PROSPERO (CRD42025636745).
Results: Of 7751 studies identified, 11 met inclusion criteria and 9 were included in the meta-analysis. Eight studies assessed the effect of CT on the FACT-Cog scale global score, showing a significant effect (SMD = 0.2; IC del 95%: -0.39 a -0.01; p = 0.04), and low heterogeneity (I2 = 0%). Seven studies analysed perceived cognitive impairments (PCI), perceived cognitive abilities (PCA), and impact on quality of life (QOL), while six included comments from others (OTH), showing a significant overall effect (SMD = 0.39; IC del 95%: -0.58 a -0.19; p < 0.001), with no significant heterogeneity. There were significant improvements in PCI and PCA. Funnel plots analysis suggested possible publication bias.
Conclusions: CT could be effective in improving CRCI in patients with breast cancer. However, the existing evidence is of low quality and, therefore, higher quality studies with larger samples are still warranted.
期刊介绍：
Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology.
This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues.
Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.
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