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Journal of Clinical Oncology, 2008 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 26, No 15S (May 20 Supplement), 2008: 5035
© 2008 American Society of Clinical Oncology
Long-term cognitive function among testicular cancer survivors treated with chemotherapy
J. Skoogh, Jr.,
G. Steineck,
U. K. Stierner,
E. Cavllin-Ståhl,
U. Olofsson,
A. Wallin,
M. Gatz and
B. Johansson
Kliniska Vetenskaper, Gothenburg, Sweden; Clinical Cancer Epidemiology, Karolinska Institutet, Stockholm, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden; Lund University Hospital, Lund, Sweden; Institute of Neuroscience and Physiology, Gothenburg, Sweden; University of Southern California, Los Angeles, CA; Department of Psychology, Gothenburg, Sweden
5035
Background: We have studied cognitive function among testicular cancer patients survivors treated with chemotherapy compared with those only treated surgically. Method: In Sweden, men diagnosed with non-seminomatous testicular cancer have prospectively been registered in SWENOTECA since 1981. During 2007 we followed up men diagnosed up to 2004; from the register we obtained clinical information about the treatment given. During a two-year period we developed a study-specific questionnaire primarily on cognitive functions. We also formulated questions about well-being and neurological symptoms. The questionnaire, extensively tested for validity, built on 40 in-depth interviews and a format developed at our division (Clinical Cancer Epidemiology). Results: We obtained information from 987/1220 (82%) testicular cancer patients survivors four to 21 years after the diagnosis. Prevalence of a "little, moderately or much" (versus none) affected well-being due difficulties "finding words and other language difficulties" was 17 percent among those having received no chemotherapy versus 36 percent among those having received 5 or more cycles, giving a prevalence ratio ("relative risk", RR) of 2.1 with a 95 percent confidence interval of 1.4–3.1. Corresponding figures for "slow thinking speed" was 1.9 (1.2–3.0), "memory" 1.8 (1.2–2.7) and "concentration" 1.7 (1.2–2.4). We found statistically significant poorer results on 5 of 7 analyzed language questions for those treated with 5 cycles or more of chemotherapy compared with those only treated surgically. The highest risk was for ‘producing similar but incorrect words‘ were those treated with 5 cycles or more of chemotherapy had a 3.2 higher risk (95% CI, 1.5–6.8) compared with those only treated surgically. Five or more cycles, as compared to no chemotherapy, resulted in having decreased feeling of touch in finger and toes (RR 7.0, 3.1–15.9). Conclusion: Patients needing more than the 4 cycles of chemotherapy are at risk of developing not only neurological but also cognitive long-term side-effects, eg concerning language function, which can affect well-being. Our results can be used to provide patients (both before and after treatment) with information about cognitive side-effects that may develop due to chemotherapy.
No significant financial relationships to disclose.
Abstract presentation from the 2008 ASCO Annual Meeting
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