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

Abstract

e14018 Background: 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. Cognitive changes and disfunction after cancer chemotherapy are increasingly reported as a disturbing side-effect in cancer survivors. 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 six months after treatment (T2). Changes in neuropsychological test scores at T0, T1 and T2 were compared with a two tail t-test (T1-T0, T2-T1, T2-T0), using the repeated measure ANOVA model. Results: We have analyzed cognitive impairment (Mini Mental State Examination, MMSE), visuo-spatial memory, information processing speed (Trial Making Test-A and Trial Making Test-B), verbal memory (Rey Auditory Verbal Learning Test), emotional distress (Psychological Distress Inventory), anxiety (State and Trait Anxiety Inventory) and depression (Beck Depression Inventory). We found no cognitive impairment in time considered, as we found a median MMSE score of 27,51 ± 1,21 at T0, 27,63 ± 0,65 at T1 and 27,26 ± 1,17 at T2. We noticed some transient variations in tests evaluating verbal memory and in information processing speed performances. The only significative scores modifications were those related to anxiety and depression. Conclusions: We found no significant 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.