Neurocognitive function (NCF) in long-term survivors of testicular cancer (TC)

Abstract

8034 Background: Cisplatin-based chemotherapy (CBCT) regimens are standard treatment for TC, delivering long-term survival and cure rates. However, cisplatin is a neurotoxin with documented iatrogenic nervous system effects, including neuronal degeneration and myelin thinning. TC occurs primarily in men aged 15 to 35, coinciding with maturation of the frontal lobes and the continuing myelination extending through middle adulthood. Thus, CBCT occurs at a time of increased neurocognitive vulnerabilty and may impact NCF. Despite recent interest in the neurocognitive sequelae of chemotherapy, little is known about the effects of CBCT on NCF in TC survivors. Method: This study compared NCF between TC survivors who had completed either CBCT (n = 16) or localized treatment (LT; n = 7). NCF was assessed with a standard neuropsychological battery. Participants also completed measures of psychological distress, fatigue, and quality of life (QOL). Results: Men ranged in age from 23–64 years (M = 41), were at least 2.5 years post-diagnosis (M = 7.4), and were primarily college educated (78%). Demographics, psychological distress, fatigue, and QOL did not differ between treatment groups (all ps > .3). Compared to men who received LT, men treated with CBCT demonstrated poorer performance on two executive function measures, Stroop Interference (p = .028), and the Penn Conditional Exclusion Test (PCET: p = .008). Increased PCET errors were associated with poorer Functional QOL (p = .007). Psychological distress and fatigue were unrelated to NCF (all ps ≥ .2). Conclusions: Although preliminary, these data suggest that TC survivors treated with CBCT have mild deficits in NCF that impact QOL. Given the similarity of the treatment groups, and that NCF was unrelated to psychological distress or fatigue, the most likely mechanism is cisplatin associated neurotoxicity. Larger scale studies are needed to elucidate the mechanisms underlying NCF deficits in TC survivors and to explore the real-life impact of these deficits on QOL. No significant financial relationships to disclose.