Neuropsychiatric Disease and Treatment (Mar 2019)
Preliminary comparison of neuropsychological performance in patients with non-small-cell lung cancer treated with chemotherapy or targeted therapy
Abstract
Hsiu-Ling Kang,1,* Vincent Chin-Hung Chen,2,3,* Wei-Lin Hung,4 Han-Pin Hsiao,2 Wei-Han Wang4,5 1Department of Nursing, Chang Gung Memorial Hospital, Chiayi, Taiwan; 2Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Taiwan; 3School of Medicine, Chang Gung University, Taoyuan, Taiwan; 4Department of Psychology, Chung Shan Medical University, Taichung, Taiwan; 5Room of Clinical Neuropsychology, Department of Neurology, Chung Shan Medical University Hospital, Taichung, Taiwan *These authors contributed equally to this work Purpose: This cross-sectional pilot study aimed to compare the effects of chemotherapy and targeted therapy on neuropsychological performance and psychiatric symptoms in patients with non-small-cell lung cancer (NSCLC). Patients and methods: A total of 113 patients with NSCLC were recruited. According to their type of cancer treatment, the patients were classified into chemotherapy (n=40), targeted therapy (n=33), and untreated control (n=40) groups. All participants completed five objective tests measuring various domains of cognitive function, a subjective cognitive functioning scale (Functional Assessment of Cancer Therapy–Cognitive Function; FACT-cog), and the Hospital Anxiety and Depression Scale (HADS) either within 6 months after diagnosis (for the untreated group) or about 18 months after treatment. Results: Overall, there were no significant intergroup differences in the proportions of patients with abnormal cognitive performance and psychiatric disturbances. Among the untreated NSCLC patients, 35% had impaired performance in at least one cognitive domain, and a comparable finding (30%–35%) was made for the other two treatment groups. The proportion of patients with impaired psychomotor speed was the highest (10%–15%) across various cognitive domains. Moreover, a significant proportion of NSCLC patients (15%–20%) exhibited HADS-defined anxiety and depression disorder. Finally, significant correlations were found between FACT-cog total scores and the HADS Depression subscale across all three groups. Conclusion: This study demonstrated that 1) a substantial proportion of NSCLC patients exhibited cognitive impairments (especially regarding psychomotor speed) and psychiatric disturbances; 2) no significant differences were observed among the three patient groups for any subjective or objective measure of cognitive deficit; and 3) perceived cognitive impairment was significantly associated with depression or anxiety. Prompt treatment of psychiatric disorders to minimize their impact is therefore recommended. Keywords: non-small-cell lung cancer, neuropsychological performance, psychomotor speed, anxiety, depression
