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Neuropsychological effects of treatments for adults with cancer: A meta-analysis and review of the literature

Published online by Cambridge University Press:  12 February 2004

CAY ANDERSON-HANLEY
Affiliation:
Skidmore College and the Cancer Center at Glens Falls Hospital, Glens Falls, New York
MARNE L. SHERMAN
Affiliation:
University of Missouri–Kansas City and The Cancer Institute, Kansas City, Missouri
RAINE RIGGS
Affiliation:
Brown University School of Medicine, Providence, Rhode Island
V. BEDE AGOCHA
Affiliation:
University of Connecticut, Farmington, Connecticut
BRUCE E. COMPAS
Affiliation:
Vanderbilt University, Nashville, Tennessee

Abstract

A meta-analysis was conducted to evaluate possible neuropsychological effects of treatments for cancer in adults. A search revealed 30 studies, encompassing 29 eligible samples, and leading to inclusion of a total of 838 patients and control participants. A total of 173 effect sizes (Cohen's d) were extracted across 7 cognitive domains and as assessed in the literature via 3 methods of comparison (post-treatment compared with normative data, controls, or baseline performance). Statistically significant negative effect sizes were found consistently across both normative and control methods of comparison for executive function, verbal memory, and motor function. The largest effects were for executive function and verbal memory normative comparisons (−.93 and −.91, respectively). When limiting the sample of studies in the analyses to only those with relatively “less severe” diagnoses and treatments, the effects remained. While these results point toward some specific cognitive effects of systemic cancer therapies in general, no clear clinical implications can yet be drawn from these results. More research is needed to clarify which treatments may produce cognitive decrements, the size of those effects, and their duration, while ruling out a wide variety of possible mediating or moderating variables. (JINS, 2003, 9, 967–982.)

Type
Research Article
Copyright
© 2003 The International Neuropsychological Society

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