The impact of cognitive impairment on treatment toxicity, treatment completion, and survival among older adults receiving chemotherapy: a systematic review

Sattar, Schroder, Haase, Kristen, Tejero, Isabel, Bradley, Cara, Mariano, Caroline, Kilgour, Heather, Verma, Ridhi, Amir, Eitan and Alibhai, Shabbir 2022. The impact of cognitive impairment on treatment toxicity, treatment completion, and survival among older adults receiving chemotherapy: a systematic review. Cancers 14 (6) , 1582. 10.3390/cancers14061582

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Abstract

Cognitive impairment (CI) is common among older adults with cancer, but its effect on cancer outcomes is not known. This systematic review sought to identify research investigating clinical endpoints (toxicity risk, treatment completion, and survival) of chemotherapy treatment in those with baseline CI. A systematic search of five databases (inception to March 2021) was conducted. Eligible studies included randomized trials, prospective studies, and retrospective studies in which the sample or a subgroup were older adults (aged ≥ 65) screened positive for CI prior to receiving chemotherapy. Risk of bias assessment was performed using the Quality in Prognosis Studies (QUIPS) tool. Twenty-three articles were included. Sample sizes ranged from n = 31 to 703. There was heterogeneity of cancer sites, screening tools and cut-offs used to ascertain CI, and proportion of patients with CI within study samples. Severity of CI and corresponding proportion of each level within study samples were unclear in all but one study. Among studies investigating CI in a qualified multivariable model, statistically significant findings were found in 4/6 studies on survival and in 1/1 study on nonhematological toxicity. The lack of robust evidence indicates a need for further research on the role of CI in predicting survival, treatment completion, and toxicity among older adults receiving chemotherapy, and the potential implications that could shape treatment decisions.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Healthcare Sciences
Additional Information:	This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/)
Publisher:	MDPI
ISSN:	2072-6694
Date of First Compliant Deposit:	17 June 2022
Date of Acceptance:	15 March 2022
Last Modified:	16 Jun 2023 22:12
URI:	https://orca.cardiff.ac.uk/id/eprint/150587

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