Preliminary comparison of neuropsychological performance in patients with non-small-cell lung cancer treated with chemotherapy or targeted therapy

Hsiu-Ling Kang; Vincent Chin-Hung Chen; Wei-Lin Hung; Han-Pin Hsiao; Wei-Han Wang

doi:10.2147/NDT.S194642

Preliminary comparison of neuropsychological performance in patients with non-small-cell lung cancer treated with chemotherapy or targeted therapy

Neuropsychiatr Dis Treat. 2019 Mar 28:15:753-761. doi: 10.2147/NDT.S194642. eCollection 2019.

Authors

Hsiu-Ling Kang¹, Vincent Chin-Hung Chen^{2

3}, Wei-Lin Hung⁴, Han-Pin Hsiao², Wei-Han Wang^{4

5}

Affiliations

¹ Department of Nursing, Chang Gung Memorial Hospital, Chiayi, Taiwan.
² Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Taiwan.
³ School of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁴ Department of Psychology, Chung Shan Medical University, Taichung, Taiwan, whwang@csmu.edu.tw.
⁵ Room of Clinical Neuropsychology, Department of Neurology, Chung Shan Medical University Hospital, Taichung, Taiwan, whwang@csmu.edu.tw.

Abstract

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: anxiety; depression; neuropsychological performance; non-small-cell lung cancer; psychomotor speed.