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Randomized Controlled Trial
. 2023 Dec;17(6):1583-1595.
doi: 10.1007/s11764-022-01261-5. Epub 2022 Oct 15.

A randomised controlled trial evaluating two cognitive rehabilitation approaches for cancer survivors with perceived cognitive impairment

Janette L Vardy  1   2   3 , Gregory R Pond  4 , Melanie L Bell  5 , Corrinne Renton  6 , Ann Dixon  6 , Haryana M Dhillon  6
Affiliations
Randomized Controlled Trial

A randomised controlled trial evaluating two cognitive rehabilitation approaches for cancer survivors with perceived cognitive impairment

Janette L Vardy et al. J Cancer Surviv. 2023 Dec.

Abstract

Purpose: Up to 70% of survivors report cognitive symptoms after chemotherapy. We compared two cognitive rehabilitation programs to a control group in cancer survivors.

Methods: Study population were adult cancer survivors with cognitive symptoms 6-60 months after adjuvant chemotherapy. Participants randomised to: Attention Process Training (APT), Compensatory Strategy Training (CST), or control group. Active interventions comprised 6-week, 2-h/week small group sessions.

Assessments: pre- and post-intervention, 6- and 12-months later. Primary outcome was change in cognitive symptoms (FACT-COG-PCI subscale) between baseline and post-intervention. Secondary endpoints included objective neuropsychological performance, Functional Impact Assessment (FIA), patient-reported outcome measures, and associations. Analyses were on an intention-to-treat basis. Analysis of covariance mixed models were used for continuous outcomes.

Results: Sixty-five participants were randomised (APT n = 21; CST n = 24; controls n = 20): 94% breast cancer, median age 54. Median time since chemotherapy 20.7 months. FACT-COG-PCI, clinical neuropsychological T-scores, and FIA improved in all groups over time, but no significant differences between arms. On mean neuropsychological T-scores 19/65 (29%) were impaired at baseline; post-intervention impairment controls 31.3%, CST 16.7%, APT 20.0%. On FIA at baseline, nine were impaired; this decreased to three post-intervention (one/group). FACT-COG-PCI was weakly associated with neuropsychological tests (rho = 0.24, p = 0.051) at baseline, and had no association with FIA. Neuropsychological total mean T-score was moderately positively associated with FIA (rho = 0.37, p = 0.003).

Conclusion: There were no significant differences between intervention groups and controls using linear mixed models adjusted for baseline scores.

Implications for cancer survivors: Cognitive symptoms and neuropsychological test scores improve over time.

Keywords: Cancer-related cognitive impairment; Cognitive rehabilitation; Cognitive symptoms; Randomised control trial.

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Conflict of interest statement

The authors declare no competing interests.

The authors have declared no conflicts of interest.

Figures

Fig. 1
Fig. 1
Consort diagram
See this image and copyright information in PMC

References

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