Chemobrain: Mysteries and the importance of their revelation

Yıl 2022, Cilt: 42 Sayı: 4, 257 - 275, 01.12.2022

Meltem Tuncer

https://doi.org/10.52794/hujpharm.1100269

Öz

Chemotherapy can be associated with both acute and delayed toxic effects on the central nervous system. Among the most commonly reported neurotoxic adverse effects in adult and pediatric cancer patients treated with chemotherapeutics are mood alterations and neurocognitive symptoms, such as disruption of memory, impaired attention, concentration, processing speed, and executive function. As a consequence of cancer therapy, these cognitive deficits that occur at any point during or following chemotherapy are called chemotherapy-related cognitive dysfunction or “chemobrain”. Notably, such symptoms can be progressive even after cessation of therapy and might significantly compromise the quality of life in affected patients who are unable to return to their prior social and academic level of performance. Trying to unpick the chemobrain’s pathophysiology has become a major challenge since patients undergoing chemotherapy have an increased risk of depression, anxiety, and other mood disorders, all of which can have a negative and interacting effect on cognitive function. The purpose of this review is to define and review what is known about this poorly understood phenomenon and unravel the mysteries of “chemobrain”, and summarize therapeutic avenues.

Anahtar Kelimeler

chemotherapy, cognitive dysfunction, chemo-fog, central neurotoxicity, cancer

Kemobeyin: Gizemleri ve Açığa Çıkarılmasının Önemi

Öz

Kemoterapi, merkezi sinir sisteminde hem akut hem de gecikmiş toksik etkilerle ilişkilendirilebilmektedir. Kemoterapötikler ile tedavi edilen yetişkin ve pediatrik kanser hastalarında en sık bildirilen nörotoksik yan etkiler arasında duygudurum değişiklikleri ve hafıza kaybı, dikkat eksikliği, odaklanmada zorluk, işlem hızı ve yürütme işlevindeki bozukluklar gibi nörobilişsel semptomlar yer almaktadır. Kanser tedavisinin bir sonucu olarak, kemoterapi sırasında veya sonrasında görülen bu bilişsel sorunlara kemoterapi ile ilişkili bilişsel işlev bozukluğu veya
“kemobeyin” denilmektedir. Bu tür semptomlar tedavinin kesilmesi sonrasında da ilerleyebilmekte ve önceki sosyal ve akademik performans seviyelerine geri dönemeyen hastalarda yaşam kalitesini önemli ölçüde bozabilmektedir. Kemoterapinin neden olduğu bilişsel işlev bozukluğunun patofizyolojisini açığa çıkarmak kolay değildir. Zira, tümü bilişsel işlev üzerinde olumsuz ve etkileşimli bir etkiye sahip olabilen depresyon, anksiyete ve diğer duygudurum bozuklukları kemobe- yine eşlik edebilmektedir. Bu derlemenin amacı, tam olarak anlaşılamayan kemobeyin hakkında bilinenleri tanımlamak, gözden geçirmek, bilinmeyenleri açığa çıkarmak ve mevcut tıbbi koşullar altındaki tedavi yaklaşımlarını özetlemektir.

Anahtar Kelimeler

kemoterapi, bilişsel işlev bozukluğu, kemo bulanıklığı, merkezi nörotoksisite, kanser

Kaynakça

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