Dataset Information

Intrinsic brain activity changes associated with adjuvant chemotherapy in older women with breast cancer: a pilot longitudinal study.

ABSTRACT:

Purpose

Older cancer patients are at increased risk of cancer-related cognitive impairment. The purpose of this study was to assess the alterations in intrinsic brain activity associated with adjuvant chemotherapy in older women with breast cancer.

Methods

Chemotherapy treatment (CT) group included sixteen women aged ≥ 60 years (range 60-82 years) with stage I-III breast cancers, who underwent both resting-state functional magnetic resonance imaging (rs-fMRI) and neuropsychological testing with NIH Toolbox for Cognition before adjuvant chemotherapy, at time point 1 (TP1), and again within 1 month after completing chemotherapy, at time point 2 (TP2). Fourteen age- and sex-matched healthy controls (HC) underwent the same assessments at matched intervals. Three voxel-wise rs-fMRI parameters: amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity, were computed at each time point. The changes in rs-fMRI parameters from TP1 to TP2 for each group, the group differences in changes (the CT group vs. the HC group), and the group difference in the baseline rs-fMRI parameters were assessed. In addition, correlative analysis between the rs-fMRI parameters and neuropsychological testing scores was also performed.

Results

In the CT group, one brain region, which included parts of the bilateral subcallosal gyri and right anterior cingulate gyrus, displayed increased ALFF from TP1 to TP2 (cluster p-corrected = 0.024); another brain region in the left precuneus displayed decreased fALFF from TP1 to TP2 (cluster level p-corrected = 0.025). No significant changes in the rs-fMRI parameters from TP1 to TP2 were observed in the HC group. Although ALFF and fALFF alterations were observed only in the CT group, none of the between-group differences in rs-fMRI parameter changes reached statistical significance.

Conclusions

Our study results of ALFF and fALFF alterations in the chemotherapy-treated women suggest that adjuvant chemotherapy may affect intrinsic brain activity in older women with breast cancer.

SUBMITTER: Chen BT

PROVIDER: S-EPMC6551279 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Intrinsic brain activity changes associated with adjuvant chemotherapy in older women with breast cancer: a pilot longitudinal study.

Chen Bihong T BT Jin Taihao T Patel Sunita K SK Ye Ningrong N Ma Huiyan H Wong Chi Wah CW Rockne Russell C RC Root James C JC Saykin Andrew J AJ Ahles Tim A TA Holodny Andrei I AI Prakash Neal N Mortimer Joanne J Waisman James J Yuan Yuan Y Li Daneng D Sedrak Mina S MS Vazquez Jessica J Katheria Vani V Dale William W

Breast cancer research and treatment 20190413 1

<h4>Purpose</h4>Older cancer patients are at increased risk of cancer-related cognitive impairment. The purpose of this study was to assess the alterations in intrinsic brain activity associated with adjuvant chemotherapy in older women with breast cancer.<h4>Methods</h4>Chemotherapy treatment (CT) group included sixteen women aged ≥ 60 years (range 60-82 years) with stage I-III breast cancers, who underwent both resting-state functional magnetic resonance imaging (rs-fMRI) and neuropsychologica ...[more]

PMID: 30989462

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Project description:BackgroundCognitive decline is among the most feared treatment-related outcomes of older adults with cancer. The majority of older patients with breast cancer self-report cognitive problems during and after chemotherapy. Prior neuroimaging research has been performed mostly in younger patients with cancer. The purpose of this study was to evaluate longitudinal changes in brain volumes and cognition in older women with breast cancer receiving adjuvant chemotherapy.MethodsWomen aged ≥ 60 years with stage I-III breast cancer receiving adjuvant chemotherapy and age-matched and sex-matched healthy controls were enrolled. All participants underwent neuropsychological testing with the US National Institutes of Health (NIH) Toolbox for Cognition and brain magnetic resonance imaging (MRI) prior to chemotherapy, and again around one month after the last infusion of chemotherapy. Brain volumes were measured using Neuroreader™ software. Longitudinal changes in brain volumes and neuropsychological scores were analyzed utilizing linear mixed models.ResultsA total of 16 patients with breast cancer (mean age 67.0, SD 5.39 years) and 14 age-matched and sex-matched healthy controls (mean age 67.8, SD 5.24 years) were included: 7 patients received docetaxel and cyclophosphamide (TC) and 9 received chemotherapy regimens other than TC (non-TC). There were no significant differences in segmented brain volumes between the healthy control group and the chemotherapy group pre-chemotherapy (p > 0.05). Exploratory hypothesis generating analyses focusing on the effect of the chemotherapy regimen demonstrated that the TC group had greater volume reduction in the temporal lobe (change = - 0.26) compared to the non-TC group (change = 0.04, p for interaction = 0.02) and healthy controls (change = 0.08, p for interaction = 0.004). Similarly, the TC group had a decrease in oral reading recognition scores (change = - 6.94) compared to the non-TC group (change = - 1.21, p for interaction = 0.07) and healthy controls (change = 0.09, p for interaction = 0.02).ConclusionsThere were no significant differences in segmented brain volumes between the healthy control group and the chemotherapy group; however, exploratory analyses demonstrated a reduction in both temporal lobe volume and oral reading recognition scores among patients on the TC regimen. These results suggest that different chemotherapy regimens may have differential effects on brain volume and cognition. Future, larger studies focusing on older adults with cancer on different treatment regimens are needed to confirm these findings.Trial registrationClinicalTrials.gov, NCT01992432 . Registered on 25 November 2013. Retrospectively registered.

Project description:ImportanceFrailty assessed at a single time point is associated with mortality in older women with breast cancer. Little is known about how changes in frailty following cancer treatment initiation affect mortality.ObjectiveTo evaluate the association between claims-based frailty trajectories following adjuvant chemotherapy initiation and 5-year mortality in older women with stage I to III breast cancer.Design, setting, and participantsThis longitudinal cohort study used the Surveillance, Epidemiology, and End Results cancer registries linked to Medicare claims data (claims from 2003-2019). Women aged 65 years or older with stage I to III breast cancer diagnosed from 2004 to 2017 were included. Eligible women underwent breast surgery followed by adjuvant chemotherapy as initial treatment. A landmark design was used to identify frailty trajectories during the year following chemotherapy initiation. Continuous enrollment in Medicare fee-for-service from 180 days before cancer diagnosis through 360 days following chemotherapy initiation (landmark) was required. Women who died or disenrolled before the landmark were excluded. Analyses were conducted between September 2022 and March 2024.ExposuresClaims-based frailty trajectories during the 360 days following chemotherapy initiation were identified using the Faurot frailty index, a validated claims-based proxy for frailty based on demographics and diagnosis, procedure, and durable medical equipment claims. The Faurot frailty index was calculated every 30 days from chemotherapy initiation through the landmark (360 days after chemotherapy initiation). Claims-based frailty trajectory clusters were identified using longitudinal K-means clustering.Main outcomes and measuresAssociations between the claims-based frailty trajectory clusters and 5-year mortality from the landmark were estimated using Kaplan-Meier analysis.ResultsIn total, 20 292 women with breast cancer (median [IQR] age, 70 [67-74] years) were identified. The K-means analysis resulted in 6 trajectory clusters: 3 robust (16 120 women [79.4%]) or resilient (3259 [16.1%]) trajectories and 3 nonresilient trajectories (913 women [4.5%]). Five-year mortality was higher in women belonging to the 3 nonresilient trajectories compared with those belonging to the 3 resilient trajectories (52.1% vs 20.3%; difference, 31.8%; 95% CI, 29.0%-36.2%).Conclusions and relevanceIn this cohort study of women with stage I to III breast cancer, frailty changes following chemotherapy initiation were associated with long-term survival. Future research should assess the association of frailty interventions following cancer treatment initiation with survival and patient-centered outcomes in this population.

Dataset Information

Intrinsic brain activity changes associated with adjuvant chemotherapy in older women with breast cancer: a pilot longitudinal study.

Purpose

Methods

Results

Conclusions

Publications

Intrinsic brain activity changes associated with adjuvant chemotherapy in older women with breast cancer: a pilot longitudinal study.

Similar Datasets

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