Furthermore, participants treated with anthracyclines were found to have significantly lower left precuneus connectivity (F = 7.48; P = .001), an area involved in memory and other cognitive functions, compared with the other groups, while participants treated with non-anthracycline chemotherapy had lower levels of connectivity in the right middle central gyrus and left precuneus compared to those who had no history of chemotherapy. Left precuneus connectivity was not associated with a history of endocrine treatment or the number of chemotherapy treatments.
“These results suggest that anthracyclines may have greater negative effects than nonanthracycline regimens on particular cognitive domains and brain network connections,” the authors wrote. “These results should be considered preliminary given the study limitations of small sample size and retrospective, cross sectional design.”
In an accompanying editorial, Kelly N. H. Nudelman, PhD, of the Center for Neuroimaging at Indiana University School of Medicine in Indianapolis, and colleagues noted that while preliminary, the study’s results are a significant step forward in better identifying the difference in effects of chemotherapy treatments.
“While previous studies have linked chemotherapy and cognitive decline, and a few other studies have linked treatment with differences in brain connectivity, there has been very little research comparing cognitive effects of different types and combinations of chemotherapy because most studies have been under-powered to distinguish these effects,” they wrote. “This present study builds on preclinical work and, although modest in power to detect regimen differences, represents an important step forward while underscoring the need for larger studies.”
- Kesler SR, Blayney DW. Neurotoxic Effects of Anthracycline- vs Nonanthracycline-Based Chemotherapy on Cognition in Breast Cancer Survivors. JAMA Oncol. 2015; doi:10.1001/jamaoncol.2015.4333.
- Nudelman KNH, McDonald BC, Saykin AJ. Imaging Brain Networks After Cancer and Chemotherapy Advances Toward Etiology and Unanswered Questions. JAMA Oncol. 2015; doi:10.1001/jamaoncol.2015.4551.