Monitor for Cognitive Function Impairment in Patients With NPC After IMRT

Cognitive function is significantly and negatively correlated with sleep quality and negative affect in patients with NPC after IMRT.

Cognitive function deficits are a serious adverse effect of intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC), according to research recently published in Cancer Nursing. Clinicians are advised to closely monitor these patients for cognitive impairment.

Researchers evaluated the level of cognitive function, the factors that may influence cognitive function, and determine the mediating role of sleep quality between negative affect and cognitive function in patients with NPC following IMRT.

For this cross-sectional study, 200 patients with NPC who had received IMRT were recruited from a single tertiary cancer center in southern China. The mean age of the participants was 45.6 years; 76% were male and 24% were female.

The participants completed a demographic and disease-related questionnaire, then were screened for mild cognitive function impairment using the Montreal Cognitive Assessment Scale (MoCA). MoCA incorporates 7 dimensions, including naming, attention and computation, language, and others. The highest possible score is 30; the participants’ mean scores were 24.08 (SD, 3.61), or 24.42 (SD, 3.35) after adjustment.

This study revealed that more than half of the patients with NPC after IMRT reported cognitive function impairment.

The Profile of Mood States-Short Form (POMS-SF) was used to assess for negative affect, and the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate subjective sleep quality.

The findings show 54.5% of patients with NPC had cognitive function impairment following IMRT and 64% had a sleep disorder.

Correlation analysis demonstrated significant and negative associations between cognitive function and both negative affect and sleep quality. Income, education level, seeking rehabilitation knowledge, sleep quality, negative affect, and radiation dose, all of which were included in the regression model, accounted for 82.6% of the total variation in cognitive function.

“This study revealed that more than half of the patients with NPC after IMRT reported cognitive function impairment,” noted the researchers.

“Clinicians should pay close attention to the cognitive function of patients with poor educational levels, low income, difficulties in seeking rehabilitation knowledge, and patients who accept higher radiation doses. To prevent or reduce the occurrence of cognitive function impairments among patients with NPC after IMRT, medical professionals could improve the patients’ physical activity as a potentially effective intervention to alleviate the patients’ negative affect and improve their sleep quality.”

This article originally appeared on Oncology Nurse Advisor


Chen X, Fan Y, Yan M, Zhang J. The mediating role of sleep quality in the association between negative affect and cognitive function among patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy. Cancer Nursing. Published online April 24, 2023. doi: 10.1097/NCC.0000000000001236