A systematic review of rehabilitation programs for cognitive impairment related to breast cancer: Different programs at different times?

Marianne Merceur; Karen T Reilly; Isabelle Bonan; Julie Holé; Emilie Hummel; Mélanie Cogné; Sophie Jacquin-Courtois

doi:10.1016/j.rehab.2024.101832

A systematic review of rehabilitation programs for cognitive impairment related to breast cancer: Different programs at different times?

Ann Phys Rehabil Med. 2024 Mar 26;67(5):101832. doi: 10.1016/j.rehab.2024.101832. Online ahead of print.

Authors

Marianne Merceur¹, Karen T Reilly², Isabelle Bonan³, Julie Holé⁴, Emilie Hummel⁵, Mélanie Cogné³, Sophie Jacquin-Courtois⁶

Affiliations

¹ Rehabilitation Medicine Unit, University Hospital of Rennes, 2 rue Henri Le Guilloux, 35000 Rennes, France. Electronic address: marianne.merceur@chu-rennes.fr.
² Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, TRAJECTOIRES, 95 Boulevard Pinel, 69500 Bron, France.
³ Rehabilitation Medicine Unit, University Hospital of Rennes, 2 rue Henri Le Guilloux, 35000 Rennes, France.
⁴ Physical Medicine and Rehabilitation Department, Henry Gabrielle Hospital, Hospices Civils de Lyon, 20 route de Vourles, 69230 Saint Genis Laval, France.
⁵ Hybrid team, Inria, Campus de Beaulieu, 263 Av. Général Leclerc, 35042 Rennes, France.
⁶ Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, TRAJECTOIRES, 95 Boulevard Pinel, 69500 Bron, France; Hybrid team, Inria, Campus de Beaulieu, 263 Av. Général Leclerc, 35042 Rennes, France.

PMID: 38537525
DOI: 10.1016/j.rehab.2024.101832

Abstract

Background: "Cancer Related Cognitive Impairment" (CRCI) defines cognitive disorders related to cancer and its treatments. Many people with breast cancer experience signs of CRCI (incidence between 20 and 30 %) and, although several intervention options exist, there is no established standard of care. Our main objective was to provide a detailed description of the methods and results of randomized controlled trials of interventions for CRCI in breast cancer survivors, paying particular attention to the timing of the interventions within the care pathway.

Methods: We conducted a systematic literature review following the PRISMA guidelines from 01 to 01-2019 to 16-07-2023 and included randomized controlled trials of interventions for CRCI after breast cancer with at least one objective cognitive assessment as a primary or secondary outcome.

Results: Among 228 identified studies, 35 (including 2821 participants) were retained for inclusion. The interventions were classified into 4 categories: cognitive rehabilitation, physical activity, complementary therapy and pharmacological treatment. Our analysis revealed that pharmacological interventions have no effect, whereas physical activity interventions proposed in the months following the initial cancer treatment improve Quality of Life and Speed of Information Processing while interventions proposed later improve Memory and Attention (Cognitive Rehabilitation) and Perceived Cognitive Function and Depression/Anxiety/Mood (Complementary Therapies).

Conclusion: CRCI is multifactorial and affected individuals frequently experience high levels of fatigue, pain, anxiety and depression and are most likely to benefit from holistic approaches that include cognition, physical activity, relaxation, psychoeducation, group support and/or psychological counselling. Thus, rehabilitation programs should be designed on multi-modal approaches, using innovative, cost-effective delivery methods that increase access to treatment, and intervention outcomes should be evaluated using measures of participation.

Database registration: The review was recorded on Prospero (01-03-2020), with the registration number 135,627.

Keywords: Breast cancer; Cancer related cognitive impairment; Cognitive function; Self-reported cognitive function; Systematic review.

Publication types

Review