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8 - Cognitive dysfunction related to chemotherapy and biological response modifiers

Published online by Cambridge University Press:  13 August 2009

By
Jeffrey S. Wefel ,
Robert Collins  and
Anne E. Kayl
Edited by
Christina A. Meyers  and
James R. Perry
Christina A. Meyers
Affiliation:
University of Texas, M. D. Anderson Cancer Center
James R. Perry
Affiliation:
University of Toronto
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Summary

Chemotherapy-related cognitive dysfunction

The successful management of many cancers has been achieved largely through aggressive use of therapy, which now generally combines surgery, radiation, chemotherapy, and immunotherapy. Many of these treatment strategies, including chemotherapy, are not highly specific and therefore place normal tissues and organs at risk. While the brain is afforded some protection from systemic treatments via the blood–brain barrier, it is increasingly recognized that many agents gain access to this environment via direct and/or indirect mechanisms, potentially contributing to central nervous system (CNS) toxicity. Furthermore, treatment strategies designed to disrupt or penetrate the blood–brain barrier are being explored as treatment options for a number of cancers including primary CNS lymphoma and brain metastases (Doolittle et al., 2006). Evidence will be presented supporting the existence of both chemotherapy-related cognitive dysfunction and unique neurobehavioral/psychiatric manifestations associated with biological response modifiers generally, and interferon alpha in particular.

Incidence and nature of chemotherapy-related cognitive dysfunction

Adult patients presenting with complaints of “chemobrain” or “chemofog” typically report cognitive symptoms arising soon after initiating treatment. For many patients, these symptoms persist even after therapy is complete. It is not uncommon for many patients and providers to treat these symptoms as an expected, albeit unfortunate, side-effect of treatment. Persistent symptoms are also a cause of considerable distress for individuals who are unable to return to their previous scholastic, occupational, or social activities (or are able to do so only with significant additional mental effort).

Type
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Cognition and Cancer , pp. 97 - 114
Publisher: Cambridge University Press
Print publication year: 2008

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References

Ahles, TA, Saykin, AJ, Noll, WWet al. (2003). The relationship of APOE genotype to neuropsychological performance in long-term cancer survivors treated with standard dose chemotherapy. Psychooncology 12: 612–619.CrossRefGoogle ScholarPubMed
Alcaraz, A, Rey, C, Concha, Aet al. (2002). Intrathecal vincristine: fatal myeloencephalopathy despite cerebrospinal fluid perfusion. J Toxicol Clin Toxicol 40: 557–561.CrossRefGoogle ScholarPubMed
Anderson-Hanley, C, Sherman, ML, Riggs, Ret al. (2003). Neuropsychological effects of treatments for adults with cancer: a meta-analysis and review of the literature. J Int Neuropsychol Soc 9: 967–982.CrossRefGoogle ScholarPubMed
Barton, D, Loprinzi, C (2002). Novel approaches to preventing chemotherapy-induced cognitive dysfunction in breast cancer: the art of the possible. Clin Breast Cancer 3 [Suppl. 3]: S121–S127.CrossRefGoogle ScholarPubMed
Bender, CM, Yasko, JM, Kirkwood, JMet al. (2000). Cognitive function and quality of life in interferon therapy for melanoma. Clin Nurs Res 9: 352–363.CrossRefGoogle ScholarPubMed
Bender, CM, Sereika, SM, Berga, SLet al. (2006). Cognitive impairment associated with adjuvant therapy in breast cancer. Psychooncology 15: 422–430.CrossRefGoogle ScholarPubMed
Birgegård, G, Aapro, MS, Bokemeyer, Cet al. (2005). Cancer-related anemia: pathogenesis, prevalence, and treatment. Oncology 68 [Suppl. 1], 3–11.CrossRefGoogle Scholar
Blalock, JE, Smith, EM (1980). Human leukocyte interferon: structural and biological relatedness to adrenocorticotropic hormones and endorphins. Proc Natl Acad Sci USA 77: 5972–5974.CrossRefGoogle ScholarPubMed
Blalock, JE, Stanton, JD (1980). Common pathways of interferon and hormonal action. Nature 283: 406–408.CrossRefGoogle ScholarPubMed
Brown, MS, Stemmer, SM, Simon, JHet al. (1998). White matter disease induced by high-dose chemotherapy: longitudinal study with MR imaging and proton spectroscopy. Am J Neuroradiol 19: 217–221.Google ScholarPubMed
Brown, WS, Marsh, JT, Wolcott, Det al. (1991). Cognitive function, mood and p3 latency: effects of the amelioration of anemia in dialysis patients. Neuropsychologia 29: 35–45.CrossRefGoogle ScholarPubMed
Büntzel, J, Küttner, K (1998). Chemoprevention with interferon alfa and 13-cis retinoic acid in the adjunctive treatment of head and neck cancer. Auris Nasus Larynx 25: 413–418.CrossRefGoogle ScholarPubMed
Capuron, L, Ravaud, A, Miller, AHet al. (2004). Baseline mood and psychosocial characteristics of patients developing depressive symptoms during interleukin-2 and/or interferon-alpha cancer therapy. Brain Behav Immun 18: 205–213.CrossRefGoogle ScholarPubMed
Caraceni, A, Gangeri, L, Martini, Cet al. (1998). Neurotoxicity of interferon-α in melanoma therapy: results from a randomized clinical trial. Cancer 83: 482–489.3.0.CO;2-S>CrossRefGoogle Scholar
Castellon, SA, Ganz, PA, Bower, JEet al. (2004). Neurocognitive performance in breast cancer survivors exposed to adjuvant chemotherapy and tamoxifen. J Clin Exp Neuropsychol 26: 955–969.CrossRefGoogle ScholarPubMed
Chen, Y, Lomnitski, L, Michaelson, DMet al. (1997). Motor and cognitive deficits in apolipoprotein E-deficient mice after closed head injury. Neuroscience 80: 1255–1262.CrossRefGoogle ScholarPubMed
Cirelly, R, Tyring, SK (1995). Major therapeutic uses of interferons. Clin Immunother 3: 27–87.CrossRefGoogle Scholar
Clark, JW (1996). Biological response modifiers. Cancer Chemother Biol Response Modif16: 239–273.Google ScholarPubMed
Crandall, J, Sakai, Y, Zhang, Jet al. (2004). 13-cis-Retinoic acid suppresses hippocampal cell division and hippocampal-dependent learning in mice. Proc Natl Acad Sci USA 101: 5111–5116.CrossRefGoogle ScholarPubMed
Cunningham, RS (2003). Anemia in the oncology patient: cognitive function and cancer. Cancer Nurs 26: 38S–42S.CrossRefGoogle ScholarPubMed
Delattre, JY, Posner, JB (1995). Neurological complications of chemotherapy and radiation therapy. In Aminoff MJ (ed.). Neurology and General Medicine (2nd edn.) (pp. 421–445). New York: Churchill Livingstone.Google Scholar
Dieperink, E, Willenbring, M, Ho, SB (2000). Neuropsychiatric symptoms associated with hepatitis C and interferon alpha: a review. Am J Psychiatry 157: 867–876.CrossRefGoogle ScholarPubMed
Doolittle, ND, Peereboom, DM, Christoforidis, GAet al. (2006). Delivery of chemotherapy and antibodies across the blood-brain barrier and the role of chemoprotection, in primary and metastatic brain tumors: report of the Eleventh Annual Blood-Brain Barrier Consortium meeting. J Neurooncol 81: 81–91.CrossRefGoogle Scholar
Eberling, JL, Wu, C, Tong-Turnbeaugh, Ret al. (2004). Estrogen- and tamoxifen-associated effects on brain structure and function. Neuroimage 21: 364–371.CrossRefGoogle ScholarPubMed
Egan, MF, Goldberg, TE, Kolachana, BSet al. (2001). Effect of COMT Val108/158 met genotype on frontal lobe function and risk for schizophrenia. Proc Natl Acad Sci USA 98: 6917–6922.CrossRefGoogle ScholarPubMed
Egan, MF, Kojima, M, Callicott, JHet al. (2003). The BDNF val66met polymorphism affects activity-dependent secretion of BDNF and human memory and hippocampal function. Cell 112: 257–269.CrossRefGoogle ScholarPubMed
Farkkila, M, Iivanainen, M, Roine, Ret al. (1984). Neurotoxic and other side effects of high dose interferon in amyotrophic lateral sclerosis. Acta Neurol Scand 70: 42–46.CrossRefGoogle ScholarPubMed
Fliessbach, K, Urbach, H, Helmstaedter, Cet al. (2003). Cognitive performance and magnetic resonance imaging findings after high-dose systemic and intraventricular chemotherapy for primary central nervous system lymphoma. Arch Neurol 60: 563–568.CrossRefGoogle ScholarPubMed
Garcia-Tena, J, Lopez-Andreu, JA, Ferris, Jet al. (1995). Intrathecal chemotherapy related myeloencephalopathy in a young child with acute lymphoblastic leukemia. Pediatr Hematol Oncol 12: 377–385.CrossRefGoogle Scholar
Gilbert, MR, Armstrong, TS (1996). Neurotoxicities. In Kirkwood, J, Lotze, M, J, Yasko (eds.) Current Cancer Therapeutics (2nd edn.) (pp. 364–371). Philadelphia, PA: Current Medicine.Google Scholar
Goldman, LS (1994). Successful treatment of interferon alfa-induced mood disorder with nortriptyline. Psychosomatics 35: 412–413.CrossRefGoogle ScholarPubMed
Green, HJ, Pakenham, KI, Headley, BCet al. (2002). Altered cognitive function in men treated for prostate cancer with luteinizing hormone-releasing hormone analogues and cyproterone acetate: a randomized controlled trial. BJU Int 90: 427–432.CrossRefGoogle ScholarPubMed
Groopman, JE, Itri, LM (1999). Chemotherapy-induced anemia in adults: incidence and treatment. J Natl Cancer Inst 91: 1616–1634.CrossRefGoogle ScholarPubMed
Haykin, ME, Gorman, M, Hoff, Jet al. (2006). Diffusion-weighted MRI correlates of subacute methotrexate-related neurotoxicity. J Neurooncol 76: 153–157.CrossRefGoogle ScholarPubMed
Heflin, LH, Meyerowitz, BE, Hall, Pet al. (2005). Cancer as a risk factor for long-term cognitive deficits and dementia. J Natl Cancer Inst 97: 854–856.CrossRefGoogle ScholarPubMed
Honigsberger, L, Fielding, JW, Priestman, TJ (1983). Neurological effects of recombinant human interferon. Br J Med 286: 719.CrossRefGoogle ScholarPubMed
Jansen, C, Miakowski, C, Dodd, Met al. (2005). Potential mechanisms for chemotherapy-induced impairments in cognitive function. Oncol Nurs Forum 32: 1151–1163.CrossRefGoogle ScholarPubMed
Jenkins, VA, Shilling, V, Fallowfield, Let al. (2004). Does hormone therapy for the treatment of breast cancer have a detrimental effect on memory and cognition? A pilot study. Psychooncology 13: 61–66.CrossRefGoogle ScholarPubMed
Jenkins, VA, Bloomfield, DJ, Shilling, VMet al. (2005). Does neoadjuvant hormone therapy for early prostate cancer affect cognition? Results from a pilot study. BJU Int 96: 48–53.CrossRefGoogle ScholarPubMed
Jenkins, V, Shilling, V, Deutsch, Get al. (2006). A 3-year prospective study of the effects of adjuvant treatments on cognition in women with early stage breast cancer. Br J Cancer 94: 828–834.CrossRefGoogle ScholarPubMed
Jensen, BV (2006). Cardiotoxic consequences of anthracycline-containing therapy in patients with breast cancer. Semin Oncol 33 [Suppl. 8]: S15–S21.CrossRefGoogle ScholarPubMed
Johnson, SA (2006). Anthracycline-induced cardiotoxicity in adult hematologic malignancies. Semin Oncol 33 [Suppl. 8]: S22–S27.CrossRefGoogle ScholarPubMed
Joshi, G, Sultana, R, Tangpong, Jet al. (2005). Free radical mediated oxidative stress and toxic side effects in brain induced by the anti cancer drug adriamycin: insight into chemobrain. Free Radic Res 39: 1147–1154.CrossRefGoogle ScholarPubMed
Juengling, FD, Ebert, D, Gut, Oet al. (2000). Prefrontal cortical hypometabolism during low-dose interferon alpha treatment. Psychopharmacology 152: 383–389.CrossRefGoogle ScholarPubMed
Kayl, AE, Wefel, JS, Meyers, CA (2006). Chemotherapy and cognition: effects, potential mechanisms and management. Am J Ther 13: 362–369.CrossRefGoogle ScholarPubMed
Keime-Guibert, F, Napolitano, M, Delattre, JY (1998). Neurological complications of radiotherapy and chemotherapy. J Neurol 245: 695–708.CrossRefGoogle ScholarPubMed
Kim, YA, Chung, HC, Choi, HJet al. (2006). Intermediate dose 5-fluorouracil-induced encephalopathy. Jpn J Clin Oncol 36: 55–59.CrossRefGoogle ScholarPubMed
Knobf, MT (2006). Reproductive and hormonal sequelae of chemotherapy in women. Am J Nurs 106 [Suppl. 3]: 60–65.CrossRefGoogle ScholarPubMed
Krajinovic, M, Robaey, P, Chiasson, Set al. (2005). Polymorphisms of genes controlling homocysteine levels and IQ score following treatment for childhood ALL. Pharmacogenomics 6: 293–302.CrossRefGoogle ScholarPubMed
Krause, I, Valesini, G, Scrivo, Ret al. (2003). Autoimmune aspects of cytokine and anticytokine therapies. Am J Med 115: 390–397.CrossRefGoogle ScholarPubMed
Kreukels, BPC, Schagen, SB, Ridderinkhof, KRet al. (2006). Effects of high-dose and conventional-dose adjuvant chemotherapy in patients with breast cancer: an electrophysiologic study. Clin Breast Cancer 7: 67–78.CrossRefGoogle Scholar
Lacosta, S, Merali, Z, Anisman, H (2000). Central monoamine activity following acute and repeated systemic interleukin-2 administration. Neuroimmunomodulation 8: 83–90.CrossRefGoogle ScholarPubMed
Largillier, R, Etienne-Grimaldi, MC, Formento, JLet al. (2006). Pharmacogenetics of capecitabine in advanced breast cancer patients. Clin Cancer Res 12: 5496–5502.CrossRefGoogle ScholarPubMed
Lee, BN, Dantzer, R, Langley, KEet al. (2004). A cytokine-based neuroimmunologic mechanism of cancer-related symptoms. Neuroimmunomodulation 11: 279–292.CrossRefGoogle ScholarPubMed
Linnebank, M, Pels, H, Klecza, Net al. (2005). MTX-induced white matter changes are associated with polymorphisms of methionine metabolism. Neurology 64: 912–913.CrossRefGoogle ScholarPubMed
Lipp, HP (1999). Neurotoxicity (including sensory toxicity) induced by cytostatics. In Lipp, HP (ed.). Anticancer Drug Toxicity: Prevention, Management, and Clinical Pharmacokinetics (pp. 431–453). New York: Marcel Dekker, Inc.Google Scholar
Lipshultz, SE (2006). Exposure to anthracyclines during childhood causes cardiac injury. Semin Oncol 33 [Suppl. 8]: 8–14.CrossRefGoogle ScholarPubMed
Madhyastha, S, Somayaji, SN, Rao, MSet al. (2002). Hippocampal brain amines in methotrexate-induced learning and memory deficit. Can J Physiol Pharmacol 80: 1076–1084.CrossRefGoogle ScholarPubMed
Malek-Ahmadi, P, Ghandour, E (2004). Bupropion for treatment of interferon-induced depression. Ann Pharmacother 38: 1202–1205.CrossRefGoogle ScholarPubMed
Malik, UR, Makower, DF, Wadler, S (2001). Interferon-mediated fatigue. Cancer 92 [Suppl]: 1664–1668.3.0.CO;2-9>CrossRefGoogle ScholarPubMed
Massa, E, Madeddu, C, Lusso, MRet al. (2006). Evaluation of the effectiveness of treatment with erythropoietin on anemia, cognitive functioning and functions studied by comprehensive geriatric assessment in elderly cancer patients with anemia related to cancer chemotherapy. Crit Rev Oncol Hematol 57: 175–182.CrossRefGoogle ScholarPubMed
Mayr, N, Zeitlhofer, J, Deecke, Let al. (1999). Neurological function during long-term therapy with recombinant interferon alpha. J Clin Neurosci 11: 343–348.Google ScholarPubMed
McAllister, TW, Ahles, TA, Saykin, AJet al. (2004). Cognitive effects of cytotoxic cancer chemotherapy: predisposing risk factors and potential treatments. Curr Psychiatr Rep 6: 364–371.CrossRefGoogle ScholarPubMed
McEwen, BS, Alves, SE (1999). Estrogen actions in the central nervous system. Endocr Rev 20: 279–307.Google ScholarPubMed
Menzies, R, Phelps, C, Wiranowska, Met al. (1996). The effect of interferon-alpha on the pituitary-adrenal axis. J Interferon Cytokine Res 16: 619–629.CrossRefGoogle ScholarPubMed
Meyers, CA, Valentine, AD (1995). Neurological and psychiatric effects of immunological therapy. CNS Drugs 3: 56–68.CrossRefGoogle Scholar
Meyers, CA, Scheibel, RS, Forman, AD (1991). Persistent neurotoxicity of systemically administered interferon-alpha. Neurology 41: 672–676.CrossRefGoogle ScholarPubMed
Meyers, CA, Kudelka, AP, Conrad, CAet al. (1997). Neurotoxicity of CI-980, a novel mitotic inhibitor. Clin Cancer Res 3: 419–422.Google ScholarPubMed
Meyers, CA, Weitzner, MA, Valentine, ADet al. (1998). Methylphenidate therapy improves cognition, mood, and function of brain tumor patients. J Clin Oncol 16: 2522–2527.CrossRefGoogle ScholarPubMed
Meyers, JN, Whiteside, TL (1996). Immunotherapy of squamous cell carcinoma of the head and neck. In Meyers, EN, Suen, JY (eds.). Cancer of the Head and Neck (pp. 805–817). Philadelphia, PA: WB Saunders Company.Google Scholar
Mihich, E (2000). Historical overview of biologic response modifiers. Cancer Invest 18: 456–466.CrossRefGoogle ScholarPubMed
Moleski, M (2000). Neuropsychological, neuroanatomical, and neurophysiological consequences of CNS chemotherapy for acute lymphoblastic leukemia. Arch Clin Neuropsychol 15: 603–630.CrossRefGoogle ScholarPubMed
Molina, JR, Barton, DL, Loprinzi, CL (2005). Chemotherapy-induced ovarian failure. Drug Safety 28: 401–416.CrossRefGoogle ScholarPubMed
Moor, BD (2005). Neurocognitive outcomes in survivors of childhood cancer. J Pediatr Psychol 30: 51–63.CrossRefGoogle Scholar
Mottet, N, Prayer-Galetti, T, Hammerer, Pet al. (2006). Optimizing outcomes and quality of life in the hormonal treatment of prostate cancer. BJU Int 98: 20–27.CrossRefGoogle ScholarPubMed
Musselman, DL, Lawson, DH, Gumnick, JFet al. (2001). Paroxetine for the prevention of depression induced by high-dose interferon alpha. N Engl J Med 344: 961–966.CrossRefGoogle Scholar
National Institutes of Health (2003). Biological Therapy. Treatments that use your Immune System to Fight Cancer. [Brochure]. NIH Publication No. 03–5406.
Nemeroff, CB, Krishnan, KR, Reed, Det al. (1992). Adrenal gland enlargement in major depression: a computed tomographic study. Arch Gen Psychiatry 49: 384–387.CrossRefGoogle ScholarPubMed
Okcu, MF, Selvan, M, Wang, Let al. (2004). Glutathione S-transferase polymorphisms and survival in primary malignant glioma. Clin Cancer Res 10: 2618–2625.CrossRefGoogle ScholarPubMed
O'Shaughnessy, JA, Svetislava, JV, Holmes, FAet al. (2005). Feasibility of quantifying the effects of epoetin alpha therapy on cognitive function in women with breast cancer undergoing adjuvant or neoadjuvant chemotherapy. Clin Breast Cancer 5: 439–446.CrossRefGoogle ScholarPubMed
Pavol, MA, Meyers, CA, Rexer, JLet al. (1995). Pattern of neurobehavioral deficits associated with interferon alpha therapy for leukemia. Neurology 45: 947–950.CrossRefGoogle ScholarPubMed
Penson, RT, Kronish, K, Duan, Zet al. (2000). Cytokines IL-1beta, IL-2, IL-6, IL-8, MCP-1, GM-CSF and TNF-alpha in patients with epithelial ovarian cancer and their relationship to treatment with paclitaxel. Int J Gynecol Cancer 1: 33–41.CrossRefGoogle Scholar
Pusztai, L, Mendoza, TR, Reuben, JMet al. (2004). Changes in plasma level of inflammatory cytokines in response to paclitaxel chemotherapy. Cytokine 25: 94–102.CrossRefGoogle ScholarPubMed
Quinn, CT, Kamen, BA (1996). A biochemical perspective of methotrexate neurotoxicity with insight on nonfolate rescue modalities. J Invest Med 44: 522–530.Google ScholarPubMed
Roe, CM, Behrens, MI, Xiong, Cet al. (2005). Alzheimer disease and cancer. Neurology 64: 895–898.CrossRefGoogle ScholarPubMed
Rottenberg, DA (ed.) (1991). Neurological Complications of Cancer Treatment. Boston, MA: Butterworth-Heinemann.
Saykin, AJ, Ahles, TA, McDonald, BC (2003). Mechanisms of chemotherapy-induced cognitive disorders: neuropsychological, pathophysiological, and neuroimaging perspectives. Semin Clin Neuropsychiatry 8: 201–216.Google ScholarPubMed
Schaefer, M, Engelbrecht, MA, Gut, Oet al. (2002). Interferon alpha (IFN-α) and psychiatric syndromes: a review. Prog Neuropsychopharmacol Biol Psychiatry 26: 731–746.CrossRefGoogle Scholar
Schaefer, M, Schwiger, M, Pich, Met al. (2003). Neurotransmitter changes by interferon-alpha and therapeutic implications. Pharmacopsychiatry 36 [Suppl. 3]: S203–S206.Google ScholarPubMed
Schagen, SB, Muller, MJ, Boogerd, Wet al. (2002). Cognitive dysfunction and chemotherapy: neuropsychological findings in perspective. Clin Breast Cancer 3 [Suppl]: S100–S108.CrossRefGoogle Scholar
Scheibel, RS, Valentine, AD, O'Brien, Set al. (2004). Cognitive dysfunction and depression during treatment with interferon alpha and chemotherapy. J Neuropsychiatry Clin Neurosci 16: 1–7.CrossRefGoogle ScholarPubMed
Schneiderman, B (2004). Hippocampal volumes smaller in chemotherapy patients. Lancet Oncol 5: 202.CrossRefGoogle ScholarPubMed
Shah, RR (2005). Mechanistic basis of adverse drug reactions: the perils of inappropriate dose schedules. Expert Opinion Drug Safety 4: 103–128.CrossRefGoogle ScholarPubMed
Shapiro, CL, Recht, A (2001). Drug therapy – side effects of adjuvant treatment of breast cancer. New Engl J Med 344: 1997–2008.CrossRefGoogle ScholarPubMed
Sheline, GE, Wara, WM, Smith, V (1980). Therapeutic irradiation and brain injury. Int J Radiat Oncol Biol Phys 6: 1215–1228.CrossRefGoogle ScholarPubMed
Shilling, V, Jenkins, V, Morris, Ret al. (2005). The effects of adjuvant chemotherapy on cognition in women with breast cancer – preliminary results of an observational longitudinal study. Breast 14: 142–150.CrossRefGoogle ScholarPubMed
Shin, DM, Khuri, FR, Murphy, Bet al. (2001). Combined interferon-alpha, 13-cis-retinoic acid, and alpha tocopherol in locally advanced head and neck squamous cell carcinoma: novel bioadjuvant phase II trial. J Clin Oncol 19: 3010–3017.CrossRefGoogle ScholarPubMed
Shin, DM, Glisson, BS, Khuri, FRet al. (2002). Phase II and biological study of interferon alpha, retinoic acid, and cisplatin in advanced squamous cell skin cancer. J Clin Oncol 20: 364–370.CrossRefGoogle Scholar
Shuper, A, Stark, B, Kornreich, Let al. (2000). Methotrexate treatment protocols and the central nervous system: significant cure with significant neurotoxicity. J Child Neurol 15: 573–580.CrossRefGoogle ScholarPubMed
Silverman, DH, Dy, CJ, Castellon, SAet al. (2007). Altered frontocortical, cerebellar, and basal ganglia activity in adjuvant-treated breast cancer survivors 5–10 years after chemotherapy. Breast Cancer Res Treat 103(3): 303–311.CrossRefGoogle Scholar
Smedley, H, Katrak, M, Sikora, Ket al. (1983). Neurological effects of recombinant interferon alpha. Br Med J 286: 262–264.CrossRefGoogle Scholar
Smith, A, Tyrrell, D, Coyle, Ket al. (1988). Effects of interferon alpha on performance in man: a preliminary report. Psychopharmacology 96: 414–416.CrossRefGoogle ScholarPubMed
Spiegel, RJ (1989). The alpha interferons: clinical overview. Urology 34: 75–79.CrossRefGoogle ScholarPubMed
Staat, K, Segatore, M (2005). The phenomenon of chemo brain. Clin J Oncol Nurs 9: 713–721.CrossRefGoogle ScholarPubMed
Steinherz, LJ, Yahalom, J (1993). Cardiac complications of cancer therapy. In DeVita, VT, Hellman, S, Rosenberg, SA (eds.) Cancer Principles and Practice of Oncology (4th edn.) (pp. 2370–2385). Philadephia, PA: J.B. Lippincott Company.Google Scholar
Strite, D, Valentine, AD, Meyers, CA (1997). Manic episodes in two patients treated with interferon alpha. J Neuropsychiatry 9: 273–276.Google ScholarPubMed
Sul, JK, DeAngelis, LM (2006). Neurologic complications of cancer chemotherapy. Semin Oncol 33: 324–332.CrossRefGoogle ScholarPubMed
Taphoorn, MJB, Klein, M (2004). Cognitive deficits in adult patients with brain tumors. Lancet Neurol 3: 159–168.CrossRefGoogle Scholar
Taylor, JL, Grossberg, SE (1998). The effects of interferon-α on the production and action of other cytokines. Semin Oncol 25 [Suppl. 1]: S3–S29.Google ScholarPubMed
Tompkins, WA (1999). Immunomodulation and therapeutic effects of the oral use of interferon-α: mechanism of action. J Interferon Cytokine Res 19: 817–828.CrossRefGoogle ScholarPubMed
Tsavaris, N, Kosmas, C, Vadiaka, Met al. (2002). Immune changes in patients with advanced breast cancer undergoing chemotherapy with taxanes. Br J Cancer 87: 21–27.CrossRefGoogle ScholarPubMed
Valentine, AD, Meyers, CA (2005). Neurobehavioral effects of interferon therapy. Curr Psychiatry Rep 7: 391–395.CrossRefGoogle ScholarPubMed
Valentine, AD, Meyers, CA, Talpaz, M (1995). Treatment of neurotoxic side effects of interferon-alpha with naltrexone. Cancer Invest 13: 561–566.CrossRefGoogle ScholarPubMed
Valentine, AD, Meyers, CA, Kling, MAet al. (1998). Mood and cognitive side effects of interferon-α therapy. Semin Oncol 25: 39–47.Google ScholarPubMed
Wagner, LI, Sweet, JJ, Desa, Jet al. (2005). Prechemotherapy hemoglobin (Hgb) and cognitive impairment among breast cancer patients. J Clin Oncol 23: 760S.CrossRefGoogle Scholar
Wefel, JS, Meyers, CA (2005). Cancer as a risk factor for dementia: a house built on shifting sand. J Natl Cancer Inst 97: 788–789.CrossRefGoogle ScholarPubMed
Wefel, JS, Lenzi, R, Theriault, Ret al. (2004a). “Chemobrain” in breast cancer? A prologue. Cancer 101: 466–475.CrossRefGoogle ScholarPubMed
Wefel, JS, Lenzi, R, Theriault, Ret al. (2004b). The cognitive sequelae of standard dose adjuvant chemotherapy in women with breast cancer: results of a prospective, randomized, longitudinal trial. Cancer 100: 2292–2299.CrossRefGoogle ScholarPubMed
Weiss, RB, Vogelzang, NJ (1993). Miscellaneous toxicities. In DeVita, VT, Hellman, S, Rosenberg, SA (eds.) Cancer Principles and Practice of Oncology (4th edn.) (pp. 2349–2358). Philadelphia, PA: JB Lippincott Company.Google Scholar
Wood, LJ, Nail, LM, Gilster, Aet al. (2006). Cancer chemotherapy-related symptoms: evidence to suggest a role for proinflammatory cytokines. Oncol Nurs Forum 33: 535–542.CrossRefGoogle ScholarPubMed
Yaffe, K, Sawaya, G, Lieberburg, Iet al. (1998). Estrogen therapy in postmenopausal women effects of cognitive function and dementia. J Am Med Assoc 279: 688–695.CrossRefGoogle ScholarPubMed
Yoshikawa, E, Matsuoka, Y, Inagaki, Met al. (2005). No adverse effects of adjuvant chemotherapy on hippocampal volume in Japanese breast cancer survivors. Breast Cancer Res Treat 92: 81–84.CrossRefGoogle ScholarPubMed
Zaloga, GP, Bhatt, B, Marik, P (2001). Critical illness and systemic inflammation. In Becker, KL (ed.) Endocrinology and Metabolism (3rd edn.) (pp. 2068–2076). Philadelphia, PA: Lippincott Williams & Wilkins.Google Scholar

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