Cognitive Function in Patients With Prostate Cancer Receiving Luteinizing Hormone-Releasing Hormone Analogues: A Prospective, Observational, Multicenter Study

The effect of androgen deprivation therapy (ADT) on cognitive performance (CP) in prostate cancer (PCa) patients is not well understood. We evaluated changes in CP after 6 months of medical castration with luteinizing hormone-releasing hormone (LHRH) analogues. We performed a prospective, observatio...

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Published in:	International journal of radiation oncology, biology, physics Vol. 98; no. 3; pp. 590 - 594
Main Authors:	Morote, Juan, Tabernero, Ángel José, Álvarez Ossorio, José Luis, Ciria, Juan Pablo, Domínguez-Escrig, José Luis, Vázquez, Fernando, Angulo, Javier, López, Francisco J., de La Iglesia, Ramón, Romero, Jesús, Sanz, Juan Pablo, Vergez, Adolfo, Llorente, Carlos, Olivier, Carlos, Zapatero, Almudena, Pérez, Ana María, Fernández, Manuel, Macías, Víctor, Miñana, Bernardino, Gutiérrez, Carlos, Solsona, Eduardo, Benedicto, Antonio, Martínez, José, Gutiérrez, José Luis, Campá, Josep, Tirapuer, Blanca, Sánchez, Manuel
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-07-2017
Subjects:	Aged Androgen Antagonists - therapeutic use Anilides - therapeutic use Antineoplastic Agents, Hormonal - therapeutic use Cognition - drug effects Cognition - physiology Gonadotropin-Releasing Hormone - agonists Humans Male Memory - drug effects Memory - physiology Middle Aged Neoplasm Grading Nitriles - therapeutic use Prospective Studies Prostatic Neoplasms - drug therapy Prostatic Neoplasms - pathology Regression Analysis Tosyl Compounds - therapeutic use
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Summary:	The effect of androgen deprivation therapy (ADT) on cognitive performance (CP) in prostate cancer (PCa) patients is not well understood. We evaluated changes in CP after 6 months of medical castration with luteinizing hormone-releasing hormone (LHRH) analogues. We performed a prospective, observational, multicenter, open-label study of PCa patients scheduled to receive LHRH analogues for ≥6 months. We assessed 4 domains of CP at baseline and after 6 months of ADT: (1) working memory, assessed with the Wechsler Adult Intelligence Scale III (WAIS III) Digit Span subtest; (2) visual memory, assessed with an ad hoc visual memory test; (3) visuospatial ability, assessed with the Judgment of Line Orientation test and Mental Rotation of Three-Dimensional Objects test; and (4) nonverbal analytical reasoning, assessed with the WAIS III Matrix Reasoning test. Changes outside the baseline 95% confidence intervals were considered significant. A total of 308 patients completed the study. Of these, 245 (79.6%) experienced no statistically significant changes on any test whereas 63 (20.4%) experienced significant changes on ≥1 test. Most of these patients showed a change on only 1 test, distributed evenly between improvement (58 patients, 18.8%) and worsening (56 patients, 18.2%). For individual tests, most patients (87.8%-91.8%) had no change from baseline; however, the significant changes (improvement vs deterioration) were as follows: WAIS III Digit Span subtest (6.3% vs 5.9%), visual memory (5.3% vs 5.7%), Judgment of Line Orientation test (5.3% vs 4.5%), Mental Rotation of Three-Dimensional Objects test (4.1% vs 4.1%), and WAIS III Matrix Reasoning test (4.8% vs 5.8%). CP in patients with PCa does not appear to be adversely affected by 6 months of LHRH analogue administration.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Undefined-2
ISSN:	0360-3016 1879-355X
DOI:	10.1016/j.ijrobp.2017.02.219