Biomarkers of cemotherapy-induced cognitive impairment in elderly patients

2020 Fiscal Year Final Research Report

• Project/Area Number: 19K21577
• Research Category: Grant-in-Aid for Challenging Research (Exploratory)
• Allocation Type: Multi-year Fund
• Review Section: Studies on the Super-Aging Society
• Research Institution: The University of Tokyo
• Principal Investigator: SUMITANI MASAHIKO 東京大学, 医学部附属病院, 准教授 (80420420)
• Project Period (FY): 2019-06-28 – 2021-03-31
• Keywords: 化学療法 / 認知機能障害 / 高齢者

Outline of Final Research Achievements

Middle-aged and younger cancer patients participated in this study. Blood sample analyses, cognitive function test and brain MRI volumetry were conducted at the following 6 time points: before the start of chemotherapy, at the time of each administration, at the end of 6 months, and at 1 year after the chemotherapy. Generalized linear mix model analyses were statistically used to compare these two patient groups. Neural axonal injury biomarker, pNF-H, did not demonstrate the interact effect between the two groups, but the pNF-H positive rate and cumulative serum levels increased according to the times of chemotherapy administrations. There were no changes in brain MRI volumetry, however, there was the interaction effect in some brain regions. In the middle-aged group, some of the brain regions, which demonstrate the interaction effect, became decreased according to the complete of the chemotherapy regimen. The other brain regions, demonstrating the interaction, became increased.

Free Research Field

緩和医療学

Academic Significance and Societal Importance of the Research Achievements

化学療法の受療に伴う認知機能の低下（ケモブレイン）が観察されたが、抑うつ・不安の心理的問題も並行して生じているため、これによる影響は否定できない。また、pNF-Hの増加が観察されたが脳領域の明らかな萎縮は観察されておらず、その一方で化学療法誘発性ニューロパチーがpNF-H陽性化・増加と並行しており、pNF-Hは末梢神経系での神経ダメージの可能性も考えられた。中高齢者では各計測項目で群間差がある際に化学療法前の状態悪かった。したがって、これら計測項目の術前状態に応じて神経保護戦略と神経ダメージのスクリーニングを強化する必要が考えられる。