经过几十年的研究，目前已明确患有非神经系统肿瘤的病人在患病过程及其治疗过程中，肿瘤相关认知障碍(CRCI)是非常常见的。2015年3月发表于《临床医生癌症杂志》(CA-A cancer journal for clinicians)对成人非神经系统肿瘤相关认知障碍的发病机制、临床特点及治疗方案进行了综述。

根据严重程度和症状,CRCI可分为多种，在疾病早期或后期均可以出现。轻度到中等的CRCI表观和内在典型症状表现在记忆力、注意力、行动力以及行为的快慢。利用动物模型和新的神经成像技术能够揭示CRCI潜在病理生理机制，包括炎性级联反应的作用、直接神经毒性、干细胞损伤、脑白质异常，以及连接功能损伤性等。该文章对初期CRCI的干预治疗，效果以及药理机制研究进行了分析。

文章指出目前对于CRCI的研究多数集中在乳腺癌，对于其他癌症的研究很少。同时，作者提出了一项假设案例研究，阐述了CRCI目前临床情况，以及目前常规做法。

参考文献：Wefel, Jeffrey S. et al. CA-A cancer journal for clinicians. 2015;65(2):123-138

英文链接：Clinical characteristics, pathophysiology, and management of noncentral nervous system cancer-related cognitive impairment in adults.

http://onlinelibrary.wiley.com/doi/10.1002/caac.v65.2/issuetoc

ClinicalCharacteristics,Pathophysiology,andManagementofNoncentralNervousSystemCancer-RelatedCognitiveImpairmentinAdults

原文摘要：

Over the past few decades, a bodyofresearch has emerged confirming what many adult patients withnoncentralnervoussystemcancerhave long reportedthatcancerand its treatment are frequently associated withcancer-relatedcognitiveimpairment(CRCI). The severityofCRCI varies, and symptoms can emerge early or lateinthe disease course. Nonetheless, CRCI is typically mild to moderateinnature and primarily involves the domainsofmemory, attention, executive functioning, and processing speed. Animal models and novel neuroimaging techniques have begun to unravel the pathophysiologic mechanisms underlying CRCI, including the roleofinflammatory cascades, direct neurotoxic effects, damage to progenitor cells, white matter abnormalities, and reduced functional connectivity, among others. Given the paucityofresearch on CRCI with othercancerpopulations, this review synthesizes the current literature with a deliberate focus on CRCI within the contextofbreastcancer. A hypothetical case-study approach is used to illustrate how CRCI often presents clinically and how current science can inform practice. While the literature regarding intervention for CRCI is nascent, behavioral and pharmacologic approaches are discussed.