Neuropsychiatric disorders in cancer patients

Current Opinion in Oncology

Volumn 8, Issue 3, 1996, Pages 182-187

  Baile, Walter F ^a  

^a UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ALPHA INTERFERON; ANTIDEPRESSANT AGENT; CORTICOSTEROID; CYCLOPHOSPHAMIDE; CYTOKINE; DEXAMETHASONE; DOXORUBICIN; FLUOROURACIL; FLUOXETINE; INTERLEUKIN 2; METHOTREXATE; TAMOXIFEN;

BRAIN INJURY; CANCER; CANCER CHEMOTHERAPY; HUMAN; NEUROPSYCHIATRY; PRIORITY JOURNAL; REVIEW;

EID: 0030001481     PISSN: 10408746     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001622-199605000-00003     Document Type: Review

References (31)

1. Meyers CA: Neuropsychological Aspects of Cancer and Cancer Treatment vol 8. In Physical Medicine and Rehabilitation State of the Art Reviews: Cancer Rehabilitation. Edited by Garden FH, Grabois M. Philadelphia: Hanley & Belfus; 1994:229-241. A brief, concise, and up-to-date summary of the effects of cancer and cancer treatment on the central nervous system by one of the experts in this area. The review covers the cognitive and psychological outcomes of chemotherapy and radiation therapy with a particularly strong section on cytokines. The paper references 112 articles, which lead the readers into the relevant literature in each of these areas.
2. Wieneke MH, Dienst ER: Neuropsychological assessment of cognitive functioning following chemotherapy for breast cancer. PsychoOncology 1995, 4:61-66.
3. Meyers CA, Valentine AD: Neurologic and psychiatric adverse effects of immunological therapy. CNS Drugs 1995, 3:56-68. A current review of the neurologic and psychiatric symptoms associated with the use of interferon, interleukin, and tumor necrosis factor. This paper touches on potential mechanisms of action and offers several suggestions for management including distinguishing patient reactions from psychiatric disorders associated with adjustment to the illness.
4. Forman A: Neurologic complications of cytokine therapy. Oncology 1994, 8:105-117.
5. Pavol MA, Meyers CA, Rexer JL, Valentine AD, Mattis PJ, Talpaz M: Pattern of neurobehavioral deficits associated with interferon alfa therapy for leukemia. Neurology 1995, 45:947-950. The authors used a battery of cognitive tests to show that frontocortical dysfunction associated with administration of interferon alfa was related to the duration of therapy. They suggested a number of mechanisms of action by which interferon may exert its effect.
6. Meyers CA, Valentine AD, Wong FCL, Leeds NE: Reversible neurotoxicity of interleukin-2 and tumor necrosis factor: correlation of SPECT with neuropsychological testing. J Neuropsychiatry Clin Neurosci 1994, 6:285-288. A case report of a patient who developed subacute reversible neurotoxicity with interleukin-2 and interferon treatment. Single photon emission CT scan performed while the patient was receiving treatment revealed bilateral decreased frontal lobe perfusion that reversed after the patient stopped receiving treatment.
7. Caraceni A, Marteni C, Belli F, Mascheroni L, Rivoltini L, Arienti F, Cascinelli N: Neuropsychological and neurophysiological assessment of the central effects of interleukin-2 administration. Eur J Cancer 1993, 29A:1266-1269.
8. Smith MJ, Mouawad R, Vuillemin E, Benhammouda A, Soubrane C, Khayat D: Psychological side-effects induced by interleukin 2/α interferon treatment. Psycho-Oncology 1994, 3:289-298.
9. Meyers CA, Yung WK: Delayed neurotoxicity of intraventricular interleukin-2: a case report. J Neuro-Oncol 1993, 15:265-267.
10. Baron DA, Hardie T, Baron SH: Possible association of interleukin 2 treatment with depression and suicide. J Am Osteopath Assoc 1993, 93:799-780.
11. Goldman LS: Successful treatment of interferon alfa induced mood disorder with nortriptyline. Psychosomatics 1995, 35:412-413.
12. Levenson J, Fallon H: Fluoxetine treatment of depression caused by interferon alpha. Am J Gastroenterol 1994, 88:760-761.
13. Valentine AD, Meyers CA, Talpaz M: Naltrexone alleviates interferon-α neurotoxicity in cancer patients. Cancer Invest 1995, 13:561-566. These authors explored the hypothesis that the neurotoxic effects of interferon alfa might be mediated by opiodlike effects. They conducted a small open trial of naltrexone with nine patients. Five patients showed improved cognitive and emotional functioning, one showed no change, and three could not tolerate the naltrexone. This study suggests that the use of opioid antagonists deserves more study as a remedy for neurotoxic side effects of interferon treatment.
14. Meyers CA, Weitzner M, Byrne K, Valentine A, Champlain R, Przepiorka D: Evaluation of the neurobehavioral functioning of patients before, during and after bone marrow transplantation. J Clin Oncol 1994, 12:820-826. The authors established a model for the study of the cognitive and neuropsychiatric effects of cancer treatment in this prospective study of bone marrow transplantation patients. Patients were administered a battery of neuropsychological and psychiatric tests prior to, during, and after bone marrow transplantation for hematologic malignancies. As many as 20% of patients had memory deficits at 8-month follow-up assessment. Interestingly, there was an inverse relationship between level of social support and mood and cognitive disturbance, which the authors attributed to increased mental stimulation and positive interactions.
15. Meyers CA, Weitzner MA: Neurobehavioral functioning and quality of life in patients treated for cancer of the central nervous system. Curr Opin Oncol 1995, 7:197-200.
16. Breitbart W, Stiefel F, Kornblith AB, Pannullo S: Neuropsychiatric disturbance in cancer patients with epidural spinal cord compression receiving high dose corticosteroids: a prospective study. Psycho-Oncology 1993, 2:233-245.
17. Amato R, Meyers C, Ellerhorst J, Finn L, Kilbourn R, Sella A, Logothetis C: A phase I trial of intermittent high-dose α-interferon and dexamethasone in metastatic renal cell carcinoma. Ann Oncol 1995, 6:911-914. This study of 30 patients with renal cell carcinoma confirmed previous findings that coadministration of dexamethasone improved the tolerance to intermittent high-dose interferon alfa.
18. Cunningham JD, Burt ME: Limbic encephalitis secondary to malignant thymoma. Ann Thorac Surg 1994, 58:250-251.
19. Komaki R, Meyers CA, Shin DM, Garden AS, Byrne K, Nickens JA, Cox JD: Evaluation of cognitive function in patients with limited small cell lung cancer prior to and shortly following prophylactic cranial irradiation. Int J Radiat Oncol Biol Phys 1995, 33:179-182.
20. Meyers CA, Byrne CA, Komaki R: Cognitive defects in patients with small cell lung cancer before and after chemotherapy. Lung Cancer 1995, 12:231-235. A comparison of untreated and newly diagnosed lung cancer patients with those already treated with chemoradiation suggests that cognitive deficits existed that were unlikely to be explained by a treatment effect. The authors raised the possibility of a subclinical paraneoplastic disorder as a possible etiology of the mental changes observed.
21. Weitzner MA, Meyers CA, Valentine AD: Methylphenidate in the treatment of neurobehavioral slowing associated with cancer and cancer treatment J Neuropsychiatr Clin Neurosci 1995, 7:347-350.
22. Weinrich S, Sarana L: Delirium in the older patient with cancer. Cancer 1994, 74:2079-2091. This overview of delirium provides some useful summary tables such as lists differentiating criteria for delirium versus depression and dementia and a list of selected instruments for diagnosing delirium.
23. de Stoutz N, Tapper M, Fainsinger RL: Reversible delirium in terminally ill patients. J Pain Symptom Manage 1995, 10:249-253.
24. Olofsson S, Weitzner MA, Valentine AD, Baile W, Meyers CA: Evaluation and management of delirium in the cancer patient. Support Care Cancer 1996, in press.
25. DiMaggio J, Brown R, Baile WF, Schapira D: Hallucinations and ifosfamide-induced neurotoxicity. Cancer 1994, 72:1509-1514.
26. Taylor D, Lewis S: Delirium. J Neurol Neurosurg Psychiatry 1993, 7:742-751.
27. Bruera E, Spachynsky K, MacEachern T, Hanson J: Cognitive failure in cancer patients in clinical trials. Lancet 1993, 341:247-248.
28. Smith M, Breitbart WS, Platt MM: A critique of instruments and methods to detect diagnose, and rate delirium. J Pain Symptom Manage 1996, 10:35-77.
29. Trzepacz PT: The neuropathogenesis of delirium: a need to focus our research. Psychosomatics 1994, 35:374-391.
30. Crippen DW: Pharmacological treatment of brain failure and delirium. Crit Care Clin 1994, 10:733-766. This review is written primarily for the intensive care unit physician, but anyone who is asked to help manage agitation in the critically ill patient will find it useful.
31. Bruera E, France JJ, Maltoni M, Watanabe S, Suarez-Almazor M: Changing pattern of agitated impaired mental status with advanced cancer: association with cognitive monitoring, hydration, and opioid rotation. J Pain Symptom Manage 1995, 10:287-291. A chart review of 279 patients following the adaptation of routine cognitive assessment and changes in mode of supportive care showed a reduction in the incidence of agitated delirium and the dose of neuroleptic needed for management.