CAJ | 학술논문

化疗相关性认知功能损害（chemotherapy - related cognitive impairment，CRCI）是指脑部无原发性或转移性肿瘤的癌症患者在接受化疗期间或化疗后出现的轻微认知功能下降。CRCI 的研究开始于20世纪70年代，但直到20世纪90年代国际上才出现对 CRCI 的一致性重要认识。研究报道 CRCI 的发生率为16%-75%，症状持续数月到超过20年。目前，有三种方法可以评估认知功能，即神经心理学测验、神经影像学研究和主观评估，但缺乏金标准。CRCI 的发生机制在很大程度上仍然是未知的；然而，一些可能的重要机制已经被确认，包括化疗药物的直接神经毒性、DNA 损伤与氧化应激、细胞因子、压力与糖皮质激素、雌激素、癌症本身及海马神经发生等。迄今，CRCI 缺乏特异、安全且有效的预防和治疗方法。因此，进一步研究 CRCI的确切机制及预防或逆转措施至关重要。
화료상관성인지공능손해（chemotherapy - related cognitive impairment，CRCI）시지뇌부무원발성혹전이성종류적암증환자재접수화료기간혹화료후출현적경미인지공능하강。CRCI 적연구개시우20세기70년대，단직도20세기90년대국제상재출현대 CRCI 적일치성중요인식。연구보도 CRCI 적발생솔위16%-75%，증상지속수월도초과20년。목전，유삼충방법가이평고인지공능，즉신경심이학측험、신경영상학연구화주관평고，단결핍금표준。CRCI 적발생궤제재흔대정도상잉연시미지적；연이，일사가능적중요궤제이경피학인，포괄화료약물적직접신경독성、DNA 손상여양화응격、세포인자、압력여당피질격소、자격소、암증본신급해마신경발생등。흘금，CRCI 결핍특이、안전차유효적예방화치료방법。인차，진일보연구 CRCI적학절궤제급예방혹역전조시지관중요。
Chemotherapy - related cognitive impairment(CRCI),a subtle cognitive decline after chemotherapy a-mong cancer patients with non - central nervous system cancers,was described since the 1970s,but significant recog-nition of CRCI did not emerge with consistency until the late 1990s. Estimates of frequency now range from 16% -75% ,and evidence suggests that CRCI may persistent from some months to more than twenty years. Three options to assess cognitive function at present include neuropsychologic testing,neuroimaging studies,and subjective evaluations, although no gold standard currently exists. The mechanisms for CRCI are largely unknown. However,several candidate mechanisms have been identified,which include direct neurotoxicity of chemotherapeutic drugs,DNA damage and oxi-dative stress,cytokines,stress and glucocorticoid,estrogen,the cancer itself and hippocampal neurogenesis. Treatment options for survivors with cognitive problems are limited because research in this arena is in its infancy. Therefore,fur-ther investigation into the exact mechanisms of CRCI,and interventions either to prevent the cognitive problems or to reverse the deficits are crucial.