Evaluation of a web based cognitive rehabilitation programme (CRP) in cancer survivors reporting cognitive symptoms following chemotherapy — ASN Events
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Evaluation of a web based cognitive rehabilitation programme (CRP) in cancer survivors reporting cognitive symptoms following chemotherapy (#18)

Victoria J Bray 1 , Haryana M Dhillon 2 , Melanie Bell 3 , Michael Kabourakis 2 , Holly Rice 2 , Desmond Yip 4 5 , Frances Boyle 6 7 , Melanie Price 2 , Janette L Vardy 2 8
  1. Medical Oncology, Liverpool Hospital, Sydney, NSW, Australia
  2. Centre for Medical Psychology & Evidence-based Decision-making, University of Sydney, Sydney, NSW, Australia
  3. University of Arizona, Arizona, United States
  4. Medical Oncology, The Canberra Hospital, Canberra, ACT, Australia
  5. ANU Medical School, Australian National University, Canberra, ACT, Australia
  6. Medical Oncology, Mater Hospital , Sydney, NSW, Australia
  7. University of Sydney, Sydney, NSW, Australia
  8. Medical Oncology, Concord Cancer Centre, Sydney, NSW, Australia

Background:

Self reported cognitive impairment is frequently seen in cancer survivors. We evaluated a CRP in cancer patients with cognitive symptoms.

Methods:

243 cancer patients who had completed adjuvant chemotherapy within 6-60 months and reported changes in memory and/or concentration on EORTC-QLQ-CF, received a 30-minute phone consultation and were randomised to a 15-week, home-based CRP (Insight™) or usual care (UC). Primary endpoint was self reported cognitive function (FACT-COG Perceived Cognitive Impairment [PCI] subscale). Secondary endpoints included: neuropsychological (NP) testing (CogState™), quality of life (QOL) and fatigue (FACT-F), anxiety/depression (GHQ), and stress (PSS). Primary analysis used linear mixed models comparing the difference in FACT-COG PCI between the 2 arms at each post baseline timepoint: post intervention (T2) and 6 months later (T3).

Results:

243 patients were randomised: median age 53 (range 23-74); 95% female; 89% breast cancer; 5% colorectal cancer. There were no significant differences between the groups at baseline. There was a significant improvement in all FACT-COG subscales in the CRP group compared to UC at T2. FACT-COG PCI was statistically different with lower PCI in the CRP group at T2 (p<0.0001), sustained at T3 (p=0.0002). NP results were not significantly different between the groups at T2 or T3. There were significantly lower levels of anxiety and depression and fatigue in the CRP group at T2, with a trend towards benefit at T3. There were significant improvements in stress in the CRP group at both time points. There was no significant difference in global QOL between the groups at T2, but the CRP group had better global QOL at T3. Of those randomised to the CRP, 86% utilised the intervention.

Conclusions:

The web-based CRP Insight™ led to improvements in cognitive symptoms that were sustained at 6 months compared to phone consultation alone. This is the first large RCT showing an improvement in cognitive function in cancer survivors. This is a feasible treatment option that we would recommend to cancer survivors reporting cognitive symptoms.

#COSA2015