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The impact of chemotherapy on subjective cognitive complaints in breast cancer: Evidence from pooled analyses with longitudinal studies.

e24050 Background: Subjective cognitive impairment (SCI) is one of the most commonly occurring symptoms in breast cancer patients. Chemotherapy (CTX) may be an important contributing factor to SCI, yet its association with SCI has been inconclusive. The meta-analysis with longitudinal data can provide more conclusive evidence as to the impact of CTX on SCI. This meta-analysis aimed to (a) determine whether CTX is associated with time-dependent SCI outcomes in breast cancer patients with pooled longitudinal data and (b) identify at the time point with the highest impact of CTX on SCI. Methods: Data were collected from Pubmed, EMBASE, CINAHL, PsychInfo, and the Cochrane library in November 2020. Effect sizes (Hedges’ g) were calculated for the mean differences of the SCI level between the CTX treated patients and controls. Data were analyzed by and across clinical time periods; during CTX, within 1-month-post CTX, within 1-year-post CTX, and 1-year or longer post-CTX. Results: The longitudinal data were pooled with 9 data sets from 13 studies, including 857 patients treated by CTX, 410 patients not treated by CTX, and 517 healthy subjects. At baseline, CTX patients showed significantly better SCI compared to the non-CTX patient controls (ES=0.17, p=.031) and did not differ from healthy controls (ES = -0.04, p = .77). The CTX-treated patients had significantly worse SCI compared to both type of controls after initiating CTX. The effect sizes for the group differences were larger for the group comparison with healthy controls than the non-CTX control (- 0.16 for the comparison with non-CTX control, -0.51 for comparison with the healthy control). The largest time effect was found at the time point of within 1-month-post CTX in comparison with the healthy control (- 0.81). Conclusions: Our analysis indicated the association of CTX with SCI. Yet, more studies are needed to confirm the impact of CTX as (a) the effect size for the comparison with non-CTX control is very small and (b) limited data on the comparison with controls at the time point during active CTX and immediately after CTX. [Table: see text]