Cognitive Rehabilitation Program to Improve Cognition of Cancer Patients Treated with Chemotherapy: A Randomized Controlled Multicenter Trial.

11521 Background: Cognitive impairment induced by cancer chemotherapy (CT) has been identified as an important side-effect with negative impact on quality of life (QoL) without specific treatment. We evaluated the impact of computer-assisted cognitive rehabilitation (CR) on cognitive complaint, objective cognitive dysfunction and QoL among cancer patients treated with CT. Methods: We included cancer patients with cognitive complaint occurring during CT or within 5 years of the end of CT. Patients were randomly assigned in a 1:1:1 ratio to face-to-face CR with a neuropsychologist (group A), home cognitive exercises (group B) or phone follow-up (group C) with 9 sessions over 3 months. Cognition was assessed by the Functional Assessment of Cancer Therapy Cognitive Function (FACT-Cog) completed by a neuropsychological battery of test and QoL assessment by the FACT-General (FACT-G). The primary endpoint was the proportion of patients with 7-point improvement in the perceived cognitive impairments (PCI) of the FACT-Cog between baseline (T0) and the end of the program (T3). Results: 167 patients were enrolled, median age was 50 years [43-59] and 96% were women with mainly breast cancer. Compliance rate with completion of all sessions was 76, 61 and 75% respectively. Proportion of patients with 7-point PCI improvement were 73, 55 and 56% without reaching the statistically significant difference between group A and B (p = 0.07) and group A and C (p = 0.08). The mean difference in PCI score were 17, 10 and 10 (p = 0.03). Patients with CR improved their working memory with significant difference between group A and C (1.4 versus 0.3, p < 0.001) but not between group A and B (1.4 versus 1.1, p = 0.43). There was a significant impact of CR on the FACT-Cog subscale score of QoL (p = 0.01) in favor of the group A, but not on the different dimensions of the FACT-G. Patients in group A presented improvement in depression compared to group B and C: -6.5 versus -1.7 and -2.3 (p = 0.03). Conclusions: CR with a neuropsychologist improves cognitive complaint. Cognitive stimulation showed improvements in working memory. CR was associated with better QoL linked to cognitive disorders and lower levels of depression. Clinical trial information: NCT01788618.