Neurocognitive function in head and neck cancer patients prior to treatment

Neurocognitive impairment is a common and clinically important problem in patients with cancer, but few studies have been conducted in head and neck cancer (HNC) patients. Our aims were to (1) determine the prevalence of baseline neurocognitive impairment in patients with newly diagnosed HNC, (2) examine the relationships between neurocognitive performance and self-reported neurocognitive function, and (3) explore relationships between neurocognitive function and sociodemographic, clinical, symptom distress, and mood variables. Seventy patients underwent testing with a brief neuropsychological test battery and completed self-report measures before starting treatment. Forty-seven percent of HNC patients in the current cohort exhibited global neurocognitive impairment on neuropsychological testing prior to starting induction chemotherapy or concurrent chemoradiation. Impairment was more common in the following neurocognitive domains: verbal learning (36%), executive function (32%), verbal memory (30%), and processing speed (27%). Neurocognitive performance was not associated with self-reported neurocognitive function. Few significant associations were noted between neurocognitive performance and other physical or psychological symptoms; however, moderately strong associations were found between self-reported neurocognitive function and these symptoms. Neurocognitive impairment is common in patients with newly diagnosed HNC before starting treatment. The impact of pretreatment neurocognitive impairment on treatment tolerance, treatment outcomes, and caregiving needs are important areas for future research. Mechanisms of pretreatment neurocognitive impairment also need to be explored.