Cisplatin-based therapy: A neurological and neuropsychological review

The present paper reviews research in the area of the broad-spectrum chemot herapeutic agent cisplatin (cis-diamminedichloro-platinum II) and examines the implications for clinical neuropsychology arising from the neurological disruption associated with cisplatin-based therapy. The paper begins with a brief review of cisplatin treatment in terms other than survival alone, a nd examines the side-effects and the potential central nervous system (CNS) dysfunction in terms of neurological symptoms and concomitant implications for neuropsychology. Two main implications for clinical neuropsychology ar ising from cisplatin therapy are identified. First, cisplatin therapy impac ts upon the psychological well-being of the patient, particularly during an d in the months following treatment. It is suggested that during this time, a primary role for neuropsychology is to focus upon the monitoring and the active enhancement of the patient's social, psychological and spiritual re sources. Second, with regard to neurocognitive changes, the review suggests that (1) neurocognitive assessment may not yield stable results within 8 m onths following treatment and (2) while perceptual, memory, attentional and executive dysfunction may be predicted following cisplatin treatment, litt le systematic research has been carried out to investigate such a possibili ty. Future research might profitably address this issue and also specifical ly examine the effects of low dosage cisplatin-based therapy and the effect s of recently developed neuroprotective agents. Finally, there is some evid ence to suggest that women may be more susceptible to neurotoxicity during cisplatin therapy, but no gender-related cognitive effects are reported in the cisplatin literature. Future research could usefully investigate gender differences in association with cisplatin chemotherapy. Copyright (C) 2000 John Wiley & Sons, Ltd.