A randomised controlled trial evaluating two cognitive rehabilitation approaches for cancer survivors with perceived cognitive impairment

Janette L. Vardy, Gregory R. Pond, Melanie L. Bell, Corrinne Renton, Ann Dixon, Haryana M. Dhillon

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Purpose: Up to 70% of survivors report cognitive symptoms after chemotherapy. We compared two cognitive rehabilitation programs to a control group in cancer survivors. Methods: Study population were adult cancer survivors with cognitive symptoms 6–60 months after adjuvant chemotherapy. Participants randomised to: Attention Process Training (APT), Compensatory Strategy Training (CST), or control group. Active interventions comprised 6–week, 2–h/week small group sessions. Assessments: pre- and post-intervention, 6- and 12-months later. Primary outcome was change in cognitive symptoms (FACT-COG-PCI subscale) between baseline and post-intervention. Secondary endpoints included objective neuropsychological performance, Functional Impact Assessment (FIA), patient-reported outcome measures, and associations. Analyses were on an intention-to-treat basis. Analysis of covariance mixed models were used for continuous outcomes. Results: Sixty-five participants were randomised (APT n = 21; CST n = 24; controls n = 20): 94% breast cancer, median age 54. Median time since chemotherapy 20.7 months. FACT-COG-PCI, clinical neuropsychological T-scores, and FIA improved in all groups over time, but no significant differences between arms. On mean neuropsychological T-scores 19/65 (29%) were impaired at baseline; post-intervention impairment controls 31.3%, CST 16.7%, APT 20.0%. On FIA at baseline, nine were impaired; this decreased to three post-intervention (one/group). FACT-COG-PCI was weakly associated with neuropsychological tests (rho = 0.24, p = 0.051) at baseline, and had no association with FIA. Neuropsychological total mean T-score was moderately positively associated with FIA (rho = 0.37, p = 0.003). Conclusion: There were no significant differences between intervention groups and controls using linear mixed models adjusted for baseline scores. Implications for Cancer Survivors: Cognitive symptoms and neuropsychological test scores improve over time.

Original languageEnglish (US)
Pages (from-to)1583-1595
Number of pages13
JournalJournal of Cancer Survivorship
Issue number6
StatePublished - Dec 2023


  • Cancer-related cognitive impairment
  • Cognitive rehabilitation
  • Cognitive symptoms
  • Randomised control trial

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)


Dive into the research topics of 'A randomised controlled trial evaluating two cognitive rehabilitation approaches for cancer survivors with perceived cognitive impairment'. Together they form a unique fingerprint.

Cite this