Digital multimodal intervention for cancer-related cognitive impairment in breast-cancer patients: Cog-Stim feasibility study

This feasibility study evaluated adherence and effectiveness to a digital multimodal intervention (cognitive and physical training) for cancer-related cognitive impairment (CRCI) in patients with breast cancer. Breast cancer patients undergoing radiotherapy and with significant cognitive complaints impacting quality of life participated in a 12-week intervention, combining non-simultaneous 20-min cognitive and 30-min physical sessions, twice weekly. Assessments included perceived cognitive impairment (PCI), objective cognition, fatigue, anxiety/depression, sleep and satisfaction. High level of adherence was defined as completing 9/12 weeks of the program. A week was complete when at least 70% of each of the planned sessions was completed. Physical activity intensity was defined by max age-related heart rate. Among 419 radiotherapy-treated patients with breast cancer, 170 had cognitive complaints (41%), 83 were eligible (49%), 29 were not included (35%) due to organizational issue and 20 among eligible contacted patients agreed to participate (37%). The majority of participants (48.3 ± 8 years of age) received chemotherapy (18/20) and 17 had I-II cancer stage. Eleven of twenty participants were highly adherent (higher adherence in physical (95%) than cognitive training (55%)). All expressed satisfaction. Post-intervention, overall objective cognition (p = 0.016), PCI (p = 0.004), fatigue (p = 0.011), and depression (p = 0.049) significantly improved. Post-intervention, high adherence was associated with significant improvements in PCI (p = 0.01) and fatigue (p = 0.03). High-intensity physical training was associated with significant improvements in PCI (p < 0.05), fatigue (p = 0.011) and depression (p = 0.037). This intervention showed to be feasible and potentially efficient for the management of CRCI in patients with breast cancer. NCT04213365, 27/12/2019.