化疗在癌症治疗结果方面有显著的积极影响，能够减少复发和死亡率。然而，许多癌症幸存儿童和成年人在学习、记忆、注意力、执行功能和处理速度方面受到异常的化疗神经毒性影响。这种化疗相关的认知障碍（CICI）被称为“化疗脑”或“化疗脑雾”。尽管化疗对认知的不良影响已经普遍存在，但关于化疗如何对癌症幸存者的认知产生有害影响的机制仍不清楚。此外，目前还没有获得批准的治疗措施来应对这种情况。为了填补这一知识的空白，本综述试图确定腺苷信号转导，尤其是通过腺苷A2A受体，如何成为减轻加速衰老表型的重要工具。值得注意的是，腺苷A2A受体在癌症治疗和改善认知方面处于十字路口的位置，因为它被广泛认为可控制肿瘤微环境中引起的免疫抑制，同时也被认为是神经退行性疾病中认知的重要调节因子。因此，我们建议腺苷A2A受体可能提供一种多方位的治疗策略，以增强抗癌活性，同时对抗化疗引起的认知缺陷，这两者对于提供针对癌症幸存者加速衰老的新型治疗干预措施至关重要。版权所有 © 2023 Elsevier Inc.

Chemotherapy has a significant positive impact in cancer treatment outcomes, reducing recurrence and mortality. However, many cancer surviving children and adults suffer from aberrant chemotherapy neurotoxic effects on learning, memory, attention, executive functioning, and processing speed. This chemotherapy-induced cognitive impairment (CICI) is referred to as "chemobrain" or "chemofog". While the underlying mechanisms mediating CICI are still unclear, there is strong evidence that chemotherapy accelerates the biological aging process, manifesting as effects which include telomere shortening, epigenetic dysregulation, oxidative stress, mitochondrial defects, impaired neurogenesis, and neuroinflammation, all of which are known to contribute to increased anxiety and neurocognitive decline. Despite the increased prevalence of CICI, there exists a lack of mechanistic understanding by which chemotherapy detrimentally affects cognition in cancer survivors. Moreover, there are no approved therapeutic interventions for this condition. To address this gap in knowledge, this review attempts to identify how adenosine signaling, particularly through the adenosine A2A receptor, can be an essential tool to attenuate accelerated aging phenotypes. Importantly, the adenosine A2A receptor uniquely stands at the crossroads of cancer treatment and improved cognition, given that it is widely known to control tumor induced immunosuppression in the tumor microenvironment, while also posited to be an essential regulator of cognition in neurodegenerative disease. Consequently, we propose that the adenosine A2A receptor may provide a multifaceted therapeutic strategy to enhance anticancer activity, while combating chemotherapy induced cognitive deficits, both which are essential to provide novel therapeutic interventions against accelerated aging in cancer survivors.Copyright © 2023. Published by Elsevier Inc.