Mayo Clinic, Department of Internal Medicine, Division of Hematology, Rochester, MN.
Department of Internal Medicine, Division of General Internal Medicine.
Ann Oncol. 2010 Nov;21(11):2262-2266. doi: 10.1093/annonc/mdq215. Epub 2010 Apr 27.
We aimed to assess anxiety and the psychological impact of routine surveillance scans in long-term survivors of adult aggressive lymphoma.
In this cross-sectional observational study of 70 survivors of curable adult aggressive lymphoma, we measured anxiety and the doctor-patient relationship and performed a qualitative interview (n = 30) focused on patient perception of routine follow-up imaging studies.
Participants were diagnosed with aggressive lymphoma a median of 4.9 years (2.4-38.0 years) before enrollment. Thirty-seven percent of patients were found to meet criteria for clinically significant anxiety, which was not associated with years since diagnosis. In multivariate analysis, history of relapse and a worse doctor-patient relationship were independently associated with higher anxiety levels. Despite representing a largely cured population, in qualitative interviews patients reported fear of recurrence as a major concern and considerable anxiety around the time of a follow-up imaging scan.
Routine surveillance scans exacerbate underlying anxiety symptoms and fear of recurrence in survivors of aggressive lymphoma. Strategies to minimize follow-up imaging and to improve doctor-patient communication should be prospectively evaluated to address these clinically significant issues.
我们旨在评估常规监测扫描对成人侵袭性淋巴瘤长期幸存者的焦虑和心理影响。
在这项针对 70 名可治愈的成人侵袭性淋巴瘤幸存者的横断面观察性研究中，我们测量了焦虑和医患关系，并进行了一项定性访谈（n=30），重点关注患者对常规随访影像学研究的看法。
参与者在入组前平均被诊断为侵袭性淋巴瘤 4.9 年（2.4-38.0 年）。37%的患者符合临床显著焦虑的标准，与诊断后年限无关。多变量分析显示，复发史和较差的医患关系与更高的焦虑水平独立相关。尽管这是一个基本治愈的人群，但在定性访谈中，患者报告说害怕复发是一个主要问题，并且在随访影像学扫描时会感到相当大的焦虑。
常规监测扫描加剧了侵袭性淋巴瘤幸存者的潜在焦虑症状和对复发的恐惧。应前瞻性评估减少随访影像学检查和改善医患沟通的策略，以解决这些具有临床意义的问题。
