Duke University Medical Center, DUMC 2732, Durham, NC 27710, USA.
J Clin Oncol. 2011 Dec 1;29(34):4526-33. doi: 10.1200/JCO.2011.37.2631. Epub 2011 Oct 11.
Little is known about the trajectory of post-traumatic stress disorder (PTSD) symptoms in cancer survivors, despite the fact that such knowledge can guide treatment. Therefore, this study examined changes in PTSD symptoms among long-term survivors of non-Hodgkin's lymphoma (NHL) and identified demographic, clinical, and psychosocial predictors and correlates of PTSD symptomatology.
Surveys were mailed to 682 NHL survivors who participated in an earlier survey and now were at least 7 years postdiagnosis. Information was obtained regarding PTSD symptoms, positive and negative perceptions of the cancer experience (ie, impact of cancer), and other potential correlates of PTSD.
A total of 566 individuals participated (83% response rate) with a median of 12.9 years since diagnosis; respondents were 52% female and 87% white. Although half (51%) of the respondents reported no PTSD symptoms and 12% reported a resolution of symptoms, more than one-third (37%) reported persistence or worsening of symptoms over 5 years. Survivors who reported a low income, stage ≥ 2 at diagnosis, aggressive lymphoma, having received chemotherapy, and greater impact of cancer (both positive and negative) at the initial survey had more PTSD symptoms at follow-up. In multivariable analysis, income and negative impacts of cancer were independent predictors of PTSD symptoms.
More than one-third of long-term NHL survivors experience persisting or worsening PTSD symptoms. Providers should be aware of enduring risk; early identification of those at prolonged risk with standardized measures and treatments that target perceptions of the cancer experience might improve long-term outcomes.
尽管了解 PTSD 症状在癌症幸存者中的轨迹可以指导治疗，但目前对非霍奇金淋巴瘤（NHL）幸存者 PTSD 症状的轨迹知之甚少。因此，本研究考察了 NHL 幸存者 PTSD 症状的变化，并确定了 PTSD 症状的人口统计学、临床和心理社会预测因素和相关因素。
对参加过早期调查且目前距诊断至少 7 年的 682 名 NHL 幸存者进行了邮寄调查。获得了 PTSD 症状、对癌症经历的正面和负面看法（即癌症的影响）以及 PTSD 的其他潜在相关因素的信息。
共有 566 人参与（83%的回复率），中位数诊断后 12.9 年；受访者中 52%为女性，87%为白人。尽管有一半（51%）的受访者报告没有 PTSD 症状，12%的受访者报告症状已缓解，但超过三分之一（37%）的受访者报告症状持续或恶化超过 5 年。在初始调查中报告收入低、诊断时分期≥2、侵袭性淋巴瘤、接受过化疗以及癌症的影响（正面和负面）较大的幸存者在随访时 PTSD 症状更多。在多变量分析中，收入和癌症的负面影响是 PTSD 症状的独立预测因素。
超过三分之一的 NHL 幸存者长期经历 PTSD 症状持续或恶化。提供者应意识到持续存在的风险；通过标准化的测量方法和针对癌症经历认知的治疗方法，早期识别那些处于延长风险的患者，可能会改善长期结局。
