Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada.
J Clin Oncol. 2012 Apr 10;30(11):1187-96. doi: 10.1200/JCO.2011.39.7372. Epub 2012 Mar 12.
Depression is a common condition in patients with cancer, although there has been a relative paucity of research on the effectiveness of treatment in this population. This review summarizes the psychosocial and pharmacologic treatment of depression in patients with cancer based on a consideration of evidence regarding etiologic factors and treatment outcomes.
A review of the evidence base for psychosocial and pharmacologic interventions for depression in patients with cancer was performed, including original studies, systematic reviews, and meta-analytic studies in the literature.
Recent evidence from randomized controlled trials has demonstrated the efficacy of psychosocial and pharmacologic treatments to alleviate depression in patients with cancer. Further research is needed to establish their relative and combined efficacy and their role in the treatment of depression that is less severe and occurs in association with more advanced disease. First-line recommendations for the treatment of depression in patients with cancer are difficult to derive based on current evidence, because comparative studies have not been conducted to support the superiority of one treatment modality over another in this population.
Both psychosocial and pharmacologic interventions have been shown to be efficacious in treating depression in cancer, but further research is needed to establish their relative and combined benefit. Future research directions include the development and evaluation of novel interventions targeted to specific biologic and psychosocial risk factors.
尽管针对癌症患者治疗效果的研究相对较少,但抑郁在癌症患者中较为常见。本综述基于对病因和治疗结果的考虑,总结了癌症患者抑郁的心理社会和药物治疗方法。
对癌症患者抑郁的心理社会和药物干预的证据进行了综述,包括文献中的原始研究、系统评价和荟萃分析。
来自随机对照试验的最新证据表明,心理社会和药物治疗可有效缓解癌症患者的抑郁症状。需要进一步的研究来确定它们的相对和联合疗效,以及它们在治疗程度较轻且与更晚期疾病相关的抑郁中的作用。由于尚未进行比较研究以支持在该人群中一种治疗方式优于另一种,因此难以根据现有证据得出治疗癌症患者抑郁的一线推荐。
心理社会和药物干预都已被证明可有效治疗癌症患者的抑郁,但需要进一步的研究来确定它们的相对和联合获益。未来的研究方向包括针对特定生物学和心理社会风险因素的新型干预措施的开发和评估。