Lewis Florence, Merckaert Isabelle, Liénard Aurore, Libert Yves, Etienne Anne-Marie, Reynaert Christine, Slachmuylder Jean-Louis, Scalliet Pierre, Paul Van Houtte, Coucke Philippe, Salamon Emile, Razavi Darius
Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l'Éducation, Brussels, Belgium.
Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l'Éducation, Brussels, Belgium; Institut Jules Bordet, Brussels, Belgium.
Radiother Oncol. 2014 May;111(2):276-80. doi: 10.1016/j.radonc.2014.03.016. Epub 2014 Apr 17.
To our knowledge, no study has specifically assessed the time course of anxiety during radiotherapy (RT). The objective of this study was to assess anxiety time courses in patients with non-metastatic breast cancer.
This multicenter, descriptive longitudinal study included 213 consecutive patients with breast cancer who completed visual analog scales (VASs) assessing state anxiety before and after the RT simulation and the first and last five RT sessions.
Pre- and post-session anxiety mean levels were highest at the RT simulation (respectively, 2.9±2.9 and 1.6±2.5) and first RT session (respectively, 3.4±2.9 and 2.0±2.4), then declined rapidly. Clinically relevant mean differences (⩾1cm on the VAS) between pre- and post-simulation/session VAS scores were found only for the RT simulation (-1.3±2.7; p<0.001) and first RT session (-1.4±2.4; p<0.001). Five percent to 16% of patients presented clinically relevant anxiety (pre- and post-simulation/session VAS scores⩾4cm) throughout treatment.
To optimize care, RT team members should offer all patients appropriate information about treatment at the simulation, check patients' understanding, and identify patients with clinically relevant anxiety requiring appropriate support throughout RT.
据我们所知，尚无研究专门评估放射治疗（RT）期间焦虑情绪的时间进程。本研究的目的是评估非转移性乳腺癌患者的焦虑时间进程。
这项多中心、描述性纵向研究纳入了213例连续的乳腺癌患者，这些患者在放疗模拟前和后以及放疗的第一个和最后五个疗程完成了评估状态焦虑的视觉模拟量表（VAS）。
放疗模拟时（分别为2.9±2.9和1.6±2.5）和第一个放疗疗程时（分别为3.4±2.9和2.0±2.4）的疗程前和疗程后焦虑平均水平最高，然后迅速下降。仅在放疗模拟（-1.3±2.7；p<0.001）和第一个放疗疗程（-1.4±2.4；p<0.001）时发现模拟前和模拟后/疗程前和疗程后VAS评分之间存在临床相关的平均差异（VAS上⩾1cm）。在整个治疗过程中，5%至16%的患者出现临床相关焦虑（模拟前和模拟后/疗程前和疗程后VAS评分⩾4cm）。
为优化护理，放疗团队成员应在模拟时为所有患者提供有关治疗的适当信息；检查患者的理解情况，并识别出在整个放疗过程中需要适当支持的有临床相关焦虑的患者。
