Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Christian-Albrechts University, Olshausenstraße 62, 24118, Kiel, Germany.
Mehdorn Consilium, Prüner Gang 7, 24103, Kiel, Germany.
Support Care Cancer. 2019 Sep;27(9):3521-3529. doi: 10.1007/s00520-019-04665-9. Epub 2019 Jan 25.
Fear of progression (FoP) is frequent in patients with cancer and of high clinical relevance. Despite the often devastating prognosis of brain cancer, FoP has not yet been assessed in neurooncological patients.
The aim of this study was thus the assessment of FoP and its clinical correlates.
In an ambulatory setting, 42 patients with a primary brain tumour completed the Fear of Progression questionnaire FoP-Q-12. Clinical correlates of FoP were assessed via a variety of measures, including patients' physical state (Karnofsky Performance Status, KPS), cancer-related psychosocial distress (Distress Thermometer, DT), anxiety (General Anxiety Disorder Scale, GAD-7), depression (Patient Health Questionnaire, PHQ-9), Quality of Life (Short Form Health Survey, SF-8), and unmet supportive care needs (Supportive Care Needs Survey, SCNS).
Eighteen patients (42%) suffered from high FoP (i.e. scored ≥ 34 in the FoP-Q-12). According to the 12 items of the FoP-Q-12, the greatest fears were worrying about what would happen to their family and being afraid of severe medical treatments. No sociodemographic variables (e.g. age, gender) or medical tumour characteristics (e.g. tumour malignancy, first or recurrent tumour) were related to FoP. Patients with more severe physical symptoms reported higher FoP. Patients with higher FoP were more anxious, more depressed, reported lower Quality of Life, and suffered from more unmet supportive care needs.
Our results demonstrate that FoP is frequent and of high clinical relevance for neurooncological patients. Its assessment is not sufficiently covered by instruments for assessment of other areas of psychological morbidity (e.g. general anxiety). Moreover, FoP cannot be predicted by objective characteristics of the patients and disease. Thus, the routine screening for FoP is recommended in neurooncological patients. Clinicians should bear in mind that patients with high FoP are likely to suffer from high emotional distress and unmet supportive care needs and initiate treatment accordingly.
对进展的恐惧（Fear of Progression，FoP）在癌症患者中很常见，且具有重要的临床意义。尽管脑癌的预后通常很严重，但在神经肿瘤学患者中尚未评估 FoP。
因此，本研究旨在评估 FoP 及其临床相关性。
在门诊环境中，42 名原发性脑肿瘤患者完成了 FoP 问卷 FoP-Q-12。通过多种措施评估 FoP 的临床相关性，包括患者的身体状况（Karnofsky 表现状态，KPS）、癌症相关的心理社会困扰（痛苦温度计，DT）、焦虑（广泛性焦虑障碍量表，GAD-7）、抑郁（患者健康问卷，PHQ-9）、生活质量（健康调查简表，SF-8）和未满足的支持性护理需求（支持性护理需求调查，SCNS）。
18 名患者（42%）患有高 FoP（即 FoP-Q-12 得分≥34）。根据 FoP-Q-12 的 12 个项目，最大的恐惧是担心他们的家人会发生什么，以及害怕严重的医疗治疗。社会人口统计学变量（如年龄、性别）或医学肿瘤特征（如肿瘤恶性程度、首次或复发性肿瘤）与 FoP 无关。身体症状越严重的患者 FoP 评分越高。FoP 评分较高的患者焦虑程度更高、抑郁程度更严重、生活质量更低，且未满足的支持性护理需求更多。
我们的研究结果表明，FoP 在神经肿瘤学患者中很常见，且具有重要的临床意义。它的评估不能充分涵盖其他心理障碍评估工具（如一般焦虑）。此外，患者和疾病的客观特征不能预测 FoP。因此，建议对神经肿瘤学患者常规筛查 FoP。临床医生应牢记，FoP 较高的患者可能会遭受严重的情绪困扰和未满足的支持性护理需求，并相应地开始治疗。
