Department of Neurology, General Hospital of Southern Theatre Command, 111 Liuhua Road, Guangzhou, Guangdong Province, China.
J Neurooncol. 2019 Apr;142(2):385-392. doi: 10.1007/s11060-019-03112-3. Epub 2019 Jan 31.
The primary objective of this study was to investigate the incidence of PTSD at 3 months postoperatively in patients who were newly diagnosed with LGGs, and its association with 5-year survival. Moreover, QoL and other psychiatric disorders like depression and anxiety were also evaluated.
From February 2011 to April 2013, patients who underwent low-grade glioma surgery at our hospital and come back for reexamination at 3-month follow-up were considered for this study. Interviews, HADS-A, HADS-D, and SF-36 scales were used for evaluating PTSD, anxiety, depression, and quality of life. Participants were asked to complete these assessments at 3 months after surgery. Followed-ups on survival status were made for 5 years.
A total of 219 subjects comprising 83 women and 136 men with a mean age of 41.5 years were included in this study. At 3 months after surgery, 35 (16%) patients were diagnosed with PTSD. Younger age (OR = 2.23, [95% CI 1.02-4.84], P = 0.04) and frontal lobe involvement of tumor (OR = 2.57, [95% CI 1.06-6.23], P = 0.04) predicted PTSD. Patients with PTSD had higher anxiety and depression level, and had worse QoL in all eight dimensions of SF-36. Kaplan-Meier analyses demonstrated that diagnosis of PTSD was associated with shorter overall survival in LGG patients (Log-rank = 7.45, P = 0.01). After adjusting for other variables, PTSD remained associated with elevated 5-year overall mortality risk of LGG patients (HR = 2.98 [95% CI 1.10-8.05], P = 0.03).
The results showed that newly diagnosed LGG patients suffering from PTSD at 3 months after surgery had lower rates of 5-year survival. In clinical practice, psychological evaluation is suggested for LGG patients and proper psychotherapy should be considered for those with PTSD.
本研究的主要目的是调查新诊断为低级别胶质瘤（LGG）患者术后 3 个月 PTSD 的发生率及其与 5 年生存率的关系。此外，还评估了生活质量（QoL）和其他精神疾病，如抑郁和焦虑。
本研究纳入了 2011 年 2 月至 2013 年 4 月在我院接受低级别胶质瘤手术并在术后 3 个月复查的患者。采用访谈、HADS-A、HADS-D 和 SF-36 量表评估 PTSD、焦虑、抑郁和生活质量。术后 3 个月时，患者需完成这些评估。对 5 年的生存状况进行随访。
本研究共纳入 219 名患者，其中女性 83 名，男性 136 名，平均年龄为 41.5 岁。术后 3 个月时，35 名（16%）患者被诊断为 PTSD。年龄较轻（OR=2.23，95%CI：1.02-4.84，P=0.04）和肿瘤额叶受累（OR=2.57，95%CI：1.06-6.23，P=0.04）预测 PTSD。PTSD 患者的焦虑和抑郁水平较高，SF-36 的所有 8 个维度的 QoL 均较差。Kaplan-Meier 分析表明，PTSD 的诊断与 LGG 患者的总生存率较短有关（Log-rank=7.45，P=0.01）。在校正其他变量后，PTSD 仍与 LGG 患者 5 年总死亡率升高相关（HR=2.98[95%CI：1.10-8.05]，P=0.03）。
研究结果表明，术后 3 个月新诊断为 PTSD 的 LGG 患者的 5 年生存率较低。在临床实践中，建议对 LGG 患者进行心理评估，并对 PTSD 患者考虑适当的心理治疗。
