Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea.
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea.
Psychooncology. 2020 Feb;29(2):364-372. doi: 10.1002/pon.5265. Epub 2020 Jan 6.
This study aimed to evaluate fear of cancer recurrence (FCR) among lymphoma patients who completed treatment and its impact on survival and quality of life (QOL).
In this prospective cohort study, 467 lymphoma patients were included who completed treatment with curative intent between February 2012 and March 2017. FCR was measured using a question from the Korean version of the QOL in Cancer Survivors Questionnaire. QOL and general health and functioning were measured using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30. Participants were actively followed up for all-cause and disease-specific mortality.
In total, 16.3% of the patients had severe FCR. The adjusted hazard ratio (HR) for all-cause mortality comparing participants with and without severe FCR was 2.52 (95% CI = 1.15-5.54), and the association was stronger in indolent non-Hodgkin lymphoma (NHL) (HR = 6.77; 95% CI = 1.04-43.92). Participants with severe FCR were also at higher risk of lymphoma-specific mortality (HR = 2.62; 95% CI = 1.13-6.05) than patients without severe FCR. Patients with severe FCR had significantly worse general health status (64.3 vs 71.0, P = .03) and physical (82.4 vs 76.7, P < .01), emotional (68.5 vs 84.8, P < .001), and social functioning (67.8 vs 84.2, P < .001) than patients without severe FCR.
A substantial number of participants with lymphoma experience FCR after treatment completion, even in the case of indolent lymphomas. Given the negative impact of severe FCR on survival and general health and functional status, active monitoring and appropriate management of FCR should be considered in clinical settings.
本研究旨在评估完成治疗的淋巴瘤患者的癌症复发恐惧（FCR）及其对生存和生活质量（QOL）的影响。
在这项前瞻性队列研究中，纳入了 467 名于 2012 年 2 月至 2017 年 3 月期间完成治愈性治疗的淋巴瘤患者。使用癌症幸存者生存质量问卷韩国版中的一个问题来衡量 FCR。使用欧洲癌症研究与治疗组织（EORTC）生活质量问卷核心 30 版（QLQ-C30）来衡量 QOL 和一般健康及功能状况。对所有原因和疾病特异性死亡率进行主动随访。
共有 16.3%的患者存在严重的 FCR。与无严重 FCR 的患者相比，有严重 FCR 的患者全因死亡的调整后危险比（HR）为 2.52（95%可信区间[CI] = 1.15-5.54），并且在惰性非霍奇金淋巴瘤（NHL）中关联更强（HR = 6.77；95%CI = 1.04-43.92）。有严重 FCR 的患者也有更高的淋巴瘤特异性死亡风险（HR = 2.62；95%CI = 1.13-6.05）。与无严重 FCR 的患者相比，有严重 FCR 的患者一般健康状况明显更差（64.3 对 71.0，P =.03），身体（82.4 对 76.7，P <.01）、情绪（68.5 对 84.8，P <.001）和社会功能（67.8 对 84.2，P <.001）也更差。
大量接受治疗的淋巴瘤患者在完成治疗后会经历 FCR，即使是惰性淋巴瘤也是如此。鉴于严重 FCR 对生存和一般健康及功能状况的负面影响，在临床环境中应考虑积极监测和适当管理 FCR。
