Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands.
Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands; Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, AmsterdamUMC location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
Oral Oncol. 2020 Mar;102:104576. doi: 10.1016/j.oraloncology.2020.104576. Epub 2020 Feb 3.
To identify sociodemographic and clinical factors, health-related quality of life (HRQOL) and head and neck cancer (HNC) symptoms associated with the course of symptoms of anxiety and depression from pretreatment to 24-month follow-up among HNC patients after (chemo)radiation.
Patients (n = 345) completed questionnaires on anxiety and depression (HADS), HRQOL and symptoms (EORTC QLQ-C30/QLQ-H&N35) before treatment, and 6-weeks,3-,6-12-,18-, and 24-months after treatment. Mixed model analyses were used to investigate the course of anxiety and depression from pretreatment to 24-months in relation to factors assessed at baseline, and the course of anxiety and depression from 6- to 24-months, in relation to factors assessed at 6-months.
Increased risk for anxiety (HADS-anxiety > 7) was 28.7% among patients before treatment, which declined to 10.0% at 24-months. Increased risk for depression (HADS-depression > 7) was 15.1% before treatment, 18.2% at 3-months, 7.2% at 12-months and 16.0% at 24-months. Factors assessed at baseline which were significantly associated with the course of anxiety were age, pain, problems with social contact, and feeling ill, whereas chemotherapy, worse emotional functioning, speech problems and weight loss were significantly associated with the course of depression. Regarding factors assessed at 6-months, chemotherapy, worse cognitive and social functioning, insomnia, swallowing problems and trouble with social eating were associated with the course of anxiety. Nausea/vomiting, dyspnea, coughing, and feeling ill were associated with the course of depression (p-values < 0.05).
Factors associated with a worse course of anxiety and depression are younger age, treatment with chemotherapy, worse HRQOL and higher symptom burden.
确定与接受放化疗后的头颈部癌症（HNC）患者从治疗前到 24 个月随访期间焦虑和抑郁症状的发展相关的社会人口统计学和临床因素、健康相关生活质量（HRQOL）和 HNC 症状。
患者（n=345）在治疗前、治疗后 6 周、3 个月、6 个月、12 个月、18 个月和 24 个月时完成焦虑和抑郁（HADS）、HRQOL 和症状（EORTC QLQ-C30/QLQ-H&N35）问卷。混合模型分析用于研究从治疗前到 24 个月的焦虑和抑郁的发展与基线评估的因素的关系，以及从 6 个月到 24 个月的焦虑和抑郁的发展与 6 个月时评估的因素的关系。
治疗前，患者发生焦虑（HADS 焦虑>7）的风险为 28.7%，到 24 个月时下降到 10.0%。治疗前发生抑郁（HADS 抑郁>7）的风险为 15.1%，3 个月时为 18.2%，12 个月时为 7.2%，24 个月时为 16.0%。与焦虑发展显著相关的基线评估因素为年龄、疼痛、社会接触问题和不适，而化疗、情绪功能更差、言语问题和体重减轻与抑郁的发展显著相关。对于 6 个月时评估的因素，化疗、认知和社会功能更差、失眠、吞咽问题和社交进食困难与焦虑的发展相关。恶心/呕吐、呼吸困难、咳嗽和不适与抑郁的发展相关（p 值<0.05）。
与焦虑和抑郁恶化相关的因素是年龄较小、接受化疗、HRQOL 更差和症状负担更高。
