Duke University School of Medicine, Durham, USA.
Division of Biostatistics, Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, 27710, USA.
Support Care Cancer. 2021 Sep;29(9):4987-4996. doi: 10.1007/s00520-021-06044-9. Epub 2021 Feb 11.
Psychological distress is prevalent in Hodgkin lymphoma (HL). Many patients, regardless of prognosis, receive ABVD chemotherapy as first-line treatment, but few studies have specifically examined the nature of distress during this shared treatment experience.
We conducted a retrospective study of patient-reported distress in HL patients receiving ABVD treatment at a single tertiary care facility. Distress was measured using the National Comprehensive Cancer Network Distress Thermometer and Problem List (PL). We used descriptive statistics and generalized estimating equations to assess the prevalence of distress and specific problem items during treatment and associations with patient- and disease-related factors.
We collected data from 50 patients comprising 467 unique encounters, with 369/467 (79.0%) reporting a distress thermometer score. Median distress score was 2 (IQR: 0-5), but actionable distress (distress thermometer ≥4) was noted for 118/369 (32.0%) encounters. Actionable distress was only related to having a prior cancer, which conferred lower odds of actionable distress (OR 0.23, 95% CI 0.07-0.74, p=0.01) Physical and emotional problems were reported for 287/369 (77.8%) and 125/369 (33.9%) visits, respectively. Female patients had greater odds of both physical (OR 3.17, 95% CI 1.32-7.66, p=0.01) and emotional (OR 3.31, 95% CI 1.25-8.73, p=0.02) problems.
ABVD treatment is associated with a high frequency of actionable distress, with physical and emotional problems acting as primary drivers. Female patients may be particularly vulnerable, while cancer survivors may be uniquely resilient. These findings demonstrate the need to thoroughly screen for and appropriately tailor distress management strategies for HL patients during treatment with ABVD.
霍奇金淋巴瘤（HL）患者普遍存在心理困扰。许多患者，无论预后如何，都接受 ABVD 化疗作为一线治疗，但很少有研究专门研究在这种共同治疗体验中困扰的性质。
我们对在一家三级保健机构接受 ABVD 治疗的 HL 患者的患者报告的困扰进行了回顾性研究。使用国家综合癌症网络困扰温度计和问题清单（PL）测量困扰。我们使用描述性统计和广义估计方程来评估治疗期间困扰和特定问题项目的发生率，并评估与患者和疾病相关因素的关联。
我们从 50 名患者中收集了数据，共包含 467 个独特的就诊，其中 369/467（79.0%）报告了困扰温度计评分。中位数困扰评分 2（IQR：0-5），但在 118/369（32.0%）就诊中出现了可采取行动的困扰（困扰温度计≥4）。可采取行动的困扰仅与先前患有癌症有关，这降低了可采取行动的困扰的可能性（OR 0.23，95%CI 0.07-0.74，p=0.01）。在 369/369（77.8%）和 125/369（33.9%）就诊中分别报告了身体和情绪问题。女性患者出现身体（OR 3.17，95%CI 1.32-7.66，p=0.01）和情绪（OR 3.31，95%CI 1.25-8.73，p=0.02）问题的可能性更大。
ABVD 治疗与可采取行动的困扰发生率高有关，身体和情绪问题是主要驱动因素。女性患者可能特别脆弱，而癌症幸存者可能具有独特的韧性。这些发现表明，在 HL 患者接受 ABVD 治疗期间，需要彻底筛查并适当调整困扰管理策略。
