Indiana University, Indianapolis, Indiana.
Oslo University Hospital, Oslo, Norway.
Cancer Epidemiol Biomarkers Prev. 2021 Jun;30(6):1129-1138. doi: 10.1158/1055-9965.EPI-20-1762. Epub 2021 Apr 13.
This study examined sociodemographic factors, cisplatin-related adverse health outcomes (AHO), and cumulative burden of morbidity (CBM) scores associated with medication use for anxiety and/or depression in testicular cancer survivors (TCS).
A total of 1,802 TCS who completed cisplatin-based chemotherapy ≥12 months previously completed questionnaires regarding sociodemographic features and cisplatin-related AHOs [hearing impairment, tinnitus, peripheral sensory neuropathy (PSN), and kidney disease]. A CBM score encompassed the number and severity of cisplatin-related AHOs. Multivariable logistic regression models assessed the relationship of individual AHOs and CBM with medication use for anxiety and/or depression.
A total of 151 TCS (8.4%) used medications for anxiety and/or depression. No cisplatin-related AHOs were reported by 511 (28.4%) participants, whereas 622 (34.5%), 334 (18.5%), 287 (15.9%), and 48 (2.7%), respectively, had very low, low, medium, and high CBM scores. In the multivariable model, higher CBM scores were significantly associated with medication use for anxiety and/or depression ( < 0.0001). In addition, tinnitus ( = 0.0009), PSN ( = 0.02), and having health insurance ( = 0.05) were significantly associated with greater use of these medications, whereas being employed ( = 0.0005) and vigorous physical activity ( = 0.01) were significantly associated with diminished use.
TCS with higher CBM scores had a higher probability of using medications for anxiety and/or depression, and conversely, those who were employed and physically active tended to have reduced use of these medications.
Healthcare providers should encourage TCS to increase physical activity to improve both physical and mental health. Rehabilitation programs should assess work-related skills and provide career development counseling/training.
本研究调查了与睾丸癌幸存者(TCS)使用焦虑和/或抑郁治疗药物相关的社会人口统计学因素、顺铂相关不良健康结局(AHO)和累积发病负担(CBM)评分。
1802 名接受过顺铂为基础的化疗且时间超过 12 个月的 TCS 完成了有关社会人口统计学特征和与顺铂相关的 AHO(听力损伤、耳鸣、周围感觉神经病(PSN)和肾脏疾病)的问卷。CBM 评分包括与顺铂相关的 AHO 的数量和严重程度。多变量逻辑回归模型评估了各个 AHO 和 CBM 与焦虑和/或抑郁治疗药物使用的关系。
共有 151 名 TCS(8.4%)使用了焦虑和/或抑郁治疗药物。511 名(28.4%)参与者未报告任何与顺铂相关的 AHO,而分别有 622 名(34.5%)、334 名(18.5%)、287 名(15.9%)和 48 名(2.7%)参与者的 CBM 评分非常低、低、中、高。在多变量模型中,更高的 CBM 评分与焦虑和/或抑郁治疗药物的使用显著相关(<0.0001)。此外,耳鸣(=0.0009)、PSN(=0.02)和有健康保险(=0.05)与这些药物的使用显著增加相关,而就业(=0.0005)和剧烈体力活动(=0.01)与这些药物的使用减少显著相关。
CBM 评分较高的 TCS 使用焦虑和/或抑郁治疗药物的可能性更高,相反,就业和积极运动的患者往往会减少这些药物的使用。
医疗保健提供者应鼓励 TCS 增加体力活动,以改善身心健康。康复计划应评估与工作相关的技能,并提供职业发展咨询/培训。