Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Department of Cancer Experiences, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, Victoria, Australia.
Int J Radiat Oncol Biol Phys. 2021 Nov 15;111(4):890-899. doi: 10.1016/j.ijrobp.2021.07.006. Epub 2021 Jul 13.
To estimate the prevalence of and characteristics associated with fear of cancer recurrence (FCR) among human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) survivors.
We conducted a cross-sectional study in HPV-OPC survivors ≥12 months from completion of definitive (chemo)radiation therapy (RT/CRT). Eligible patients completed the Fear of Cancer Recurrence Inventory short-form (FCRI-SF), the European Organisation for research and Treatment of Cancer QLQ-C30, MD Anderson Symptom Inventory-Head and Neck, and PROMIS Anxiety and Depression short forms. Associations between FCRI-SF scores and other variables were investigated using linear regression models.
A total of 136 HPV-OPC survivors were enrolled; the median age was 61 years (range, 42-87 years), 84% were male, 72% were currently partnered, 83% were current nonsmokers, 67% were regular alcohol consumers, and the median time since treatment was 2.8 years (range, 1.0-5.5 years). Clinical levels of FCR (≥13) were observed in 72 of 135 patients (53%; 95% confidence interval [CI], 45%-62%). Characteristics significantly associated with increasing FCR scores were younger age (-0.9/5 years; 95% CI, -1.7 to -0.01; P = .031), lower global quality of life (-0.8/10 unit increase; 95% CI, -1.4 to -0.2; P = .012), higher symptom interference (0.8/unit increase; 95% CI, 0.1-1.5; P = .017), and a higher burden of anxiety (0.4/unit; 95% CI, 0.3-0.5; P <.001) and depression (0.3/unit; 95% CI, 0.1-0.4; P <.001). Other sociodemographic tumor- and treatment-related characteristics were not statistically significant. Compared with patients reporting nonclinical levels of FCR, significantly more patients reporting clinical levels of FCR than expected believed professional psychological assistance would have been beneficial (60% vs 33%; P = .002).
Clinical levels of FCR were observed in approximately half of the HPV-OPC survivors. Survivors reporting higher FCR were younger with worse self-reported global quality of life and higher symptom interference and emotional distress. No other patient, tumor, or treatment factors were associated with higher FCR.
评估 HPV 相关性口咽癌（OPC）幸存者中与癌症复发恐惧（FCR）相关的特征和流行率。
我们对完成根治性（放化疗）治疗后≥12 个月的 HPV-OPC 幸存者进行了一项横断面研究。符合条件的患者完成了恐惧癌症复发量表简表（FCRI-SF）、欧洲癌症研究与治疗组织生活质量问卷核心 30 项（QLQ-C30）、MD 安德森症状量表-头颈部和 PROMIS 焦虑和抑郁简表。使用线性回归模型研究了 FCRI-SF 评分与其他变量之间的关联。
共纳入 136 例 HPV-OPC 幸存者；中位年龄为 61 岁（范围，42-87 岁），84%为男性，72%为当前伴侣，83%为当前不吸烟者，67%为规律饮酒者，治疗后中位时间为 2.8 年（范围，1.0-5.5 年）。135 例患者中有 72 例（53%；95%置信区间[CI]，45%-62%）出现临床水平的 FCR。与 FCR 评分增加显著相关的特征包括年龄较小（每 5 岁减少 0.9；95%CI，-1.7 至-0.01；P=0.031）、整体生活质量较低（每 10 分单位降低 0.8；95%CI，-1.4 至-0.2；P=0.012）、症状干扰较高（每单位增加 0.8；95%CI，0.1-1.5；P=0.017）以及焦虑负担较高（每单位增加 0.4；95%CI，0.3-0.5；P<.001）和抑郁（每单位增加 0.3；95%CI，0.1-0.4；P<.001）。其他社会人口学、肿瘤和治疗相关特征无统计学意义。与报告非临床水平 FCR 的患者相比，报告临床水平 FCR 的患者中，明显更多的患者认为接受专业的心理帮助将是有益的（60%比 33%；P=0.002）。
大约一半的 HPV-OPC 幸存者出现临床水平的 FCR。报告 FCR 较高的幸存者更年轻，自我报告的整体生活质量更差，症状干扰和情绪困扰更严重。没有其他患者、肿瘤或治疗因素与较高的 FCR 相关。
