Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
In Silico Oncology and In Silico Medicine Group, Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece.
Sci Rep. 2022 Feb 8;12(1):2112. doi: 10.1038/s41598-022-06138-2.
We aimed to (a) investigate the interplay between depression, symptoms and level of functioning, and (b) understand the paths through which they influence health related quality of life (QOL) during the first year of rehabilitation period of early breast cancer. A network analysis method was used. The population consisted of 487 women aged 35-68 years, who had recently completed adjuvant chemotherapy or started endocrine therapy for early breast cancer. At baseline and at the first year from randomization QOL, symptomatology and functioning by the EORTC QLQ-C30 and BR-23 questionnaires, and depression by the Finnish version of Beck's 13-item depression scale, were collected. The multivariate interplay between the related scales was analysed via regularized partial correlation networks (graphical LASSO). The median global quality of life (gQoL) at baseline was 69.9 ± 19.0 (16.7-100) and improved to 74.9 ± 19.0 (0-100) after 1 year. Scales related to mental health (emotional functioning, cognitive functioning, depression, insomnia, body image, future perspective) were clustered together at both time points. Fatigue was mediated through a different route, having the strongest connection with physical functioning and no direct connection with depression. Multiple paths existed connecting symptoms and functioning types with gQoL. Factors with the strongest connections to gQoL included: social functioning, depression and fatigue at baseline; emotional functioning and fatigue at month 12. Overall, the most important nodes were depression, gQoL and fatigue. The graphical LASSO network analysis revealed that scales related to fatigue and emotional health had the strongest associations to the EORTC QLQ-C30 gQoL score. When we plan interventions for patients with impaired QOL it is important to consider both psychological support and interventions that improve fatigue and physical function like exercise.Trial registration: http://www.clinicaltrials.gov/ (identifier number NCT00639210).
(a) 研究抑郁、症状和功能水平之间的相互作用，以及 (b) 了解它们在早期乳腺癌康复期的第一年如何通过影响健康相关生活质量（QOL）。使用了网络分析方法。该人群由 487 名年龄在 35-68 岁之间的女性组成，她们最近完成了辅助化疗或开始内分泌治疗早期乳腺癌。在随机分组时基线和第一年，通过 EORTC QLQ-C30 和 BR-23 问卷收集了生活质量、症状和功能，以及芬兰版贝克 13 项抑郁量表评估的抑郁情况。通过正则化偏相关网络（图形 LASSO）分析了相关量表之间的多变量相互作用。基线时的中位总体生活质量（gQoL）为 69.9±19.0（16.7-100），1 年后提高到 74.9±19.0（0-100）。心理健康相关的量表（情绪功能、认知功能、抑郁、失眠、身体形象、未来展望）在两个时间点都聚集在一起。疲劳通过不同的途径介导，与身体功能的联系最强，与抑郁没有直接联系。有多种途径将症状和功能类型与 gQoL 联系起来。与 gQoL 联系最紧密的因素包括：基线时的社会功能、抑郁和疲劳；第 12 个月时的情绪功能和疲劳。总体而言，最重要的节点是抑郁、gQoL 和疲劳。图形 LASSO 网络分析表明，与疲劳和情绪健康相关的量表与 EORTC QLQ-C30 gQoL 评分的相关性最强。当我们计划干预生活质量受损的患者时，重要的是要考虑到心理支持和改善疲劳和身体功能的干预措施，如运动。试验注册：http://www.clinicaltrials.gov/（标识符编号 NCT00639210）。
