Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, Beijing, China.
National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, PLA General Hospital, Beijing, China.
Front Public Health. 2022 Jul 5;10:916004. doi: 10.3389/fpubh.2022.916004. eCollection 2022.
This study aimed to investigate the quality of life and mental health status and further to identify relevant risk factors among advanced cancer patients with spine metastases. This study prospectively included and analyzed 103 advanced cancer patients with spine metastases. Patient's basic information, lifestyles, comorbidities, tumor characteristics, therapeutic strategies, economic conditions, quality of life, anxiety, and depression were collected. Patient's quality of life was assessed using the Functional Assessment of Cancer Therapy-General Scale (FACT-G), and anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale (HADS). Subgroup analysis was performed based on different age groups, and a multivariate analysis was performed to test the ability of 20 potential risk factors to predict quality of life, anxiety, and depression. The mean total FACT-G score was only 61.38 ± 21.26. Of all included patients, 52.43% had skeptical or identified anxiety and 53.40% suffered from skeptical or identified depression. Patients had an age of 60 or more and <70 years had the lowest FACT-G score (54.91 ± 19.22), highest HADS anxiety score (10.25 ± 4.22), and highest HADS depression score (10.13 ± 4.94). After adjusting all other potential risk factors, age was still significantly associated with quality of life (OR = 0.57, 95%CI: 0.38-0.86, < 0.01) and depression (OR = 1.55, 95%CI: 1.00-2.42, = 0.05) and almost significantly associated with anxiety (OR = 1.52, 95%CI: 0.94-2.43, = 0.08). Besides, preference to eating vegetables, time since knowing cancer diagnosis, surgical treatment at primary cancer, hormone endocrine therapy, and economic burden due to cancer treatments were found to be significantly associated with the quality of life. A number of comorbidities and economic burden due to cancer treatments were significantly associated with anxiety. Advanced cancer patients with spine metastases suffer from poor quality of life and severe anxiety and depression, especially among patients with an age of 60 or more and <70 years. Early mental health care and effective measures should be conducted to advanced cancer patients with spine metastases, and more attention should be paid to take care of patients with an age of 60 or more and <70 years in terms of their quality of life and mental health status.
本研究旨在调查晚期癌症伴脊柱转移患者的生活质量和心理健康状况，并进一步确定相关的风险因素。本研究前瞻性纳入并分析了 103 例晚期癌症伴脊柱转移患者。收集患者的基本信息、生活方式、合并症、肿瘤特征、治疗策略、经济状况、生活质量、焦虑和抑郁情况。采用癌症患者生活功能量表（FACT-G）评估患者的生活质量，采用医院焦虑抑郁量表（HADS）评估焦虑和抑郁。根据不同年龄组进行亚组分析，并进行多变量分析以检验 20 个潜在风险因素预测生活质量、焦虑和抑郁的能力。总 FACT-G 评分平均为 61.38±21.26。所有纳入患者中，52.43%有可疑或确诊的焦虑，53.40%有可疑或确诊的抑郁。60 岁及以上、<70 岁的患者 FACT-G 评分最低（54.91±19.22），HADS 焦虑评分最高（10.25±4.22），HADS 抑郁评分最高（10.13±4.94）。调整所有其他潜在风险因素后，年龄与生活质量（OR=0.57，95%CI：0.38-0.86， <0.01）和抑郁（OR=1.55，95%CI：1.00-2.42， =0.05）仍显著相关，与焦虑（OR=1.52，95%CI：0.94-2.43， =0.08）也几乎显著相关。此外，喜欢吃蔬菜、从确诊癌症到评估的时间、原发肿瘤的手术治疗、激素内分泌治疗以及癌症治疗的经济负担与生活质量显著相关。多种合并症和癌症治疗的经济负担与焦虑显著相关。晚期癌症伴脊柱转移患者生活质量差，焦虑和抑郁严重，尤其是 60 岁及以上、<70 岁的患者。应早期对晚期癌症伴脊柱转移患者进行心理健康护理，并采取有效措施，尤其应关注 60 岁及以上、<70 岁的患者的生活质量和心理健康状况。
