全脑放疗后脑转移瘤患者心理困扰、认知障碍与生活质量之间的相关性

The correlations between psychological distress, cognitive impairment and quality of life in patients with brain metastases after whole-brain radiotherapy.

作者信息

Yao Senbang, Zuo He, Li Wen, Cai Yinlian, Zhang Qianqian, Pang Lulian, Jing Yanyan, Yin Xiangxiang, Cheng Huaidong

机构信息

Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, Anhui, China.

Cancer and Cognition Laboratory, Anhui Medical University, Hefei, 230032, Anhui, China.

出版信息

Clin Transl Oncol. 2023 Jan;25(1):207-217. doi: 10.1007/s12094-022-02927-3. Epub 2022 Aug 29.

DOI:10.1007/s12094-022-02927-3

PMID:36038750

Abstract

BACKGROUND

Psychological distress and cognitive impairment are highly prevalent among patients with brain metastases after whole-brain radiotherapy (WBRT). Our purpose was to evaluate the correlations between psychological distress, cognitive impairment and quality of life in patients with brain metastases after WBRT.

METHODS

Seventy-one patients with brain metastasis treated with WBRT were enrolled in this study and were investigated with several scales, including the Montreal Cognitive Assessment Scale (MoCA), the Functional Assessment of Cancer Therapy-Cognitive Function version 3 (FACT-Cog, version 3), the Functional Assessment of Cancer Therapy-Brain Module version 4 (FACT-Br, version 4) and the Psychological Distress Thermometer (DT), before and after WBRT.

RESULTS

The MoCA, FACT-Cog and FACT-Br scores in patients with brain metastases were significantly decreased after WBRT compared with before WBRT (z = - 7.106, - 6.933 and - 6.250, respectively, P < 0.001), while the DT scores were significantly increased (z = 6.613, P < 0.001). There was an obvious negative correlation between the DT score and the FACT-Cog score (r = - 0.660, P < 0.001), a significant negative correlation between the DT score and the FACT-Br score (r = - 0.833, P < 0.001), and an obvious positive correlation between the FACT-Cog score and the FACT-Br score (r = 0.603, P < 0.001). These results suggest that WBRT can cause cognitive impairment in patients with brain metastases, increase their psychological distress and reduce their quality of life (QOL).

CONCLUSION

After receiving WBRT, the cognitive function and QOL of patients with brain metastases were decreased, while psychological distress increased. The cognitive impairment and the decline of QOL after WBRT are associated with increased psychological distress, and that the decline of QOL is associated with cognitive impairment of patients.

摘要

背景

心理困扰和认知障碍在全脑放疗（WBRT）后的脑转移瘤患者中非常普遍。我们的目的是评估WBRT后脑转移瘤患者心理困扰、认知障碍与生活质量之间的相关性。

方法

本研究纳入71例接受WBRT治疗的脑转移瘤患者，在WBRT前后用多种量表进行调查，包括蒙特利尔认知评估量表（MoCA）、癌症治疗功能评估-认知功能第3版（FACT-Cog，第3版）、癌症治疗功能评估-脑模块第4版（FACT-Br，第4版）和心理困扰温度计（DT）。

结果

与WBRT前相比，脑转移瘤患者WBRT后的MoCA、FACT-Cog和FACT-Br评分显著降低（z分别为-7.106、-6.933和-6.250，P<0.001），而DT评分显著升高（z=6.613，P<0.001）。DT评分与FACT-Cog评分之间存在明显的负相关（r=-0.660，P<0.001），DT评分与FACT-Br评分之间存在显著的负相关（r=-0.833，P<0.001），FACT-Cog评分与FACT-Br评分之间存在明显的正相关（r=0.603，P<0.001）。这些结果表明，WBRT可导致脑转移瘤患者出现认知障碍，增加其心理困扰并降低其生活质量（QOL）。