Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.
Cancer Med. 2023 Feb;12(4):4794-4800. doi: 10.1002/cam4.5283. Epub 2022 Sep 26.
Patients with breast cancer are more likely to experience psychological distress than the general population. This study aimed to explore the relationship between depression and anxiety status measured before chemotherapy and adverse events during adjuvant chemotherapy in Chinese breast cancer patients.
This prospective study was conducted on 290 postoperative early-stage breast cancer patients (response rate 96.7%) in China. Depression and anxiety status before adjuvant chemotherapy were assessed by the Hospital Anxiety and Depression Scale (HADS). Adverse events that occurred throughout the course of chemotherapy were graded and recorded according to Common Terminology Criteria for Adverse Events (CTCAE) 4.02.
The rates of depression and anxiety were 20.0% and 31.4%, respectively, at baseline. The incidence of grade two or higher myelosuppression induced by chemotherapy was correlated with depression before chemotherapy (p = 0.037). Multivariate analysis showed that the incidence of myelosuppression was significantly related to depression before chemotherapy (p = 0.032). There was no association between depression and anxiety status and other adverse events (p > 0.05).
We observed an association between depression status in breast cancer patients receiving adjuvant chemotherapy and chemotherapy-induced myelosuppression. Monitoring the depression status of breast cancer patients before chemotherapy may help to optimize the management of adverse events.
乳腺癌患者比一般人群更易出现心理困扰。本研究旨在探讨中国乳腺癌患者化疗前抑郁和焦虑状态与辅助化疗期间不良事件之间的关系。
本前瞻性研究在中国 290 例术后早期乳腺癌患者(应答率 96.7%)中进行。化疗前采用医院焦虑抑郁量表(HADS)评估抑郁和焦虑状态。根据不良事件通用术语标准 4.02 对整个化疗过程中发生的不良事件进行分级和记录。
基线时抑郁和焦虑的发生率分别为 20.0%和 31.4%。化疗引起的二级或更高级别的骨髓抑制与化疗前的抑郁相关(p=0.037)。多变量分析显示,骨髓抑制的发生率与化疗前的抑郁显著相关(p=0.032)。抑郁和焦虑状态与其他不良事件之间无相关性(p>0.05)。
我们观察到接受辅助化疗的乳腺癌患者的抑郁状态与化疗引起的骨髓抑制之间存在关联。监测化疗前乳腺癌患者的抑郁状态可能有助于优化不良事件的管理。