Bastien Etienne, Lefèvre-Arbogast Sophie, Lequesne Justine, Gernier François, Cherifi François, Rigal Olivier, Guittet Lydia, Grellard Jean-Michel, Binarelli Giulia, Lange Marie, Fernette Marie, Tron Laure, Morel Adeline, Richard Doriane, Griffon Bénédicte, Leconte Alexandra, Quilan Florian, Pépin Louis-Ferdinand, Jardin Fabrice, Leheurteur Marianne, Faveyrial Audrey, Clarisse Bénédicte, Joly Florence
Medical Oncology Department, François Baclesse Center, Caen, France.
Anticipe (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086, Caen, France.
J Natl Compr Canc Netw. 2023 Feb 22;21(3):265-272.e7. doi: 10.6004/jnccn.2023.7085.
Patients with cancer may be particularly vulnerable to psychological consequences of the COVID-19 pandemic. We studied the prevalence and evolution of posttraumatic stress symptoms (PTSS) in patients with cancer during the pandemic waves, and we investigated factors associated with high symptoms.
COVIPACT is a 1-year longitudinal prospective study of French patients with solid/hematologic malignancies receiving treatment during the first nationwide lockdown. PTSS were measured every 3 months from April 2020 using the Impact of Event Scale-Revised. Patients also completed questionnaires on their quality of life, cognitive complaints, insomnia, and COVID-19 lockdown experience.
Longitudinal analyses involved 386 patients with at least one PTSS assessment after baseline (median age, 63 years; 76% female). Among them, 21.5% had moderate/severe PTSS during the first lockdown. The rate of patients reporting PTSS decreased at lockdown release (13.6%), increased again at second lockdown (23.2%), and slightly declined from the second release period (22.7%) to the third lockdown (17.5%). Patients were grouped into 3 trajectories of evolution. Most patients had stable low symptoms throughout the period, 6% had high baseline symptoms slowly decreasing over time, and 17.6% had moderate symptoms worsening during the second lockdown. Female sex, feeling socially isolated, worrying about COVID-19 infection, and using psychotropic drugs were associated with PTSS. PTSS were associated with impaired quality of life, sleep, and cognition.
Approximately one-fourth of patients with cancer experienced high and persistent PTSS over the first year of the COVID-19 pandemic and may benefit from psychological support.
gov identifier: NCT04366154.
癌症患者可能特别容易受到新冠疫情的心理影响。我们研究了疫情期间癌症患者创伤后应激症状（PTSS）的患病率及演变情况，并调查了与高症状相关的因素。
COVIPACT是一项针对法国实体/血液系统恶性肿瘤患者的为期1年的纵向前瞻性研究，这些患者在全国首次封锁期间接受治疗。自2020年4月起，每3个月使用事件影响量表修订版对PTSS进行测量。患者还完成了关于其生活质量、认知主诉、失眠和新冠疫情封锁经历的问卷调查。
纵向分析纳入了386例在基线后至少有一次PTSS评估的患者（中位年龄63岁；76%为女性）。其中，21.5%的患者在首次封锁期间出现中度/重度PTSS。报告有PTSS的患者比例在封锁解除时下降（13.6%），在第二次封锁时再次上升（23.2%），从第二次解除期（22.7%）到第三次封锁时略有下降（17.5%）。患者被分为3种演变轨迹。大多数患者在此期间症状稳定且较轻，6%的患者基线症状较高且随时间缓慢下降，17.6%的患者在第二次封锁期间中度症状加重。女性、感到社会孤立、担心新冠感染以及使用精神药物与PTSS相关。PTSS与生活质量、睡眠和认知受损有关。
在新冠疫情的第一年，约四分之一的癌症患者经历了高度且持续的PTSS，可能需要心理支持。
美国国立医学图书馆标识符：NCT04366154。
