Division of Imaging and Oncology, University Medical Centre Utrecht, Cancer Centre, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
Department of Surgery, St. Antonius Hospital, Utrecht, The Netherlands.
Qual Life Res. 2023 Aug;32(8):2375-2390. doi: 10.1007/s11136-023-03400-6. Epub 2023 Apr 4.
During the first SARS-CoV-2-infection wave, a deterioration in emotional well-being and increased need for mental health care were observed among patients treated or being treated for breast cancer. In this follow-up study, we assessed patient-reported quality of life (QoL), physical functioning, and psychosocial well-being during the second SARS-CoV-2-infection wave in a large, representative cohort.
This longitudinal cohort study was conducted within the prospective, multicenter UMBRELLA breast cancer cohort. To assess patient-reported QoL, physical functioning and psychosocial well-being, COVID-19-specific surveys were completed by patients during the first and second SARS-CoV-2-infection waves (April and November 2020, respectively). An identical survey was completed by a comparable reference population during the second SARS-CoV-2-infection waves. All surveys included the validated EORTC-QLQ-C30/BR23, HADS and "De Jong-Gierveld Loneliness" questionnaires. Pre-COVID-19 EORTC-QLQ-C30/BR23 and HADS outcomes were available from UMBRELLA. Response rates were 69.3% (n = 1106/1595) during the first SARS-CoV-2-infection wave and 50.9% (n = 822/1614) during the second wave. A total of 696 patients responded during both SARS-CoV-2-infection waves and were included in the analysis comparing patient-reported outcomes (PROs) during the second SARS-CoV-2-infection wave to PROs during the first wave. Moreover, PROs reported by all patients during the second SARS-CoV-2-infection wave (n = 822) were compared to PROs of a similar non-cancer reference population (n = 241) and to their pre-COVID-19 PROs.
Patient-reported QoL, physical functioning, and psychosocial well-being of patients treated or being treated for breast cancer remained stable or improved from the first to the second SARS-CoV-2-infection wave. The proportion of emotional loneliness reduced from 37.6 to 29.9% of patients. Compared to a similar non-cancer reference population, physical, emotional, and cognitive functioning, future perspectives and symptoms of dyspnea and insomnia were worse in patients treated or being treated for breast cancer during the second SARS-CoV-2-infection wave. PROs in the second wave were similar to pre-COVID-19 PROs.
Although patients scored overall worse than individuals without breast cancer, QoL, physical functioning, and psychosocial well-being did not deteriorate between the first and second wave. During the second wave, PROs were similar to pre-COVID-19 values. Overall, current findings are cautiously reassuring for future mental health of patients treated or being treated for breast cancer.
在首次 SARS-CoV-2 感染浪潮期间，接受或正在接受乳腺癌治疗的患者的情绪健康状况恶化，对心理健康护理的需求增加。在这项随访研究中，我们在一个大型代表性队列中评估了患者在第二次 SARS-CoV-2 感染浪潮期间的报告的生活质量 (QoL)、身体功能和心理社会健康状况。
这项纵向队列研究是在前瞻性、多中心 UMBRELLA 乳腺癌队列中进行的。为了评估患者报告的 QoL、身体功能和心理社会健康状况，患者在首次和第二次 SARS-CoV-2 感染浪潮期间（分别为 2020 年 4 月和 11 月）完成了 COVID-19 特定的调查。具有可比性的参考人群在第二次 SARS-CoV-2 感染浪潮期间完成了相同的调查。所有调查均包括经过验证的 EORTC-QLQ-C30/BR23、HADS 和“De Jong-Gierveld 孤独”问卷。来自 UMBRELLA 的预 COVID-19 EORTC-QLQ-C30/BR23 和 HADS 结果可用。首次 SARS-CoV-2 感染浪潮期间的应答率为 69.3%（n=1106/1595），第二次 SARS-CoV-2 感染浪潮期间的应答率为 50.9%（n=822/1614）。共有 696 名患者在两次 SARS-CoV-2 感染浪潮期间做出了回应，并纳入了对第二次 SARS-CoV-2 感染浪潮期间患者报告的结果 (PROs) 与首次 SARS-CoV-2 感染浪潮期间的 PROs 进行比较的分析中。此外，在第二次 SARS-CoV-2 感染浪潮期间，所有患者报告的 PROs（n=822）与类似的非癌症参考人群（n=241）和他们的预 COVID-19 PROs 进行了比较。
接受或正在接受乳腺癌治疗的患者的报告 QoL、身体功能和心理社会健康状况从首次 SARS-CoV-2 感染浪潮到第二次 SARS-CoV-2 感染浪潮保持稳定或有所改善。情绪孤独的患者比例从 37.6%下降到 29.9%。与类似的非癌症参考人群相比，接受或正在接受乳腺癌治疗的患者在第二次 SARS-CoV-2 感染浪潮期间的身体、情绪和认知功能、未来前景以及呼吸困难和失眠症状恶化。第二波的 PROs 与预 COVID-19 的 PROs 相似。
尽管患者的总体得分低于没有乳腺癌的个体，但在第一波和第二波之间，QoL、身体功能和心理社会健康状况并未恶化。在第二波中，PROs 与预 COVID-19 时的值相似。总体而言，目前的研究结果谨慎地令人放心，因为接受或正在接受乳腺癌治疗的患者未来的心理健康状况。
