Homan Eva, Kwakkenbos Linda, Deuning-Smit Esther, Jansen Femke, Verdonck-de Leeuw Irma M, Takes Robert P, Langendijk Johannes A, Leemans C René, de Bree Remco, Hardillo Jose A, Lamers Femke, Prins Judith B, Custers José A E
Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
J Cancer Surviv. 2024 Dec 16. doi: 10.1007/s11764-024-01731-y.
Limited data exists on the long-term course of fear of cancer recurrence (FCR) in head and neck cancer (HNC) patients. One in five patients was found to experience persistent high FCR in the first months after diagnosis. This study assessed the 3-year trajectories and associated factors of FCR in newly diagnosed HNC patients.
Six hundred twenty-one patients from the NETherlands Quality of life and Biomedical Cohort study (NET-QUBIC) completed the FCR assessment at baseline, 3-, 6-, 12-, 24-, and 36-months posttreatment. Trajectories of FCR were identified using latent class growth analysis. Multinominal logistic regression analysis was used to assess associations between FCR trajectories and baseline demographic and medical variables, personality, and coping.
Three FCR trajectories were identified: "consistently high" (n = 45, 7%), "elevated and declining" (n = 209, 34%), and "low and declining" (n = 367, 59%). Patients in the "elevated and declining" and "consistently high" trajectory were younger, had more comorbidities, higher negative adjustment, a higher level of neuroticism, more social support seeking, and more reliance on passive and palliative coping strategies.
Three years following diagnosis, the majority of HNC patients showed a resilient FCR trajectory whereas a small percentage of HNC patients (7%) showed persistent high FCR over time.
Younger patients and those with a higher level of neuroticism or maladaptive coping strategies were more vulnerable to have a consistent high level of FCR over time. It is important to identify these patients to provide optimal and tailored psychosocial support.
关于头颈癌（HNC）患者癌症复发恐惧（FCR）的长期病程，现有数据有限。研究发现，五分之一的患者在确诊后的头几个月会经历持续的高FCR。本研究评估了新确诊的HNC患者FCR的3年轨迹及相关因素。
来自荷兰生活质量与生物医学队列研究（NET-QUBIC）的621名患者在基线、治疗后3个月、6个月、12个月、24个月和36个月完成了FCR评估。使用潜在类别增长分析确定FCR的轨迹。多项逻辑回归分析用于评估FCR轨迹与基线人口统计学和医学变量、人格及应对方式之间的关联。
确定了三种FCR轨迹：“持续高”（n = 45，7%）、“先升高后下降”（n = 两百零九，34%）和“低且下降”（n = 三百六十七，59%）。处于“先升高后下降”和“持续高”轨迹的患者更年轻，合并症更多，消极适应程度更高，神经质水平更高，寻求更多社会支持，且更多依赖被动和姑息性应对策略。
诊断三年后，大多数HNC患者的FCR轨迹具有恢复力，而一小部分HNC患者（7%）随着时间推移表现出持续的高FCR。
年轻患者以及神经质水平较高或采用适应不良应对策略的患者，随着时间推移更易出现持续的高FCR水平。识别这些患者以提供最佳且量身定制的心理社会支持非常重要。
