头颈部癌症治疗患者的创伤后应激障碍：一项系统综述。
PTSD in Patients Who Undergo Head and Neck Cancer Treatment: A Systematic Review.
作者信息
Weiss Orli, Runnels Juliana, Dickstein Daniel R, Hsieh Kristin, Jacobs Lauren, Shah Anuja, Arons Danielle, Reed Samuel, Sindhu Kunal K, Bakst Richard, Bloom Julie
机构信息
Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
出版信息
Curr Oncol. 2025 Feb 26;32(3):134. doi: 10.3390/curroncol32030134.
BACKGROUND/OBJECTIVES: Post-traumatic stress disorder (PTSD) can develop after exposure to real or perceived threats to life and is characterized by symptoms including intrusive thoughts, hyperarousal, and emotional numbness. While PTSD is well-studied in populations affected by disasters and combat, the impact of serious medical conditions like cancer and its treatments remain under-researched. Due to the aggressive nature of the disease, fear of recurrence, and disfiguring nature of treatments, patients with head and neck cancer (HNC) may experience a real or perceived risk of death. This systematic review synthesizes current knowledge on PTSD in patients with HNC.
METHODS
A systematic review was conducted per PRISMA guidelines. Five databases (PubMed, EMBASE, SCOPUS, CINAHL, and COCHRANE) were searched for studies describing PTSD in patients with and survivors of HNC. Studies with PTSD diagnosis and/or symptom data specific to patients with HNC were included.
RESULTS
Of 80 studies, 14 met the inclusion criteria. The most commonly used scale was the PTSD Checklist-Civilian Version. The prevalence of PTSD ranged from 8% to 41% across the studies. No significant differences were found with regards to PTSD prevalence by HNC tumor site, disease stage, or treatment modality. Two studies identified significant associations between PTSD after treatment and depression at the time of diagnosis. Patients with PTSD who received cognitive behavioral therapy showed improvement in their PTSD symptoms compared to those who did not.
CONCLUSIONS
PTSD is common in individuals with HNC; however, the lack of a standardized approach to diagnosing PTSD in patients with and survivors of HNC creates challenges in identifying patients who may benefit from treatment. Given that HNC is the seventh most common cancer worldwide, with increasing incidence, there is a need to better understand the relationship between HNC and PTSD to allow for better PTSD screening, identification, and treatment to improve patients' health-related quality of life and provide optimal patient care.
背景/目的：创伤后应激障碍（PTSD）可在暴露于真实或感知到的生命威胁后发生，其特征症状包括侵入性思维、过度警觉和情感麻木。虽然PTSD在受灾难和战斗影响的人群中已有充分研究，但癌症等严重疾病及其治疗的影响仍研究不足。由于疾病的侵袭性、对复发的恐惧以及治疗的毁容性，头颈癌（HNC）患者可能会经历真实或感知到的死亡风险。本系统评价综合了关于HNC患者PTSD的现有知识。
方法
按照PRISMA指南进行系统评价。检索了五个数据库（PubMed、EMBASE、SCOPUS、CINAHL和COCHRANE），以查找描述HNC患者及幸存者中PTSD的研究。纳入具有特定于HNC患者的PTSD诊断和/或症状数据的研究。
结果
80项研究中，14项符合纳入标准。最常用的量表是《创伤后应激障碍检查表 - 平民版》。各项研究中PTSD的患病率在8%至41%之间。在HNC肿瘤部位、疾病阶段或治疗方式方面，PTSD患病率未发现显著差异。两项研究确定了治疗后PTSD与诊断时的抑郁之间存在显著关联。接受认知行为疗法的PTSD患者与未接受该疗法的患者相比，其PTSD症状有所改善。
结论
PTSD在HNC患者中很常见；然而，在HNC患者及幸存者中缺乏诊断PTSD的标准化方法，给识别可能从治疗中受益的患者带来了挑战。鉴于HNC是全球第七大常见癌症，且发病率不断上升，有必要更好地了解HNC与PTSD之间的关系，以便进行更好的PTSD筛查、识别和治疗，从而改善患者的健康相关生活质量并提供最佳的患者护理。
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