接受放疗的乳腺癌患者的抑郁和焦虑：一项纵向研究。
Depression and anxiety in patients with breast cancer receiving radiotherapy: a longitudinal study.
作者信息
Wang Shi-Jia, Feng Xin, Zhang Wei, Sun Guang-Yi, Fang Hui, Jing Hao, Tang Yu, Li Tao, Qi Shu-Nan, Song Yong-Wen, Zhang Wen-Wen, Lu Ning-Ning, Tang Yuan, Liu Yue-Ping, Chen Bo, Liu Xin, Li Ye-Xiong, Zhai Yi-Rui, Wang Shu-Lian
机构信息
State Key Laboratory of Molecular Oncology and Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
出版信息
Ther Adv Med Oncol. 2025 Jul 8;17:17588359251345930. doi: 10.1177/17588359251345930. eCollection 2025.
BACKGROUND
Depression and anxiety are common among patients with breast cancer, but prospective studies of depression and anxiety after radiotherapy (RT) among these patients remain scarce.
OBJECTIVE
To evaluate the prevalence of and changes in depression and anxiety among patients with breast cancer from the first day of RT (T0) to 6 months post-RT, and to identify risk factors associated with depression and anxiety and higher levels of them over time.
DESIGN
This observational study used a prospective, longitudinal design.
METHODS
This study was conducted in China between August 2022 and August 2023. Depression and anxiety were measured, respectively, by Patient Health Questionnaire and the Generalized Anxiety Disorder Scale, from T0 to 6 months post-RT. Univariate and multivariate logistic regressions were performed to explore risk factors for baseline depression and anxiety. Generalized Estimating Equations were performed to evaluate changes in depression and anxiety and risk factors for higher levels of them over time.
RESULTS
A total of 504 patients completed baseline questionnaires (response rate: 90.9%). The prevalence of depression and anxiety decreased significantly over time, from 37.3% and 26.0% at T0, to 28.4% and 20.3% at 6 months post-RT, respectively. Having a family history of cancer and receiving anti-HER2-targeted therapy were independently associated with depression at T0, and premenopausal status, poor family income, and self-reported menopausal symptoms were independently associated with both depression and anxiety at T0. Receiving anti-HER2-targeted therapy, having a lower personal income, and living in rural areas were associated with higher depression levels over time, whereas poor family income and self-reported menopausal symptoms were associated with higher anxiety levels over time.
CONCLUSION
Depression and anxiety levels were high among patients with breast cancer receiving RT and decreased over time from pre-RT to 6 months post-RT. Routine screening is necessary, especially for high-risk patients.
背景
抑郁症和焦虑症在乳腺癌患者中很常见，但对这些患者放疗（RT）后抑郁症和焦虑症的前瞻性研究仍然很少。
目的
评估乳腺癌患者从放疗第一天（T0）到放疗后6个月抑郁症和焦虑症的患病率及变化，并确定与抑郁症和焦虑症及其随时间推移的更高水平相关的风险因素。
设计
这项观察性研究采用前瞻性纵向设计。
方法
本研究于2022年8月至2023年8月在中国进行。从T0到放疗后6个月，分别通过患者健康问卷和广泛性焦虑症量表测量抑郁症和焦虑症。进行单因素和多因素逻辑回归以探索基线抑郁症和焦虑症的风险因素。进行广义估计方程以评估抑郁症和焦虑症的变化以及随时间推移其更高水平的风险因素。
结果
共有504名患者完成了基线问卷（应答率：90.9%）。抑郁症和焦虑症的患病率随时间显著下降，从T0时的37.3%和26.0%，分别降至放疗后6个月时的28.4%和20.3%。有癌症家族史和接受抗HER2靶向治疗在T0时与抑郁症独立相关，绝经前状态、家庭收入低和自我报告的更年期症状在T0时与抑郁症和焦虑症均独立相关。随时间推移，接受抗HER2靶向治疗、个人收入较低和生活在农村地区与较高的抑郁症水平相关，而家庭收入低和自我报告的更年期症状与较高的焦虑症水平相关。
结论
接受放疗的乳腺癌患者中抑郁症和焦虑症水平较高，从放疗前到放疗后6个月随时间下降。常规筛查是必要的，尤其是对于高危患者。
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