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基于放化疗的免疫检查点阻断与头颈癌患者治疗后抑郁和焦虑之间的关联:一项横断面研究。

Associations between chemoradiotherapy-based immune checkpoint blockade and posttreatment depression and anxiety in head and neck cancer patients: a cross-sectional study.

作者信息

Zhang Yang, Chen Yunhao, Zhang Xianxing, Hong Yafang, Zhou Zihan, Ding Xingchen

机构信息

Clinical Diagnosis and Treatment Center of Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, China.

Institute of Radiotherapy & Oncology, Soochow University, Suzhou, China.

出版信息

Front Immunol. 2025 Sep 1;16:1649486. doi: 10.3389/fimmu.2025.1649486. eCollection 2025.

Abstract

Immune checkpoint blockade (ICB) and combination treatment paradigms have gradually improved the prognosis of head and neck cancer (HNC) patients. However, HNC survivors struggle with anxiety and depression because of the large variety of persistent cancer-related or treatment-related symptoms. Recent studies have suggested that emotional distress is closely related to the therapeutic efficacy of ICB. In this study, 232 advanced HNC patients were recruited and their anxiety and depression status were assessed by the Hospital Anxiety and Depression Scale (HADS). Propensity score matching (PSM) was applied to balance confounders. The nearest-neighbor matching method was used for PSM matching to perform 1:1 matching. By comparing the anxiety and depression status of HNC patients after PSM, we showed that HNC patients receiving chemoradiotherapy (CRT) combined with ICB, both concurrent radiotherapy (RT) and sequential RT, had lower depression levels than did those receiving CRT alone. These findings suggest that ICB treatment may be associated with emotional status, which may could offer insights into ameliorate quality of life, both physically and psychologically, of HNC patients.

摘要

免疫检查点阻断(ICB)及联合治疗模式已逐渐改善了头颈癌(HNC)患者的预后。然而,由于存在大量持续的癌症相关或治疗相关症状,HNC幸存者仍饱受焦虑和抑郁之苦。近期研究表明,情绪困扰与ICB的治疗效果密切相关。在本研究中,招募了232例晚期HNC患者,并通过医院焦虑抑郁量表(HADS)评估他们的焦虑和抑郁状态。采用倾向评分匹配(PSM)来平衡混杂因素。最近邻匹配法用于PSM匹配以进行1:1匹配。通过比较PSM后HNC患者的焦虑和抑郁状态,我们发现接受放化疗(CRT)联合ICB(包括同步放疗(RT)和序贯RT)的HNC患者的抑郁水平低于单纯接受CRT的患者。这些发现表明,ICB治疗可能与情绪状态有关,这可能为改善HNC患者的身体和心理生活质量提供见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0138/12434114/9d6f2942d6bd/fimmu-16-1649486-g001.jpg

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