接受放射治疗的头颈部癌症患者的抑郁和焦虑症状：纵向研究的系统回顾和荟萃分析。

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology Pub Date : 2024-11-24 DOI:10.1016/j.radonc.2024.110649

Pablo Jiménez-Labaig , Claudia Aymerich , Antonio Rullan , Jon Cacicedo , Irene Braña , Christopher Nutting , Kate Newbold , Kevin J. Harrington , Ana Catalan

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引用次数: 0

摘要

背景和目的：头颈癌（HNC）患者尤其容易受到心理健康问题的困扰。放疗（RT）仍是治疗此类恶性肿瘤的主要方法，治愈率很高。然而，放疗对心理健康的影响尚不明确。我们旨在纵向描述HNC患者在接受RT治疗期间焦虑和抑郁症状的发生率和风险：我们进行了一次文献检索，时间从数据库建立之初到 2024 年 11 月 1 日。符合PROSPERO/MOOSE标准并预先注册（PROSPERO:CRD42023441432）的系统综述确定了对接受治愈性RT的HNC患者进行纵向报告的研究。采用随机效应荟萃分析法估算了不同治疗时间点之间具有临床意义的焦虑和抑郁症状的汇总患病率和几率：共纳入 18 项研究（样本总数为 1,920 个，平均年龄为 59.9 岁[SD = 3.17]，22.2% 为女性，93.0% 为白人）。在 RT 之前，抑郁症状的总体流行率为 18.1%（95% 置信区间 [CI] = 13.1%-24.4%）。完成 RT 后短期内（≤3 个月），抑郁症状的发生率达到峰值，为 26.1%（95 %CI = 18.9 %-35.0%），在长期（≥6 个月）评估中降至 16.4%（95 %CI = 12.6 %-21.0%）。焦虑症状从基线（合计患病率为 29.9 % [95 %CI = 27.3 %-32.7%]）持续下降至长期的 17.4 % (95 %CI = 12.1 %-24.5%)。女性和已婚患者的抑郁症状发生率较高。接受过手术的患者焦虑症状发生率较低：结论：在接受 RT 治疗的 HNC 患者中，从基线到长期随访，临床上抑郁症状和焦虑症状的发生率都很高。RT结束后的几周是关键时期，因为在此期间抑郁症状会增加。在 RT 之前、期间，尤其是 RT 结束后立即进行筛查和干预将是有益的。

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Prevalence of depressive and anxiety symptoms in patients with head and neck cancer undergoing radiotherapy: A systematic review and meta-analysis of longitudinal studies

Background and purpose

Patients with head and neck cancer (HNC) are particularly vulnerable to mental health concerns. Radiotherapy (RT) remains a key treatment modality for these malignancies, offering high chances of cure. However, the effects on mental health are not well defined. We aim to characterize longitudinally the prevalence and risk of depressive and anxiety symptoms over the course of RT in patients with HNC.

Material and methods

A literature search was performed from database inception until November 1st, 2024. PROSPERO/MOOSE-compliant and pre-registered (PROSPERO:CRD42023441432) systematic review identified studies longitudinally reporting in patients with HNC undergoing curative intent RT. Pooled prevalence and odds ratio of clinically significant anxiety and depressive symptoms between different treatment timepoints were estimated using random-effects meta-analysis.

Results

18 studies (total sample 1,920, mean age 59.9[SD = 3.17], 22.2 % female, 93.0 % white ethnicity) were included. Before RT, a pooled prevalence of depressive symptoms of 18.1 % (95 % confidence intervals [CI] = 13.1 %-24.4 %) was found. Short-term after completing RT (≤3 months), the prevalence of depressive symptoms peaked to 26.1 % (95 %CI = 18.9 %-35.0 %), decreasing in long-term (≥6 months) assessments to 16.4 % (95 %CI = 12.6 %-21.0 %). Anxiety symptoms continuously decreased from baseline (pooled prevalence 29.9 % [95 %CI = 27.3 %–32.7 %]) to 17.4 % (95 %CI = 12.1 %-24.5 %) in the long-term. Female and married patients showed higher prevalence of depressive symptoms. Those who underwent surgery showed a lower prevalence of anxiety symptoms.

Conclusions

High prevalence of clinically significant depressive and anxiety symptoms were found in patients with HNC undergoing RT, from baseline to long-term follow-up. The weeks following completion of RT are key, as depressive symptoms increase in this period. Screening and interventions prior to, during, and especially immediately post-RT would be beneficial.

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来源期刊

Radiotherapy and Oncology 医学-核医学

CiteScore

10.30

自引率

10.50%

发文量

2445

审稿时长

45 days

期刊介绍： Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.