Psychological Factors Related to Treatment Outcomes in Head and Neck Cancer

IF 3.4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Advances in Therapy Pub Date : 2024-08-07 DOI:10.1007/s12325-024-02945-3

Antti A. Mäkitie, Rasheed Omobolaji Alabi, Laura Pulkki-Råback, Alhadi Almangush, Jonathan J. Beitler, Nabil F. Saba, Primož Strojan, Robert Takes, Orlando Guntinas-Lichius, Alfio Ferlito

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Abstract

Background

Patients with head and neck cancer (HNC) often demonstrate stress, distress, anxiety, depression, and are at risk for suicide. These affect their quality of life (QoL) but less attention has been given to psychological variables that may impact response to treatment.

Objectives

This study aims to systematically review publications during 2013–2023 to collate evidence on the effects of psychological variables on HNC treatment outcomes.

Methods

We searched Ovid Medline, PubMed, Scopus, and Web of Science for articles that examined psychological factors related to treatment outcomes in patients with HNC.

Results

There were 29 studies (5 before treatment, 2 during, 17 after, and 5 covering the whole management trajectory) including 362,766 patients. The psychological factors were either behavioral (adjustment and coping strategy, unrealistic ideas, self-blame), cognitive (elevated risk of psychiatric co-comorbidity), or emotional (distress, depression, anxiety, nervousness, and fear of disfigurement and complications). It was found that there was a relationship between depression and decreased survival in patients with HNC. Pretreatment pain was an independent predictor of decreased survival in a large sample of patients. The distress level was approximately 54%, emotional problems ranged between 10 and 44%, while financial difficulties were identified in 54% of the patients. Sixty-nine percent of patients were reported to have used at least one cost-coping strategy within 6 months after treatment initiation. During post-treatment period, depression increased from 15% at the baseline to 29%, while the fear of recurrence was found among at least 35% of patients.

Discussion and Conclusion

Several psychological factors predict QoL and survival among HNC survivors. Distress encompasses depression and anxiety, and physical burden from HNC diagnosis and treatment. Routine screening and early interventions that target distress could improve HNC survivors’ QoL. A systematic and standardized measurement approach for QoL is warranted to homogenize these findings and to understand the underlying relationships.

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与头颈癌治疗结果相关的心理因素。

背景：头颈部癌症（HNC）患者经常表现出压力、痛苦、焦虑和抑郁，并面临自杀风险。这些都会影响他们的生活质量（QoL），但人们对可能影响治疗反应的心理变量关注较少：本研究旨在系统回顾 2013-2023 年间发表的文献，整理心理变量对 HNC 治疗效果影响的证据：方法：我们检索了Ovid Medline、PubMed、Scopus和Web of Science中研究心理因素对HNC患者治疗效果影响的文章：共有 29 项研究（5 项在治疗前，2 项在治疗中，17 项在治疗后，5 项涵盖整个治疗过程），包括 362 766 名患者。心理因素包括行为因素（适应和应对策略、不切实际的想法、自责）、认知因素（精神疾病并发症风险升高）或情绪因素（痛苦、抑郁、焦虑、紧张以及对毁容和并发症的恐惧）。研究发现，抑郁与 HNC 患者存活率下降之间存在关系。在大样本患者中，治疗前疼痛是生存率下降的独立预测因素。约 54% 的患者感到痛苦，10% 至 44% 的患者有情绪问题，54% 的患者有经济困难。据报告，69%的患者在开始治疗后的 6 个月内至少使用过一种费用应对策略。在治疗后期间，抑郁症患者从基线的 15%增加到 29%，而至少 35% 的患者对复发感到恐惧：讨论和结论：有几种心理因素可预测 HNC 存活者的生活质量和存活率。困扰包括抑郁和焦虑，以及 HNC 诊断和治疗带来的身体负担。针对困扰的常规筛查和早期干预可改善 HNC 幸存者的 QoL。有必要对QoL采用系统化和标准化的测量方法，以统一这些研究结果，并了解其中的内在关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.