认知行为疗法对局部晚期鼻咽癌同期放化疗患者焦虑、抑郁的影响

The effects of cognitive behavioral therapy on anxiety and depression of locoregional advanced nasopharyngeal carcinoma patients with concurrent chemoradiotherapy

目的比较认知行为疗法(CBT)与常规治疗(TAU)对局部晚期鼻咽癌患者焦虑抑郁情绪、近期疗效及急性不良反应的影响。方法选择2020年4月—2020年7月收治的123例被确诊为Ⅲ-Ⅳa期鼻咽癌的患者,随机分为认知行为疗法联合同期放化疗组(CBT组,n=60)和常规治疗联合同期放化疗组(TAU组,n=63)。分别于治疗前、同期放化疗结束时和同期放化疗结束后1个月,采用医院焦虑抑郁量表(HADS)评价两组患者的焦虑、抑郁情绪,同时观察两组患者的近期疗效和急性不良反应。结果CBT组患者的焦虑、抑郁评分明显低于TAU组(P<0.001),完全缓解率及客观缓解率显著高于TAU组(P<0.05),急性不良反应发生率明显低于TAU组(P<0.05)。结论在放化疗的基础上联合CBT可显著减轻局部晚期鼻咽癌患者的焦虑、抑郁情绪,提高近期疗效,降低急性不良反应发生率,值得临床推广应用。

ObjectiveTo explore the effects of cognitive behavioral therapy(CBT)and treatment as usual(TAU)on the anxiety and depression,short-term efficacy and acute adverse events of patients with locoregional advanced nasopharyngeal carcinoma(LA-NPC).MethodsTotally 123 patients with stageⅢ-Ⅳa nasopharyngeal carcinoma enrolled in the hospital between April 2020 and July 2020 were randomly divided into the CBT group(n=60)and the TAU group(n=63).Patients in CBT group got cognitive behavioral therapy(CBT)plus chemoradiotherapy,and those in TAU group got treatment as usual(TAU)plus chemoradiotherapy.The hospital anxiety and depression scale(HADS)was used to evaluate the depression and anxiety of patients in both groups before treatment,right after chemoradiotherapy,and 1 month after chemoradiotherapy.The short-term efficacy and acute adverse events were also observed,and were compared between the two groups.ResultsPatients in the CBT group had significantly lower scores of depression and anxiety than those in TAU group(P<0.001).The CBT group also had higher complete response rate and objective response rate than the TAU group(P<0.05).In the CBT group,the incidence rate of acute adverse events was significantly lower than that in the TAU group(P<0.05).ConclusionCBT can significantly alleviate the anxiety and depression of patients with LA-NPC.CBT combined with chemoradiotherapy can improve the short-term efficacy and reduce the incidence of adverse events.It is worthy of popularization.