鼻咽癌患者放疗前焦虑抑郁状态在预后中的作用研究

Prognostic role of anxiety and depression condition before radiotherapy in patients with nasopharyngeal carcinoma

目的探讨鼻咽癌根治性放疗患者放疗前焦虑抑郁评分与预后的关系。方法回顾性分析2013年1月至2022年1月行根治性放疗的358例鼻咽癌患者,治疗前进行汉密尔顿焦虑、抑郁量表评估焦虑、抑郁状态。比较焦虑、非焦虑患者及抑郁、非抑郁患者之间生存率,并分析潜在的预后相关因素。结果全组患者5年总生存率(OS)74.8%。放疗前存在焦虑患者142例,无焦虑患者216例,两组患者5年OS分别为64%和82.5%,差异有统计学意义(P<0.001)。放疗前存在抑郁患者82例,无抑郁患者276例,两组患者5年OS分别为54.8%和79.8%,差异有统计学意义(P<0.001)。多因素COX回归分析均显示肿瘤T分期、KPS评分、同步化疗、焦虑、抑郁状态为影响患者OS的独立预后因素。结论鼻咽癌患者放疗前焦虑、抑郁状态为预后不良因素。

Objective To investigate the relationship between the scores of anxiety and depression before radiotherapy and the prognosis in patients with nasopharyngeal carcinoma.Methods A total of 358 patients with nasopharyngeal carcinoma treated with radical radiotherapy in our hospital from January 2013 to January 2022 were selected.The clinical data were retrospectively analyzed.Hamilton Anxiety and Depression Scale were used to evaluate the degree of anxiety and depression before radiotherapy.The survival rates were compared between patients with and without anxiety and patients with and without depression.The potential prognostic factors were also analyzed.Results The 5-year overall survival rate(OS)in all patients was 74.8%.There were 142 patients with anxiety and 212 patients without anxiety before radiotherapy.The 5-year OS of the two groups was 64%and 82.5%,respectively(P<0.000).There were 82 patients with depression and 276 patients without depression before radiotherapy.The 5-year OS of the two groups were 54.8%and 79.8%,respectively(P<0.000).Univariate and multivariate COX regression analysis showed that T stage,KPS score,concurrent chemotherapy,anxiety status and depression status were independent prognostic factors for OS.Conclusions Anxiety and depression before radiotherapy are unfavorable prognostic factors in patients with nasopharyngeal carcinoma.