Depressive symptoms predict head and neck cancer survival: Examining plausible behavioral and biological pathways.

Autor: Zimmaro LA; Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky., Sephton SE; Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky.; James Graham Brown Cancer Center, Louisville, Kentucky., Siwik CJ; Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky., Phillips KM; Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky., Rebholz WN; Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders, University of Louisville School of Medicine, Louisville, Kentucky., Kraemer HC; Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, California., Giese-Davis J; Alberta Health Services Center Care (Holy Cross Site), Calgary, Alberta, Canada.; Division of Psychosocial Oncology, Department of Oncology, Faculty of Medicine, University of Calgary, Alberta, Canada.; Department of Psychology, University of Calgary, Calgary, Alberta, Canada., Wilson L; James Graham Brown Cancer Center, Louisville, Kentucky.; Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders, University of Louisville School of Medicine, Louisville, Kentucky., Bumpous JM; James Graham Brown Cancer Center, Louisville, Kentucky.; Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders, University of Louisville School of Medicine, Louisville, Kentucky., Cash ED; Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky.; James Graham Brown Cancer Center, Louisville, Kentucky.; Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders, University of Louisville School of Medicine, Louisville, Kentucky.
Jazyk: angličtina
Zdroj: Cancer [Cancer] 2018 Mar 01; Vol. 124 (5), pp. 1053-1060. Date of Electronic Publication: 2018 Jan 22.
DOI: 10.1002/cncr.31109
Abstrakt: Background: Head and neck cancers are associated with high rates of depression, which may increase the risk for poorer immediate and long-term outcomes. Here it was hypothesized that greater depressive symptoms would predict earlier mortality, and behavioral (treatment interruption) and biological (treatment response) mediators were examined.
Methods: Patients (n = 134) reported depressive symptomatology at treatment planning. Clinical data were reviewed at the 2-year follow-up.
Results: Greater depressive symptoms were associated with significantly shorter survival (hazard ratio, 0.868; 95% confidence interval [CI], 0.819-0.921; P < .001), higher rates of chemoradiation interruption (odds ratio, 0.865; 95% CI, 0.774-0.966; P = .010), and poorer treatment response (odds ratio, 0.879; 95% CI, 0.803-0.963; P = .005). The poorer treatment response partially explained the depression-survival relation. Other known prognostic indicators did not challenge these results.
Conclusions: Depressive symptoms at the time of treatment planning predict overall 2-year mortality. Effects are partly influenced by the treatment response. Depression screening and intervention may be beneficial. Future studies should examine parallel biological pathways linking depression to cancer survival, including endocrine disruption and inflammation. Cancer 2018;124:1053-60. © 2018 American Cancer Society.
(© 2018 American Cancer Society.)
Databáze: MEDLINE
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