The prognostic factors and trajectory of HRQOL in patients with pancreatic cancer who received psychiatric intervention

Sugimoto, Hiroyuki; Kawashima, Hiroki; Ohno, Eizaburo; Hayashi, Daijuro; Kuwahara, Takamichi; Morishima, Toshitaka; Kawai, Manabu; Suhara, Hiroki; Takeyama, Tomoaki; Yamamura, Takeshi; Funasaka, Kohei; Nakamura, Masanao; Miyahara, Ryoji; Watanabe, Osamu; Ishigami, Masatoshi; Suzuki, Miho; Kimura, Hiroyuki; Ozaki, Norio; Hashimoto, Senju; Goto, Hidemi; Hirooka, Yoshiki

doi:10.1111/jgh.13172

Cited by 16 publications

(17 citation statements)

References 24 publications

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“…Asides from assessing the evolution of HRQoL in real-life patients receiving first-line chemotherapy, we investigated the prognostic value of baseline HRQoL in our study population. Previous clinical trials and real-life studies have demonstrated that baseline HRQoL and subsequent changes during treatment (global and subscales) are associated with survival of patients with pancreatic cancer[8,9,[11][12][13][14]35]. Our results confirmed this trend in a real-life setting, with patients scoring ≥50 in the QLQ-C30 global health status scale and showing higher OS and PFS.…”

supporting

confidence: 86%

Quality of Life of Patients with Metastatic Pancreatic Adenocarcinoma Initiating First‐Line Chemotherapy in Routine Practice

Laquente

Macarulla²,

Bugés

et al. 2020

Preprint

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Background Considering the physical decline of patients with metastatic pancreatic adenocarcinoma, assessing their health-related quality of life becomes a matter of major concern. Methods Observational, prospective, multicenter study including patients with metastatic pancreatic adenocarcinoma who started first‐line chemotherapy in 12 Spanish centers. Treatment and clinical characteristics were recorded at baseline. Patients’ health-related quality of life, ECOG, and Karnofsky index were measured at baseline, at Days 15 and 30, and every four weeks up to 6 months of chemotherapy. Health-related quality of life was measured using the EORTC-QLQ‐C30 and EQ-5D questionnaires. Other endpoints included overall survival and progression‐free survival. Results The study sample included 116 patients (median age of 65 years). Mean (SD) scores for the QLQ-C30 global health status scale showed a significant increasing trend throughout the treatment (p=0.005). Patients with either a Karnofsky index of 70-80 or ECOG 2 showed greater improvement in the QLQ-C30 global health status score than the corresponding groups with better performance status (p≤0.010). Pain, appetite, sleep disturbance, nausea, and constipation significantly improved throughout the treatment (p<0.005). Patients with QLQ-C30 global health status scores ≥50 at baseline had significantly greater overall survival and progression-free survival (p=0.005 and p=0.021, respectively). No significant associations were observed regarding the EQ-5D score. Conclusions Most metastatic pancreatic adenocarcinoma patients receiving first-line chemotherapy improved their health-related quality of life throughout the treatment. Patients with lower performance status and health-related quality of life at baseline tended to greater improvement. The EORTC QLQ-C30 scale is suitable for measuring the health-related quality of life of metastatic pancreatic adenocarcinoma patients receiving first-line chemotherapy.

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supporting

confidence: 86%

Quality of Life of Patients with Metastatic Pancreatic Adenocarcinoma Initiating First‐Line Chemotherapy in Routine Practice

Laquente

Macarulla²,

Bugés

et al. 2020

Preprint

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“…Reductions in cortisol levels or normalization of diurnal cortisol patterns have also been reported 150,152 . The changes in immunological and endocrine responses associated with psychological interventions do not seem only to exert a beneficial impact on coping strategies, stress relieving, affective symptoms and on quality of life measures [153][154][155] , but there is also some evidence of a long-lasting effect on survival. For instance, in a study with a 11-year follow-up of breast cancer patients, psychological treatment was effective in reducing the risk of recurrence (hazard ratio [HR]= 0.55; 95% CI 0.28-0.93) and death from breast cancer (HR = 0.44; 95% CI 0.32-0.957) 156 .…”

Section: Effects Of Psychological Treatments On Depression In Patientmentioning

confidence: 99%

Depression in cancer: The many biobehavioral pathways driving tumor progression

Bortolato

Hyphantis

Valpione

et al. 2017

Cancer Treatment Reviews

248

179

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Major Depressive Disorder (MDD) is common among cancer patients, with prevalence rates up to four-times higher than the general population. Depression confers worse outcomes, including non-adherence to treatment and increased mortality in the oncology setting. Advances in the understanding of neurobiological underpinnings of depression have revealed shared biobehavioral mechanisms may contribute to cancer progression. Moreover, psychosocial stressors in cancer promote:(1) inflammation and oxidative/nitrosative stress; (2) a decreased immunosurveillance; and (3) a dysfunctional activation of the autonomic nervous system and of the hypothalamic-pituitary-adrenal axis. Consequently, the prompt recognition of depression among patients with cancer who may benefit of treatment strategies targeting depressive symptoms, cognitive dysfunction, fatigue and sleep disturbances, is a public health priority. Moreover, behavioral strategies aiming at reducing psychological distress and depressive symptoms, including addressing unhealthy diet and life-style choices, as well as physical inactivity and sleep dysfunction, may represent important strategies not only to treat depression, but also to improve wider cancer-related outcomes. Herein, we provide a comprehensive review of the intertwined biobehavioural pathways linking depression to cancer progression. In addition, the clinical implications of these findings are critically reviewed.

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“…Recent studies have indicated that early psychiatric intervention is essential for patients with cancer and could improve their QoL and prevent subsequent psychological distress. 27,28 Considering the high levels of anxiety about AL-CFR and prolonged treatment in patients with malignant skull base tumors, early psychiatric intervention before surgery is important.…”

Section: Discussionmentioning

confidence: 99%

Prospective Evaluation of Health-Related Quality of Life in Patients Undergoing Anterolateral Craniofacial Resection with Orbital Exenteration

Mukoyama

Nishio

Kimura

et al. 2019

J Neurol Surg B Skull Base

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Objective This study was aimed to evaluate health-related quality of life in patients undergoing anterolateral craniofacial resection (AL-CFR) with orbital exenteration (OE) for malignant skull base tumors and to investigate the effects of early psychiatric intervention. Design Present study is a prospective, observational study. Setting The study took place at the hospital department. Participants Twenty-six consecutive patients were selected who underwent AL-CFR with OE at our hospital between 2005 and 2015. Main Outcome Measures Health-related quality of life was assessed preoperatively and 3, 6, 12, and 24 months after surgery using the Hospital Anxiety and Depression Scale (HADS) and medical outcomes study 8-items Short Form health survey (SF-8). In all cases, psychiatric intervention was organized by the consultation liaison psychiatry team preoperatively and postoperatively. Results Ten (38.0%) of the 26 patients died and 16 (62.0%) were alive and disease-free at the end of the study. The 3-year overall and disease-free survival rates were 64.9% and 53.3%, respectively. Twenty-one patients (80.8%) developed psychiatric complications after surgery and needed treatment with psychotropic medication. Before surgery, 28% of patients had HADS scores ≥8 for anxiety and 20% had scores ≥8 for depression. Seven of the eight items in the SF-8 were significantly lower than those for the general Japanese population. However, scores for all the SF-8 items gradually improved during postoperative follow-up, reaching approximately 50 points, which is the national standard value, at 2 years after surgery. Conclusions Craniofacial resection with OE was feasible and well tolerated in patients with malignant skull base tumors who received early psychiatric intervention to decrease the considerable psychological impact of this procedure.

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The prognostic factors and trajectory of HRQOL in patients with pancreatic cancer who received psychiatric intervention

Abstract: Early psychiatric intervention in patients with pancreatic cancer may maintain HRQOL. More effective pain management and reduction of psychological distress are important for patients with pancreatic cancer.

Cited by 16 publications

References 24 publications

Quality of Life of Patients with Metastatic Pancreatic Adenocarcinoma Initiating First‐Line Chemotherapy in Routine Practice

Quality of Life of Patients with Metastatic Pancreatic Adenocarcinoma Initiating First‐Line Chemotherapy in Routine Practice

Depression in cancer: The many biobehavioral pathways driving tumor progression

Prospective Evaluation of Health-Related Quality of Life in Patients Undergoing Anterolateral Craniofacial Resection with Orbital Exenteration

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