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Psychological distress as a risk factor for the efficacy of chemotherapy in advanced gastric cancer patients

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Abstract

Aim

To assess the relationship between psychological distress and quality of life (QoL), cancer-related fatigue (CRF), and chemotherapy efficacy in advanced gastric cancer patients.

Methods

Advanced gastric cancer patients (39 with psychological distress and 35 without psychological distress) completed the Distress Thermometer (DT), QoL, and CRF test before receiving chemotherapy and assessed the efficacy after completing 2 courses of chemotherapy.

Results

Psychological distress was a significant factor in the efficacy of chemotherapy in advanced gastric cancer patients (χ2 = 6.324; p = 0.042). Compared to advanced gastric cancer patients with no psychological distress, advanced gastric cancer patients with psychological distress had a poorer QoL (50.41 ± 6.17 vs. 60.01 ± 7.94, t =  − 5.882, p < 0.01) and more pronounced CRF (5.75 ± 1.16 vs. 3.22 ± 0.75, t = 11.231, p < 0.01) while receiving chemotherapy. FACT-G (p = 0.0035, r =  − 0.4568), as well as PFS (p < 0.0001, r = 0.6599), correlated significantly with efficacy for patients in the psychological distress group. The FACT-G (p = 0.0134, r =  − 0.4139) of patients in the no psychological distress group correlated significantly with efficacy.

Conclusion

Psychological distress has a negative impact on QoL, CRF, and efficacy and may be a potential risk for the efficacy of palliative chemotherapy in advanced gastric cancer patients.

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Data Availability

The data that support the findings of this study are available from the corresponding author, Huaidong Cheng, upon reasonable request. All authors agree to provide data to the journal for review if needed.

References

  1. Ajani JA, Lee J, Sano T, Janjigian YY, Fan D, Song S (2017) Gastric adenocarcinoma Nat Rev Dis Primers 3:17036

    PubMed  Google Scholar 

  2. Holland JC, Alici Y (2010) Management of distress in cancer patients. J Support Oncol 8(1):4–12

    PubMed  Google Scholar 

  3. Chung J, Ju G, Yang J, Jeong J, Jeong Y, Choi MK, Kwon J, Lee KH, Kim ST, Han HS (2018) Prevalence of and factors associated with anxiety and depression in Korean patients with newly diagnosed advanced gastrointestinal cancer. Korean J Intern Med 33(3):585–594

    PubMed  Google Scholar 

  4. Kim GM, Kim SJ, Song SK, Kim HR, Kang BD, Noh SH, Chung HC, Kim KR, Rha SY (2017) Prevalence and prognostic implications of psychological distress in patients with gastric cancer. BMC Cancer 17(1):283

    PubMed  PubMed Central  Google Scholar 

  5. Abu-Odah H, Molassiotis A, Zhao IY, Su JJ, Allsop MJ (2022) Psychological distress and associated factors among Palestinian advanced cancer patients: a cross-sectional study. Front Psychol 13:1061327

    PubMed  PubMed Central  Google Scholar 

  6. Fallowfield L (2002) Quality of life: a new perspective for cancer patients. Nat Rev Cancer 2(11):873–879

    CAS  PubMed  Google Scholar 

  7. Blazeby JM, Vickery CW (2001) Quality of life in patients with cancers of the upper gastrointestinal tract. Expert Rev Anticancer Ther 1(2):269–276

    CAS  PubMed  Google Scholar 

  8. Post MW (2014) Definitions of quality of life: what has happened and how to move on. Top Spinal Cord Inj Rehabil 20(3):167–180

    PubMed  PubMed Central  Google Scholar 

  9. Schütte K, Schulz C, Middelberg-Bisping K (2021) Impact of gastric cancer treatment on quality of life of patients. Best Pract Res Clin Gastroenterol 50–51:101727

    PubMed  Google Scholar 

  10. Deshields TL, Potter P, Olsen S, Liu J (2014) The persistence of symptom burden: symptom experience and quality of life of cancer patients across one year. Support Care Cancer 22(4):1089–1096

    PubMed  Google Scholar 

  11. Phoosuwan N, Lundberg PC (2022) Psychological distress and health-related quality of life among women with breast cancer: a descriptive cross-sectional study. Support Care Cancer 30(4):3177–3186

    PubMed  Google Scholar 

  12. Bergerot CD, Philip EJ, Bergerot PG, Pal SK (2020) Distress and quality of life among patients with advanced genitourinary cancers. Eur Urol Focus 6(6):1150–1154

    PubMed  Google Scholar 

  13. Brown LF, Kroenke K, Theobald DE, Wu J, Tu W (2010) The association of depression and anxiety with health-related quality of life in cancer patients with depression and/or pain. Psychooncology 19(7):734–741

    PubMed  PubMed Central  Google Scholar 

  14. Fabi A, Bhargava R, Fatigoni S, Guglielmo M, Horneber M, Roila F, Weis J, Jordan K, Ripamonti CI (2020) Cancer-related fatigue: ESMO Clinical Practice Guidelines for diagnosis and treatment. Ann Oncol 31(6):713–723

    CAS  PubMed  Google Scholar 

  15. Bower JE (2014) Cancer-related fatigue–mechanisms, risk factors, and treatments. Nat Rev Clin Oncol 11(10):597–609

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Shitara K, Van Cutsem E, Bang YJ, Fuchs C, Wyrwicz L, Lee KW, Kudaba I, Garrido M, Chung HC, Lee J, Castro HR, Mansoor W, Braghiroli MI, Karaseva N, Caglevic C, Villanueva L, Goekkurt E, Satake H, Enzinger P, Alsina M, Benson A, Chao J, Ko AH, Wainberg ZA, Kher U, Shah S, Kang SP, Tabernero J (2020) Efficacy and safety of pembrolizumab or pembrolizumab plus chemotherapy vs chemotherapy alone for patients with first-line, advanced gastric cancer: the KEYNOTE-062 phase 3 randomized clinical trial. JAMA Oncol 6(10):1571–1580

    PubMed  Google Scholar 

  17. Park S, Nam CM, Kim SG, Mun JE, Rha SY, Chung HC (2021) Comparative efficacy and tolerability of third-line treatments for advanced gastric cancer: a systematic review with Bayesian network meta-analysis. Eur J Cancer 144:49–60

    CAS  PubMed  Google Scholar 

  18. Ownby KK (2019) Use of the distress thermometer in clinical practice. J Adv Pract Oncol 10(2):175–179

    PubMed  PubMed Central  Google Scholar 

  19. Yost KJ, Thompson CA, Eton DT, Allmer C, Ehlers SL, Habermann TM, Shanafelt TD, Maurer MJ, Slager SL, Link BK, Cerhan JR (2013) The Functional Assessment of Cancer Therapy - General (FACT-G) is valid for monitoring quality of life in patients with non-Hodgkin lymphoma. Leuk Lymphoma 54(2):290–297

    PubMed  Google Scholar 

  20. Zhang Q, Li F, Zhang H, Yu X, Cong Y (2018) Effects of nurse-led home-based exercise & cognitive behavioral therapy on reducing cancer-related fatigue in patients with ovarian cancer during and after chemotherapy: a randomized controlled trial. Int J Nurs Stud 78:52–60

    PubMed  Google Scholar 

  21. Dalhammar K, Malmström M, Schelin M, Falkenback D, Kristensson J (2020) The impact of initial treatment strategy and survival time on quality of end-of-life care among patients with oesophageal and gastric cancer: a population-based cohort study. PLoS ONE 15(6):e0235045

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Wagner AD, Syn NL, Moehler M, Grothe W, Yong WP, Tai BC, Ho J, Unverzagt S (2017) Chemotherapy for advanced gastric cancer. Cochrane Database Syst Rev 8(8):CD004064

  23. Han L (2020) Prevalence, risk factors and prognostic role of anxiety and depression in surgical gastric cancer patients. Transl Cancer Res 9(3):1371–1383

    PubMed  PubMed Central  Google Scholar 

  24. Li W, Gan C, Zuo H, Yin X, Jing Y, Pang L, Yu S, Tang L, Yao S, Cheng H (2023) Psychological distress as risk factor for the efficacy of whole-brain radiotherapy in brain metastasis patients. Future Oncol 19(1):49–60

    CAS  PubMed  Google Scholar 

  25. Ettlin DA, Napimoga MH, Meira ECM, Clemente-Napimoga JT (2021) Orofacial musculoskeletal pain: an evidence-based bio-psycho-social matrix model. Neurosci Biobehav Rev 128:12–20

    PubMed  Google Scholar 

  26. Miles A, McClements PL, Steele RJ, Redeker C, Sevdalis N, Wardle J (2017) Perceived diagnostic delay and cancer-related distress: a cross-sectional study of patients with colorectal cancer. Psychooncology 26(1):29–36

    PubMed  Google Scholar 

  27. Lesage P, Portenoy RK (2002) Management of fatigue in the cancer patient. Oncology (Williston Park) 16(3):373–8, 381 (discussion 381-2, 385-6, 388-9)

    PubMed  Google Scholar 

  28. Stone P, Richards M, A’Hern R, Hardy J (2000) A study to investigate the prevalence, severity and correlates of fatigue among patients with cancer in comparison with a control group of volunteers without cancer. Ann Oncol 11(5):561–567

    CAS  PubMed  Google Scholar 

  29. Ahlberg K, Ekman T, Wallgren A, Gaston-Johansson F (2004) Fatigue, psychological distress, coping and quality of life in patients with uterine cancer. J Adv Nurs 45(2):205–213

    PubMed  Google Scholar 

  30. Syrowatka A, Motulsky A, Kurteva S, Hanley JA, Dixon WG, Meguerditchian AN, Tamblyn R (2017) Predictors of distress in female breast cancer survivors: a systematic review. Breast Cancer Res Treat 165(2):229–245

    PubMed  PubMed Central  Google Scholar 

  31. Chad-Friedman E, Coleman S, Traeger LN, Pirl WF, Goldman R, Atlas SJ, Park ER (2017) Psychological distress associated with cancer screening: a systematic review. Cancer 123(20):3882–3894

    PubMed  Google Scholar 

  32. DiMatteo MR, Lepper HS, Croghan TW (2000) Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 160(14):2101–2107

    CAS  PubMed  Google Scholar 

  33. Moreno-Smith M, Lutgendorf SK, Sood AK (2010) Impact of stress on cancer metastasis. Future Oncol 6(12):1863–1881

    PubMed  Google Scholar 

  34. Dai S, Mo Y, Wang Y, Xiang B, Liao Q, Zhou M, Li X, Li Y, Xiong W, Li G, Guo C, Zeng Z (2020) Chronic stress promotes cancer development. Front Oncol 10:1492

    PubMed  PubMed Central  Google Scholar 

  35. Nissen MD, Sloan EK, Mattarollo SR (2018) β-Adrenergic signaling impairs antitumor CD8(+) T-cell responses to B-cell lymphoma immunotherapy. Cancer Immunol Res 6(1):98–109

    CAS  PubMed  Google Scholar 

  36. Baek JH, Lee H, Myung W, Kim H, Choi YH, Kim DK, Hong KS, Choi H (2019) The association between inflammatory markers and general psychological distress symptoms. Gen Hosp Psychiatry 56:9–12

    PubMed  Google Scholar 

  37. Baritaki S, de Bree E, Chatzaki E, Pothoulakis C (2019) Chronic stress, inflammation, and colon cancer: a crh system-driven molecular crosstalk. J Clin Med 8(10):1669

    CAS  PubMed  PubMed Central  Google Scholar 

  38. Molfino A, Formiconi A, Rossi Fanelli F, Muscaritoli M (2014) Ghrelin: from discovery to cancer cachexia therapy. Curr Opin Clin Nutr Metab Care 17(5):471–6

    CAS  PubMed  Google Scholar 

  39. Fu L, Feng X, Jin Y, Lu Z, Li R, Xu W, Chang VT, Hu Y, Ye X (2022) Symptom clusters and quality of life in gastric cancer patients receiving chemotherapy. J Pain Symptom Manage 63(2):230–243

    PubMed  Google Scholar 

  40. Compen F, Bisseling E, Schellekens M, Donders R, Carlson L, van der Lee M, Speckens A (2018) Face-to-face and internet-based mindfulness-based cognitive therapy compared with treatment as usual in reducing psychological distress in patients with cancer: a multicenter randomized controlled trial. J Clin Oncol 36(23):2413–2421

    PubMed  Google Scholar 

  41. Lei Chui P, Wai S, Lai LL, See MH, Tan SB (2021) Mindful breathing: effects of a five-minute practice on perceived stress and mindfulness among patients with cancer. Clin J Oncol Nurs 25(2):174–180

    PubMed  Google Scholar 

  42. Hejazi F, Bahrami M, Keshvari M, Alavi M (2017) The effect of a communicational program on psychological distress in the elderly suffering from cancer. Iran J Nurs Midwifery Res 22(3):201–207

    PubMed  PubMed Central  Google Scholar 

  43. Clark PG (2010) Decreasing psychological distress in cancer inpatients using FLEX Care®: a pilot study. Soc Work Health Care 49(9):872–890

    PubMed  Google Scholar 

  44. Rossetti A, Chadha M, Torres BN, Lee JK, Hylton D, Loewy JV, Harrison LB (2017) The impact of music therapy on anxiety in cancer patients undergoing simulation for radiation therapy. Int J Radiat Oncol Biol Phys 99(1):103–110

    PubMed  PubMed Central  Google Scholar 

  45. Lundt A, Jentschke E (2019) Long-term changes of symptoms of anxiety, depression, and fatigue in cancer patients 6 months after the end of yoga therapy. Integr Cancer Ther 18:1534735418822096

    PubMed  PubMed Central  Google Scholar 

  46. Zhang X, Zhang Y, He Z, Yin K, Li B, Zhang L, Xu Z (2019) Chronic stress promotes gastric cancer progression and metastasis: an essential role for ADRB2. Cell Death Dis 10(11):788

    PubMed  PubMed Central  Google Scholar 

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Funding

This work was supported by the grants from the National Natural Science Foundation of China (No. 81872504).

Author information

Author notes

  1. Yongkang Zhang and Chen Gan contributed equally to this work.

Authors and Affiliations

  1. Department of Oncology, Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, 230088, China

    Yongkang Zhang

  2. Department of Oncology, Anhui Medical University, Hefei, 230601, China

    Chen Gan, Jian Xu, Lulian Pang, Wen Li & Huaidong Cheng

  3. Department of Oncology, Shenzhen Hospital of Southern Medical University, Shenzhen, 518000, China

    Huaidong Cheng

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Contributions

Conceptualization: Huaidong Cheng, Chen Gan, and Yongkang Zhang; methodology: Wen Li and Jian Xu; resources: Yongkang Zhang and Lulian Pang; writing—original draft preparation: Yongkang Zhang and Chen Gan; writing—review and editing: Chen Gan and Wen Li; and funding acquisition: Huaidong Cheng; Yongkang Zhang and Chen Gan contributed equally to this work. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Huaidong Cheng.

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The authors declare no competing interests.

Institutional review board statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Research Ethics Committee of the Second Affiliated Hospital of Anhui Medical University (Number of Ethical Approval: 2012088).

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The authors declare no competing interests.

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Zhang, Y., Gan, C., Xu, J. et al. Psychological distress as a risk factor for the efficacy of chemotherapy in advanced gastric cancer patients. Support Care Cancer 31, 669 (2023). https://doi.org/10.1007/s00520-023-08143-1

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