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The effect of psychological condition before radiotherapy on prognosis in 390 patients initially treated for nasopharyngeal carcinoma

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Abstract

Purpose

To explore whether anxiety and depression are prognostic indexes for overall survival in patients with nasopharyngeal carcinoma (NPC) who underwent intensity-modulated radiotherapy (IMRT).

Methods

Clinical data were collected for NPC patients who underwent IMRT. Anxiety and depression were investigated before radiotherapy by using the Hospital Anxiety and Depression Scale (HADS). The survival rate was calculated by the Kaplan-Meier method, and survival curves were compared among patients with different levels of anxiety and depression. The Cox risk regression model was used to screen the factors affecting survival.

Results

A total of 390 initially treated NPC patients were included in the study. Among them, 166 patients suffered from anxiety, and 95 patients suffered from depression before radiotherapy. The 5-year overall survival rates for patients with and without anxiety before radiotherapy were 71.6% and 81.8% (χ2 = 5.31, P = 0.021), respectively. The 5-year overall survival rates for patients with and without depression before radiotherapy were 74.3% and 78.1% (χ2 = 0.05, P = 0.82), respectively. Cox regression analysis indicated clinical stages (HR = 3.982, 95% CI: 2.365~6.705), anxiety (HR = 1.832, 95% CI: 1.140~2.944), and gender (HR = 0.555, 95% CI: 0.313~0.984) as independent prognostic factors.

Conclusion

Anxiety before radiotherapy is associated with poor prognosis in NPC patients.

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Data availability

The datasets used or analyzed in the current study are available from the corresponding authors on reasonable request.

Abbreviations

NPC:

Nasopharyngeal carcinoma

IMRT:

Intensity-modulated radiotherapy

HADS:

Hospital Anxiety and Depression Scale

GTV:

Gross tumor volume

CTV:

Clinical tumor volume

PTV:

Planning target volume

DDP:

Cisplatin

OS:

Overall survival

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Authors and Affiliations

  1. The Department of Radiation Oncology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China

    Jinmei Chen, Li Su, Jinru Ye, Xiurong Song, Weijian Zhang & Jinsheng Hong

  2. Key Laboratory of Radiation Biology (Fujian Medical University), Fujian Province University, Fuzhou, Fujian, China

    Jinmei Chen, Li Su & Jinsheng Hong

  3. The Graduate School, Fujian Medical University, Fuzhou, Fujian, China

    Yangjingling Hua, Caihong Wang, Hairong Zhang & Rong Li

  4. The School of Public Health, Fujian Medical University, Fuzhou, Fujian, China

    Jun Tian

Authors
  1. Jinmei Chen
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  2. Yangjingling Hua
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  3. Li Su
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  5. Hairong Zhang
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  9. Jun Tian
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  10. Weijian Zhang
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  11. Jinsheng Hong
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Contributions

Weijian Zhang and Jinsheng Hong contributed to the idea and design of the study; Jinmei Chen, Yangjingling Hua, Li Su, Caihong Wang, Hairong Zhang, Jinru Ye, Xiurong Song, and Rong Li performed the data collection; Jinmei Chen and Yangjingling Hua performed the data analyses and wrote the manuscript; Jun Tian helped perform the statistical analysis.

Corresponding author

Correspondence to Jinsheng Hong.

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The study protocol was approved by the relevant institutional review boards for human research at the First Affiliated Hospital of Fujian Medical University.

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Written informed consent was obtained from all participants.

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The authors declare no competing interests.

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Chen, J., Hua, Y., Su, L. et al. The effect of psychological condition before radiotherapy on prognosis in 390 patients initially treated for nasopharyngeal carcinoma. Support Care Cancer 29, 5967–5972 (2021). https://doi.org/10.1007/s00520-021-06130-y

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  • DOI: https://doi.org/10.1007/s00520-021-06130-y

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