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The correlations between psychological distress, cognitive impairment and quality of life in patients with brain metastases after whole-brain radiotherapy

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Abstract

Background

Psychological distress and cognitive impairment are highly prevalent among patients with brain metastases after whole-brain radiotherapy (WBRT). Our purpose was to evaluate the correlations between psychological distress, cognitive impairment and quality of life in patients with brain metastases after WBRT.

Methods

Seventy-one patients with brain metastasis treated with WBRT were enrolled in this study and were investigated with several scales, including the Montreal Cognitive Assessment Scale (MoCA), the Functional Assessment of Cancer Therapy-Cognitive Function version 3 (FACT-Cog, version 3), the Functional Assessment of Cancer Therapy-Brain Module version 4 (FACT-Br, version 4) and the Psychological Distress Thermometer (DT), before and after WBRT.

Results

The MoCA, FACT-Cog and FACT-Br scores in patients with brain metastases were significantly decreased after WBRT compared with before WBRT (z = − 7.106, − 6.933 and − 6.250, respectively, P < 0.001), while the DT scores were significantly increased (z = 6.613, P < 0.001). There was an obvious negative correlation between the DT score and the FACT-Cog score (r = − 0.660, P < 0.001), a significant negative correlation between the DT score and the FACT-Br score (r = − 0.833, P < 0.001), and an obvious positive correlation between the FACT-Cog score and the FACT-Br score (r = 0.603, P < 0.001). These results suggest that WBRT can cause cognitive impairment in patients with brain metastases, increase their psychological distress and reduce their quality of life (QOL).

Conclusion

After receiving WBRT, the cognitive function and QOL of patients with brain metastases were decreased, while psychological distress increased. The cognitive impairment and the decline of QOL after WBRT are associated with increased psychological distress, and that the decline of QOL is associated with cognitive impairment of patients.

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Data availability

The data that support the study may be available upon request with permission from the researchers who collected the data.

Abbreviations

DT:

Distress thermometer

IMRT:

Intensity-modulated radiotherapy

MoCA:

Montreal cognitive assessment scale

QOL:

Quality of life

SD:

Standard deviation

SRS:

Stereotactic radiosurgery

WBRT:

Whole-brain radiotherapy

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Acknowledgements

Thanks to the cancer patients who are confronting with cancer. Their dedication and persistence have promoted the advance of the anti-cancer career. We sincerely wish these cancer survivors restore their mental and physical health. We would like to thank the reviewers for their valuable comments.

Funding

Funding was supplied by National Natural Science Foundation of China (No. 81872504; 81372487). Funders were not involved in the formulation and completion of the research.

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Author notes

  1. Senbang Yao, He Zuo and Wen Li have contributed equally to this work.

Authors and Affiliations

  1. Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, Anhui, China

    Senbang Yao, He Zuo, Wen Li, Yinlian Cai, Qianqian Zhang, Lulian Pang, Yanyan Jing, Xiangxiang Yin & Huaidong Cheng

  2. Cancer and Cognition Laboratory, Anhui Medical University, Hefei, 230032, Anhui, China

    Senbang Yao, He Zuo, Wen Li, Yinlian Cai, Qianqian Zhang, Lulian Pang, Yanyan Jing, Xiangxiang Yin & Huaidong Cheng

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Contributions

Conceptualization: HC, SY, HZ. Data collection: HZ, SY, WL. Data analysis: SY, HZ. Original draft writing: HZ, SY. Review and editing: SY, YC, QZ, WL, LP, YJ, XY. SY, HZ, WL contributed equally to this work. And the publication of this manuscript was approved by all authors.

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Correspondence to Huaidong Cheng.

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All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Research Ethics Committee of the Second Affiliated Hospital of Anhui Medical University, and all included patients provided a written informed consent.

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Yao, S., Zuo, H., Li, W. et al. The correlations between psychological distress, cognitive impairment and quality of life in patients with brain metastases after whole-brain radiotherapy. Clin Transl Oncol 25, 207–217 (2023). https://doi.org/10.1007/s12094-022-02927-3

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