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Depressive symptoms during the first chemotherapy cycle predict mortality in patients with advanced non-small cell lung cancer

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Abstract

Purpose

Depressive symptoms are commonly experienced by cancer patients, especially those with advanced disease. The link between depression and survival outcome in cancer patients has received increasing attention. The purpose of this study was to determine, after adjusting the known covariates, whether the depressive symptoms during the first cycle of chemotherapy can predict the mortality of patients with advanced non-small cell lung cancer (NSCLC).

Methods

Patients with stage III or IV NSCLC were recruited from a large teaching hospital located in northern Taiwan. Depressive symptoms were assessed during the first cycle of chemotherapy using the Hospital Anxiety and Depression Scale-Depression subscale. A cut-off of 7/8 was used to categorize patients into depressed and non-depressed groups. All patients were followed up until the end of the study. The follow-up time ranged from 10 to 30 months.

Results

The study sample consisted of 90 NSCLC patients. Twenty patients (22.2%) were categorized as depressed. The median survival time in the depressed group was significantly shorter than that of the non-depressed group (11.83 vs. 24.47 months, P = 0.017). After controlling for demographic and clinical factors, depressive symptoms remained significantly (p = 0.023) associated with a shorter survival time. Compared to the non-depressed group, the depressed group had twice the risk of death (HR = 2.18, 95% CI = 1.11 to 4.28).

Conclusion

The finding supports that depressive symptoms at the early phase of treatment can predict shorter survival in patients with advanced NSCLC.

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Acknowledgement

This study was supported by research grants to Dr. Mei-Ling Chen from the National Science Council, Taiwan (grant numbers: NSC 94-2314-B-182-055, NSC 95-2314-B-182-012, and NSC 96-2314-B-182-006).

Conflict of interest

There is no relevant conflict of interest in this manuscript. We have full control of all primary data which can be reviewed by the journal if required.

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Authors and Affiliations

  1. Graduate Institute of Nursing, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Taoyuan, Taiwan, Republic of China

    Mei-Ling Chen

  2. Department of Public Health and Biostatistics Consulting Center, School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China

    Min-Chi Chen

  3. Department of Thoracic Medicine, Chang Gung Memorial Hospital, Lin-Ko, Taiwan, Republic of China

    Chih-Teng Yu

Authors
  1. Mei-Ling Chen
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  2. Min-Chi Chen
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  3. Chih-Teng Yu
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Correspondence to Mei-Ling Chen.

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Chen, ML., Chen, MC. & Yu, CT. Depressive symptoms during the first chemotherapy cycle predict mortality in patients with advanced non-small cell lung cancer. Support Care Cancer 19, 1705–1711 (2011). https://doi.org/10.1007/s00520-010-1005-8

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  • DOI: https://doi.org/10.1007/s00520-010-1005-8

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