接受神经外科手术的脑转移瘤患者的心理肿瘤负担

Psycho-oncological burden in patients with brain metastases undergoing neurological surgery.

作者信息

Araceli Tommaso, Fischl Anna, Haj Amer, Doenitz Christian, Stoerr Eva-Maria, Hillberg Andrea, Vogelhuber Martin, Rosengarth Katharina, Riemenschneider Markus J, Hau Peter, Blazquez Raquel, Pukrop Tobias, Bumes Elisabeth, Schmidt Nils Ole, Proescholdt Martin

机构信息

Department of Neurosurgery, Regensburg University Medical Center, Regensburg, Germany.

Wilhelm Sander-NeuroOncology Unit, Regensburg University Medical Center, Regensburg, Germany.

出版信息

Front Oncol. 2024 Nov 28;14:1463467. doi: 10.3389/fonc.2024.1463467. eCollection 2024.

DOI:10.3389/fonc.2024.1463467

PMID:39669367

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11634795/

Abstract

PURPOSE

The development of brain metastases (BM) can significantly increase the psycho-oncological burden in cancer patients, requiring timely intervention. In addition, this aspect may negatively affect the course of the disease and treatment outcome. However, screening for psycho-oncological burden is often overlooked in clinical routine. Therefore, we analyzed the extent of psycho-oncological distress in a patient population with BM receiving neurosurgical resection and identified clinical characteristics associated with a high need for psycho-oncological intervention.

METHODS

We prospectively screened 353 patients (169 female, 184 male, mean age 61.9 years) scheduled for microsurgical resection of one or more BM. Psycho-oncological screening was performed on the day of admission using the Hornheider screening instrument (HSI) and the distress thermometer (DT). Screening results were correlated with demographic and clinical data.

RESULTS

Most patients (73.1%) completed the screening questionnaire. Patients who failed to complete the questionnaire presented more frequently with metachronous BM (74.7% . 25.3%, p=0.009), were significantly older (p=0.0018), and had a significantly lower KPS score (p=0.0002). Based on the threshold values of the questionnaires, 59.3% of the patients showed a significant psycho-oncological burden requiring immediate intervention. Univariate analysis demonstrated that synchronous BM (p=0.034), tumors in eloquent areas (p=0.001), lower KPS (p=0.031), female gender (p=0.009), and presurgical aphasia (p=0.042) were significantly associated with high psycho-oncological burden. Multivariate analysis showed synchronous BM (p=0.045), female gender (p=0.005), and lower KPS (p=0.028) as independent factors associated with high psycho-oncological burden.

CONCLUSION

The majority of patients with BM have a high psycho-oncological burden. Female gender, synchronous BM, and lower KPS are independently associated with a need for psycho-oncological intervention.

摘要

目的

脑转移瘤（BM）的发生会显著增加癌症患者的心理肿瘤负担，需要及时干预。此外，这方面可能会对疾病进程和治疗结果产生负面影响。然而，在临床常规中，心理肿瘤负担的筛查常常被忽视。因此，我们分析了接受神经外科手术切除的BM患者群体的心理肿瘤困扰程度，并确定了与心理肿瘤干预高需求相关的临床特征。

方法

我们前瞻性地筛查了353例计划进行一个或多个BM显微手术切除的患者（169例女性，184例男性，平均年龄61.9岁）。入院当天使用霍恩海德筛查工具（HSI）和苦恼温度计（DT）进行心理肿瘤筛查。筛查结果与人口统计学和临床数据相关。

结果

大多数患者（73.1%）完成了筛查问卷。未完成问卷的患者更常出现异时性BM（74.7%对25.3%，p = 0.009），年龄显著更大（p = 0.0018），且KPS评分显著更低（p = 0.0002）。根据问卷阈值，59.3%的患者显示出需要立即干预的显著心理肿瘤负担。单因素分析表明，同时性BM（p = 0.034）、功能区肿瘤（p = 0.001）、较低的KPS（p = 0.031）、女性（p = 0.009）和术前失语（p = 0.042）与高心理肿瘤负担显著相关。多因素分析显示，同时性BM（p = 0.045）、女性（p = 0.005）和较低的KPS（p = 0.028）是与高心理肿瘤负担相关的独立因素。