Decrease in Depression Symptoms Is Associated With Longer Survival in Patients With Metastatic Breast Cancer: A Secondary Analysis
Decrease in Depression Symptoms Is Associated With Longer Survival in Patients With Metastatic Breast Cancer: A Secondary Analysis
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DOI：
10.1200/jco.2010.28.4455
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发表时间：
2011-02-01
影响因子：
45.3
通讯作者：
Spiegel, David
中科院分区：
文献类型：
--
作者：
Giese-Davis, Janine;Collie, Kate;Spiegel, David
研究目的：许多研究已经检测了抑郁症与癌症的共病，有些研究表明抑郁症可能与癌症的进展或生存有关。然而，很少有研究评估抑郁症状的变化是否与生存率有关。125名转移性乳腺癌（MBC）妇女完成了抑郁症状测量（流行病学中心抑郁量表[CES-D]）并随机分配到接受教育材料的治疗组或对照组。在基线和三个随访点，125名妇女中有101名完成了抑郁症状测量。我们使用这些数据中的考克斯比例风险分析，以检查是否减少抑郁症的症状，在第一年的研究（干预的长度）将与较长的survival.Results中位生存时间为53.6个月的女性下降CES-D分数超过1年和25.1个月的女性增加CES-D分数。第一年内CES-D的变化对14年生存率有显著影响（P = 0.007），但治疗条件和CES-D变化对生存率无显著相互作用。无论是人口统计学还是医学变量都不能解释这种关联。结论在第一年抑郁症状的减少与该样本中MBC女性的后续生存期延长相关。需要进一步研究以在其他样本中证实这一假设，并且不能根据这一分析假设因果关系。J Clin Oncol 29：413-420. (C)2010年美国临床肿瘤学会
Purpose Numerous studies have examined the comorbidity of depression with cancer, and some have indicated that depression may be associated with cancer progression or survival. However, few studies have assessed whether changes in depression symptoms are associated with survival.Methods In a secondary analysis of a randomized trial of supportive-expressive group therapy, 125 women with metastatic breast cancer (MBC) completed a depression symptom measure (Center for Epidemiologic Studies-Depression Scale [CES-D]) at baseline and were randomly assigned to a treatment group or to a control group that received educational materials. At baseline and three follow-up points, 101 of 125 women completed a depression symptom measure. We used these data in a Cox proportional hazards analysis to examine whether decreasing depression symptoms over the first year of the study (the length of the intervention) would be associated with longer survival.Results Median survival time was 53.6 months for women with decreasing CES-D scores over 1 year and 25.1 months for women with increasing CES-D scores. There was a significant effect of change in CES-D over the first year on survival out to 14 years (P = .007) but no significant interaction between treatment condition and CES-D change on survival. Neither demographic nor medical variables explained this association.Conclusion Decreasing depression symptoms over the first year were associated with longer subsequent survival for women with MBC in this sample. Further research is necessary to confirm this hypothesis in other samples, and causation cannot be assumed based on this analysis. J Clin Oncol 29:413-420. (C) 2010 by American Society of Clinical Oncology