Depression in women breast cancer patients receiving radiation therapy: A pilot study

Abstract

Background: The purpose of this study is to study depression and its risk factors at baseline and explore the changes of depression status during the course of radiation therapy in breast patients. Methods: This is part of a prospective study of treatment toxicity and quality of life. Breast cancer patients, aged 18-year old and above requiring adjuvant radiation therapy were eligible. The primary endpoint depression was assessed by a self-addressed “depression” questionnaires according to NCI “PROMIS”. The Questionnaires were completed one day prior to, during and at the end of treatment. Patient, tumor and prior treatment factors were collected. Cancer specific symptoms were collected by treating physicians and graded according to NIH/NCI CTCAE v4.0. The variables of our interest included age, menopausal status, N-stage,pathology stage, immunohistochemisty, surgical approaches,margin,prior treatments and radiation models. Data are presented as mean (95% confidence interval) unless otherwise specified. Statistical significances were tested using generalized linear model, pearson correlation and t-text. Ps less than 0.05 were considered to be significant. Results: Between July 2019 and January 2020, a total of 185 patients enrolled and completed the PROMIS questionaires. Before RT commencement, 50/185 (27.0%) had some levels of depressive feeling including 40/185 (21.6%), 10/185 (5.4%), and 0/185 (0%) patients for “rarely” (score = 5-8), “sometimes” (score = 9-12), “often” (score = 13-16), and “always” (score 17-20), respectively. Interestingly, N stage and pathology staging group were significantly associated with the depression at baseline while age, menopausal status, immunohistochemistry, previous chemo cycles, chemo regimens and anti-Her2 taget therapy were not. At the end of RT, 51/149 (34.2%) patients had depression level changed, though the absolute lumped scores of depression did not change significantly (p = 0.437). Changes in depression during were significantly associated with menopausal status (p = 0.015) while grade 2 and above toxicities were not (p = 0.421). Conclusions: Depression feeling is not uncommon in breast patients receiving adjuvant radiation. Future study may identify patients with depression and associated risk factors so that proper intervention may be applied to improve long-term survival and quality of life in patients. © 2020 American Society of Clinical Oncology