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Ikhile D, Ford E, Glass D, Gremesty G, van Marwijk H. A systematic review of risk factors associated with depression and anxiety in cancer patients. PLoS One 2024; 19:e0296892. [PMID: 38551956 PMCID: PMC10980245 DOI: 10.1371/journal.pone.0296892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 12/18/2023] [Indexed: 04/01/2024] Open
Abstract
Depression and anxiety are common comorbid conditions associated with cancer, however the risk factors responsible for the onset of depression and anxiety in cancer patients are not fully understood. Also, there is little clarity on how these factors may vary across the cancer phases: diagnosis, treatment and depression. We aimed to systematically understand and synthesise the risk factors associated with depression and anxiety during cancer diagnosis, treatment and survivorship. We focused our review on primary and community settings as these are likely settings where longer term cancer care is provided. We conducted a systematic search on PubMed, PsychInfo, Scopus, and EThOS following the PRISMA guidelines. We included cross-sectional and longitudinal studies which assessed the risk factors for depression and anxiety in adult cancer patients. Quality assessment was undertaken using the Newcastle-Ottawa assessment checklists. The quality of each study was further rated using the Agency for Healthcare Research and Quality Standards. Our search yielded 2645 papers, 21 of these were eligible for inclusion. Studies were heterogenous in terms of their characteristics, risk factors and outcomes measured. A total of 32 risk factors were associated with depression and anxiety. We clustered these risk factors into four domains using an expanded biopsychosocial model of health: cancer-specific, biological, psychological and social risk factors. The cancer-specific risk factors domain was associated with the diagnosis, treatment and survivorship phases. Multifactorial risk factors are associated with the onset of depression and anxiety in cancer patients. These risk factors vary across cancer journey and depend on factors such as type of cancer and individual profile of the patients. Our findings have potential applications for risk stratification in primary care and highlight the need for a personalised approach to psychological care provision, as part of cancer care.
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Affiliation(s)
- Deborah Ikhile
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Elizabeth Ford
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Devyn Glass
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Georgie Gremesty
- National Institute for Health and Care Research Applied Research Collaboration Kent, Surrey and Sussex, Hove, United Kingdom
| | - Harm van Marwijk
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
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Effect of Citrate- and Gold-Stabilized Superparamagnetic Iron Oxide Nanoparticles on Head and Neck Tumor Cell Lines during Combination Therapy with Ionizing Radiation. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 9:bioengineering9120806. [PMID: 36551012 PMCID: PMC9774466 DOI: 10.3390/bioengineering9120806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/05/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide. They are associated with alcohol and tobacco consumption, as well as infection with human papillomaviruses (HPV). Therapeutic options include radiochemotherapy, surgery or chemotherapy. Nanoparticles are becoming more and more important in medicine. They can be used diagnostically, but also therapeutically. In order to provide therapeutic alternatives in the treatment of HNSCC, the effect of citrate-coated superparamagnetic iron oxide nanoparticles (Citrate-SPIONs) and gold-coated superparamagnetic iron oxide nanoparticles (Au-SPIONs) in combination with ionizing irradiation (IR) on two HPV positive and two HPV negative HNSCC and healthy fibroblasts and keratinocytes cell lines were tested. Effects on apoptosis and necrosis were analyzed by using flow cytometry. Cell survival studies were performed with a colony formation assay. To better understand where the SPIONs interact, light microscopy images and immunofluorescence studies were performed. The HNSCC and healthy cell lines showed different responses to the investigated SPIONs. The cytotoxic effects of SPIONs, in combination with IR, are dependent on the type of SPIONs, the dose administered and the cell type treated. They are independent of HPV status. Reasons for the different cytotoxic effect are probably the different compositions of the SPIONs and the related different interaction of the SPIONs intracellularly and paramembranously, which lead to different strong formations of double strand breaks.
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Mortality during In-Hospital Treatment for Head and Neck Cancer in Germany: A Diagnosis-Related Group-Based Nationwide Analysis, 2005–2018. JOURNAL OF ONCOLOGY 2022; 2022:1387860. [PMID: 36164347 PMCID: PMC9509216 DOI: 10.1155/2022/1387860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 08/30/2022] [Indexed: 11/18/2022]
Abstract
Background Data on in-hospital MR (IHMR) of head and neck cancer (HNC) are sparse. Methods IHMR was determined in Germany between 2005 and 2018 using nationwide population-based diagnosis-related group (DRG) data of 1,090,596 HNC. Results The overall average IHMR was 0.04 ± 0.02. IHMR increased with older age to 0.04 ± 0.01 for patients of 65-79 years of age (relative risk [RR] in relation to patients of 35-49 years of age = 1.767; 95%confidence interval [CI] = 1.040 to3.001) to a maximum of 0.07 ± 0.01 for patients of 80 years and older (RR = 2.826; CI = 1.663 to 4.803). IHMR was the highest when no HNC-specific treatment, i.e., best supportive and palliative care, was applied (0.11 ± 0.01; RR in relation to tumor biopsy surgery = 7.241; CI = 3.447 to 5.211). IHMR was not different between surgery, radiotherapy, or chemotherapy/biologicals. Conclusions IHMR did not change over time. Efforts are needed to decrease the IHMR for HNC.
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Obermeier KT, Kraus M, Smolka W, Henkel J, Saller T, Otto S, Liokatis P. Postoperative Delirium in Patients with Oral Cancer: Is Intraoperative Fluid Administration a Neglected Risk Factor? Cancers (Basel) 2022; 14:cancers14133176. [PMID: 35804948 PMCID: PMC9265071 DOI: 10.3390/cancers14133176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Squamous cell carcinoma is the most typical malignant tumor of the oral cavity (OSCC) and surgery, including tumor resection and neck dissection with an appropriate reconstruction, remains the first line of treatment. Postoperative complications delay the healing process, and can have negative consequences for the patient. This study aimed to evaluate the impact of intraoperative fluid administration on developing postoperative delirium, and to identify other parameters leading to an increased risk of delirium. Abstract Squamous cell carcinoma (SCC) is a malignant tumor derived from squamous cells and can be found in different localizations. In the oral cavity especially, it represents the most common type of malignant tumor. First-line therapy for oral squamous cell carcinoma (OSCC) is surgery, including tumor resection, neck dissection, and maybe reconstruction. Although perioperative mortality is low, complications such as delirium are very common, and may have long-lasting consequences on the patient’s quality of life. This study examines if excessive fluid administration, among other parameters, is an aggravating factor for the development of postoperative delirium. A total of 198 patients were divided into groups concerning the reconstruction technique used: group A for primary wound closure or reconstruction with a local flap, and group B for microsurgical reconstruction. The patients with and without delirium in both groups were compared regarding intraoperative fluid administration, fluid balance, and other parameters, such as blood loss, duration of surgery and overall ventilation, alcohol consumption, and creatinine, albumin, natrium, and hematocrit levels. The logistic regression for group A shows that fluid intake (p = 0.02, OR = 5.27, 95% CI 1.27–21.8) and albumin levels (p = 0.036, OR = 0.22, CI 0.054–0.908) are independent predictors for the development of delirium. For group B, gender (p = 0.026, OR = 0.34, CI 0.133–0.879) with a protective effect for females, fluid intake (p = 0.003, OR = 3.975, CI 1.606–9.839), and duration of ventilation (p = 0.025, OR = 1.178, CI 1.021–1.359) are also independent predictors for delirium. An intake of more than 3000 mL for group A, and 4150 mL for group B, increases the risk of delirium by approximately five and four times, respectively. Fluid management should be considered carefully in patients with OSCC, in order to reduce the occurrence of postoperative delirium. Different factors may become significant for the development of delirium regarding different surgical procedures.
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Affiliation(s)
- Katharina Theresa Obermeier
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU Munich, 80337 Munich, Germany; (W.S.); (S.O.); (P.L.)
- Correspondence:
| | - Moritz Kraus
- Musculoskeletal University Center Munich, Department of Orthopaedics and Trauma Surgery, University Hospital, LMU Munich, 80539 Munich, Germany;
| | - Wenko Smolka
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU Munich, 80337 Munich, Germany; (W.S.); (S.O.); (P.L.)
| | - Jochen Henkel
- Department of Anaesthesiology, University Hospital, LMU Munich, 81377 Munich, Germany; (J.H.); (T.S.)
| | - Thomas Saller
- Department of Anaesthesiology, University Hospital, LMU Munich, 81377 Munich, Germany; (J.H.); (T.S.)
| | - Sven Otto
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU Munich, 80337 Munich, Germany; (W.S.); (S.O.); (P.L.)
| | - Paris Liokatis
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU Munich, 80337 Munich, Germany; (W.S.); (S.O.); (P.L.)
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Ota Y, Moore AG, Spector ME, Casper K, Stucken C, Malloy K, Lobo R, Baba A, Srinivasan A. Prediction of Wound Failure in Patients with Head and Neck Cancer Treated with Free Flap Reconstruction: Utility of CT Perfusion and MR Perfusion in the Early Postoperative Period. AJNR Am J Neuroradiol 2022; 43:585-591. [PMID: 35361578 PMCID: PMC8993192 DOI: 10.3174/ajnr.a7458] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/08/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND PURPOSE Free flap reconstruction in patients with head and neck cancer carries a risk of postoperative complications, and radiologic predictive factors have been limited. The aim of this study was to assess the factors that predict free flap reconstruction failure using CT and MR perfusion. MATERIALS AND METHODS This single-center prospective study included 24 patients (mean age, 62.7 [SD, 9.0] years; 16 men) who had free flap reconstruction from January 2016 to May 2018. CT perfusion and dynamic contrast-enhanced MR imaging with conventional CT and MR imaging were performed between 2 and 4 days after the free flap surgery, and the wound assessments within 14 days after the surgery were conducted by the surgical team. The parameters of CT perfusion and dynamic contrast-enhanced MR imaging with conventional imaging findings and patient demographics were compared between the patients with successful free flap reconstruction and those with wound failure as appropriate. P < .05 was considered significant. RESULTS There were 19 patients with successful free flap reconstruction and no wound complications (mean age, 63.9 [SD, 9.5] years; 14 men), while 5 patients had wound failure (mean age, 58.0 [SD, 5.7] years; 2 men). Blood flow, blood volume, MTT, and time maximum intensity projection (P = .007, .007, .015, and .004, respectively) in CT perfusion, and fractional plasma volume, volume transfer constant, peak enhancement, and time to maximum enhancement (P = .006, .039, .004, and .04, respectively) in dynamic contrast-enhanced MR imaging were significantly different between the 2 groups. CONCLUSIONS CT perfusion and dynamic contrast-enhanced MR imaging are both promising imaging techniques to predict wound complications after head and neck free flap reconstruction.
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Affiliation(s)
- Y Ota
- From the Division of Neuroradiology (Y.O., R.L., A.B., A.S.)
| | - A G Moore
- Department of Radiology (A.G.M.), Western Michigan University, Kalamazoo, Michigan
| | - M E Spector
- Department of Radiology, and Department of Otolaryngology (M.E.S., K.C., C.S., K.M.), University of Michigan, Ann Arbor, Michigan
| | - K Casper
- Department of Radiology, and Department of Otolaryngology (M.E.S., K.C., C.S., K.M.), University of Michigan, Ann Arbor, Michigan
| | - C Stucken
- Department of Radiology, and Department of Otolaryngology (M.E.S., K.C., C.S., K.M.), University of Michigan, Ann Arbor, Michigan
| | - K Malloy
- Department of Radiology, and Department of Otolaryngology (M.E.S., K.C., C.S., K.M.), University of Michigan, Ann Arbor, Michigan
| | - R Lobo
- From the Division of Neuroradiology (Y.O., R.L., A.B., A.S.)
| | - A Baba
- From the Division of Neuroradiology (Y.O., R.L., A.B., A.S.)
| | - A Srinivasan
- From the Division of Neuroradiology (Y.O., R.L., A.B., A.S.)
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Jin Y, Jung SN, Lim MA, Oh C, Piao Y, Kim HJ, Liu L, Kang YE, Chang JW, Won HR, Song K, Koo BS. Transcriptional Regulation of GDF15 by EGR1 Promotes Head and Neck Cancer Progression through a Positive Feedback Loop. Int J Mol Sci 2021; 22:ijms222011151. [PMID: 34681812 PMCID: PMC8538541 DOI: 10.3390/ijms222011151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 01/01/2023] Open
Abstract
Growth and differentiation factor 15 (GDF15), a divergent member of the transforming growth factor-β (TGF-β) superfamily, has been reported to be overexpressed in different kinds of cancer types. However, the function and mechanism of GDF15 in head and neck cancer (HNC) remains unclear. The Cancer Genome Atlas (TCGA) data show that the expression of GDF15 is significantly associated with tumor AJCC stage, lymph vascular invasion and tumor grade in HNC. In this study, we confirmed that knockdown of GDF15 attenuated: cell proliferation, migration and invasion via regulation of EMT through a canonical pathway; SMAD2/3 and noncanonical pathways; PI3K/AKT and MEK/ERK in HNC cell lines. Furthermore, we found that early growth response 1 (EGR1) was a transcription factor of GDF15. Interestingly, we also demonstrated that GDF15 could regulate the expression of EGR1, which meant a positive feedback loop occurred between these two factors. Moreover, combined inhibition of both GDF15 and EGR1 in a HNC mouse xenograft model showed significantly decreased tumor volume compared to inhibition of EGR1 or GDF15 alone. Our study showed that the GDF15–EGR1 signaling axis may be a good target in HNC patients.
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Affiliation(s)
- Yanli Jin
- Department of Medical Science, Chungnam National University College of Medicine, Daejeon 35015, Korea; (Y.J.); (C.O.); (Y.P.); (H.J.K.); (L.L.); (J.W.C.); (H.-R.W.)
| | - Seung-Nam Jung
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon 35015, Korea; (S.-N.J.); (M.A.L.); (K.S.)
| | - Mi Ae Lim
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon 35015, Korea; (S.-N.J.); (M.A.L.); (K.S.)
| | - Chan Oh
- Department of Medical Science, Chungnam National University College of Medicine, Daejeon 35015, Korea; (Y.J.); (C.O.); (Y.P.); (H.J.K.); (L.L.); (J.W.C.); (H.-R.W.)
| | - Yudan Piao
- Department of Medical Science, Chungnam National University College of Medicine, Daejeon 35015, Korea; (Y.J.); (C.O.); (Y.P.); (H.J.K.); (L.L.); (J.W.C.); (H.-R.W.)
| | - Hae Jong Kim
- Department of Medical Science, Chungnam National University College of Medicine, Daejeon 35015, Korea; (Y.J.); (C.O.); (Y.P.); (H.J.K.); (L.L.); (J.W.C.); (H.-R.W.)
| | - Lihua Liu
- Department of Medical Science, Chungnam National University College of Medicine, Daejeon 35015, Korea; (Y.J.); (C.O.); (Y.P.); (H.J.K.); (L.L.); (J.W.C.); (H.-R.W.)
| | - Yea Eun Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon 35015, Korea;
| | - Jae Won Chang
- Department of Medical Science, Chungnam National University College of Medicine, Daejeon 35015, Korea; (Y.J.); (C.O.); (Y.P.); (H.J.K.); (L.L.); (J.W.C.); (H.-R.W.)
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon 35015, Korea; (S.-N.J.); (M.A.L.); (K.S.)
| | - Ho-Ryun Won
- Department of Medical Science, Chungnam National University College of Medicine, Daejeon 35015, Korea; (Y.J.); (C.O.); (Y.P.); (H.J.K.); (L.L.); (J.W.C.); (H.-R.W.)
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon 35015, Korea; (S.-N.J.); (M.A.L.); (K.S.)
| | - Kunho Song
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon 35015, Korea; (S.-N.J.); (M.A.L.); (K.S.)
| | - Bon Seok Koo
- Department of Medical Science, Chungnam National University College of Medicine, Daejeon 35015, Korea; (Y.J.); (C.O.); (Y.P.); (H.J.K.); (L.L.); (J.W.C.); (H.-R.W.)
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon 35015, Korea; (S.-N.J.); (M.A.L.); (K.S.)
- Correspondence: ; Tel.: +82-42-280-7690
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