Journal of Prevention and Treatment for Stomatological Diseases ›› 2019, Vol. 27 ›› Issue (11): 723-728.doi: 10.12016/j.issn.2096-1456.2019.11.007

• Prevention and Treatment Practice • Previous Articles     Next Articles

Depression status of 136 patients with adjuvant radiotherapy after reconstruction of the oral cancer flap and analysis of influencing factors

WANG Cuiping1,WANG Mengxi1,LV Bo2()   

  1. 1. Department of Stomatology, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
    2. Oral Care Teaching and Research Office, Heilongjiang Nursing College, Harbin 150001, China
  • Received:2018-12-05 Revised:2019-05-22 Online:2019-11-20 Published:2019-12-03

Abstract: Objective To explore the depression and influencing factors of patients with adjuvant radiotherapy after reconstruction of oral cancer flaps and to provide evidence for postoperative care. Methods One hundred thirty-six patients with oral cancer who had undergone adjuvant radiotherapy after reconstruction of skin flaps at 4 affiliated hospitals in Harbin Medical University were selected by convenience sampling. The basic information of the patients with adjuvant radiotherapy after reconstruction of skin flaps was collected, a self-rating scale for depression was used to assess depression, and a questionnaire was used to assess symptom distress. Depression and its influencing factors were determined by multiple stepwise regression analysis. Results The average score of depression in patients with oral cancer after skin flap reconstruction was (52.32±13.11): 33.1% of the patients showed mild depression, 21.3% showed moderate depression, and 2.2% showed severe depression. Postoperatively, the patients had pain, dysphagia, taste disorders, temporomandibular joint and salivary gland dysfunction, as well as marital and financial problems. The results showed that dysphagia (P < 0.001), taste disorder (P < 0.001), marital status (P=0.004) and family income per month (P= 0.011) could be the influencing factors of depression in patients with oral cancer during radiotherapy, and a significant correlation was found between them. Conclusion Patients with adjuvant radiotherapy after reconstruction of oral cancer flaps have depressive symptoms, which will seriously affect the quality of life. Therefore, the care of such patients should focus on improving the postoperative depression of patients.

Key words: oral cancer, flap reconstruction, radiotherapy, depression, influencing factors, dysfunction, economic income, nursing

CLC Number: 

  • R782

Table 1

Basic information of the selected patients"

项目类别例数比例(%)
性别8965.4
4734.6
婚姻状况已婚11786.0
未婚/离异/丧偶1914.0
教育程度大专及以上4230.9
中学6447.1
小学及以下3022.0
家庭人均月收入(元)>5 0006346.3
4 999~3 0002316.9
<3 0005036.8
医保状况省医保2216.2
市医保5137.5
新农合3727.2
自费2619.1
吸烟11886.8
1813.2
饮酒9166.9
4533.1
癌症位置唇部75.1
颊黏膜5943.4
4230.9
牙龈96.6
磨牙后10.8
硬腭1813.2
癌症分期Ⅰ期1511.0
Ⅱ期2316.9
Ⅲ期4432.4
Ⅳ期5439.7
治疗方案手术+放疗10476.5
手术+放疗+化疗3223.5
放疗次数3次6245.6
4次7454.4

"

项目n抑郁得分tFP
婚姻状况在婚11752.13±13.489.793<0.001
非在婚1953.53±10.77
家庭人均月收入(元)>5 0006348.76±12.8047.067<0.001
4 999~3 0002350.30±11.14
<3 0005055.37±13.36
医疗费用支付方式省医保2248.45±14.272.8920.034
市医保5152.12±12.15
新农合3753.24±13.24
自费2654.69±13.74
吸烟11850.99±13.425.550<0.001
1861.06±5.63
癌症分期1549.62±11.018.492<0.001
2347.44±12.65
4452.45±13.94
5456.47±11.62

Table 3

Correlation between symptom severity and depression in patients with adjuvant radiotherapy after reconstruction of the oral cancer flap n = 136"

症状严重程度评分例数严重程度平均得分(x ± s相关系数P
疼痛0820.63±0.830.577<0.001
轻微18
中度231
重度315
吞咽困难0191.80±1.140.766<0.001
吞咽不适,饮食不受干扰130
吞咽困难,需要食用软食257
吞咽相当困难,仅能进食液体315
吞咽液体严重困难415
味觉障碍0530.85±0.780.820<0.001
部分丧失151
完全丧失232
牙关紧闭000.85±0.740.2910.001
轻微159
中度223
重度354
口腔干燥081.36±0.950.587<0.001
轻微142
中度263
重度323

Table 4

Multivariate stepwise regression analysis of factors affecting depression in patients with adjuvant radiotherapy after reconstruction of the oral cancer flap n = 136"

自变量BBEβFP95%CI
常数48.5293.15515.381<0.00142.287 ~ 54.770
味觉障碍7.1350.9150.4247.800<0.0015.325 ~ 8.944
吞咽困难4.3730.5900.3807.407<0.0013.205 ~ 5.541
婚姻状况-3.8181.290-0.144-2.9600.004-6.370 ~ -1.266
家庭人均月收入-1.8680.723-0.128-2.5830.011-3.298 ~ -0.437
[1] Dwivedi RC, St Rose S, Chisholm EJ, et al.Acoustic parameters of speech: lack of correlation with perceptual and questionnaire-based speech evaluation in patients with oral and oropharyngeal cancer treated with primary surgery[J]. Head Neck, 2016, 38(5): 670-676.
doi: 10.1002/hed.23956 pmid: 25524696
[2] 侯劲松, 张亚东. 放射性颌骨坏死手术难点与严重并发症的预防和处理[J]. 口腔疾病防治, 2019, 27(7): 409-416.
[3] Cheng Y, Gao XH, Li XJ, et al.Depression promotes prostate cancer invasion and metastasis via a sympathetic-cAMP-FAK signaling pathway[J]. Oncogene, 2018, 37(22): 2953-2966.
doi: 10.1038/s41388-018-0177-4 pmid: 29515233
[4] Van der Meulen IC, May AM, Koole R, et al. A Distress thermometer intervention for patients with head and neck cancer[J]. Oncol Nurs Forum, 2018, 45(1): e14-e32.
doi: 10.1188/18.ONF.E14-E32 pmid: 29251296
[5] 杨英珍, 袁亚萍, 吕银,等. 宫颈癌同步放化疗患者抑郁状况及其影响因素[J]. 中华肿瘤防治杂志, 2017, 24(23): 1619-1623.
[6] Chhabria KS, Carnaby GD.Psychometric validation of the center for epidemiological studies depression scale in head and neck cancer patients[J]. Oral Oncol, 2017, 75 158-162.
doi: 10.1016/j.oraloncology.2017.11.010 pmid: 29224813
[7] Wu YF, Si RR, Yang S, et al.Depression induces poor prognosis associates with the down-regulation brain derived neurotrophic factor of serum in advanced small cell lung cancer[J]. Oncotarget, 2016, 27(suppl 9): 85975-85986.
[8] Umegaki Y, Todo N.Psychometric properties of the Japanese CES-D, SDS, and PHQ-9 depression scales in university students[J]. Psychol Assess, 2017, 29(3): 354-359.
doi: 10.1037/pas0000351 pmid: 27322202
[9] Dische S, Curie M.111 principles of recording morbidity[J]. Radiother Oncol, 1996, 40(Suppl 1): 31.
doi: 10.1016/B978-0-444-52891-9.00005-1 pmid: 23622150
[10] Choi KH, Park SM.Psychological status and associated factors among Korean cancer survivors: a cross-sectional analysis of the Fourth & Fifth Korea National Health and Nutrition Examination Surveys[J]. J Korean Med Sci, 2016, 31(7): 1105-1113.
doi: 10.3346/jkms.2016.31.7.1105 pmid: 27366010
[11] Philiponis G, Kagan SH.Speaking legibly: qualitative perceptions of altered voice among oral tongue cancer survivors[J]. Asia Pac J Oncol Nurs, 2015, 2(4): 250-256.
doi: 10.4103/2347-5625.158020 pmid: 27981121
[12] 何悦,李晓光. 放射性颌骨坏死的防治[J]. 口腔疾病防治, 2019, 27(3): 143-152.
[13] Jeong WS, Oh TS.Oral and oropharyngeal reconstruction with a free flap[J]. Arch Craniofac Surg, 2016, 17(2): 45-50.
doi: 10.7181/acfs.2016.17.2.45 pmid: 28913254
[14] Kharade P, Dholam K, Bachher G.Appraisal of function after rehabilitation with tongue prosjournal[J]. J Craniofac Surg, 2018, 29(1): e41-e44.
doi: 10.1097/SCS.0000000000004008 pmid: 29023298
[15] 袁平. 头颈部肿瘤患者营养状况与放射治疗急性毒性反应关系的探讨[D]. 福州: 福建医科大学, 2010.
[16] Scheff NN, Ye Y, Bhattacharya A, et al.Tumor necrosis factor alpha secreted from oral squamous cell carcinoma contributes to cancerpain and associated inflammation[J]. Pain, 2017, 158(12):2396-2409.
doi: 10.1097/j.pain.0000000000001044 pmid: 28885456
[17] Zhang L, Huang Z, Wu H, et al.Effect of swallowing training on dysphagia and depression in postoperative tongue cancer patients[J]. Eur J Oncol Nurs, 2014, 18(6): 626-629.
doi: 10.1016/j.ejon.2014.06.003
[18] Sroussi HY, Epstein JB, Bensadoun RJ, et al.Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis[J]. Cancer Med, 2017, 6(12): 2918-2931.
doi: 10.1002/cam4.1221 pmid: 29071801
[19] Michelson M, Veitz-Keenan A.Taste disturbances--are there any effective treatments?[J]. Evid Based Dent, 2018, 19(2): 60-61.
doi: 10.1038/sj.ebd.6401312 pmid: 29930370
[20] Grattan K, Kubrak C, Caine V, et al.Experiences of head and neck cancer patients in middle adulthood: consequences and coping[J]. Glob Qual Nurs Res, 2018, doi: 10.1177/2333393618760337
doi: 10.1177/2333393619878150 pmid: 31700946
[21] Gariepy G, Honkaniemi H, Quesnel-Vallee A.Social support and protection from depression: systematic review of current findings in western countries[J]. Br J Psychiatry, 2016, 209(4): 284-293.
doi: 10.1192/bjp.bp.115.169094 pmid: 27445355
[22] Tomita A, Manuel JI.Evidence on the association between cigarette smoking and incident depression from the South African National Income Dynamics Study 2008-2015: mental health implications for a resource-limited setting[J]. Nicotine Tob Res, 2018, doi: 10.1093/ntr/nty163
doi: 10.1093/ntr/ntz215 pmid: 31774123
[1] OU Yanzhen,LI Baosheng,CAI Qing,JIANG Jiayang,JIN Zhuohua,MENG Weiyan. The impact of masticatory dysfunction caused by occlusal disharmony on cognitive function [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(9): 644-648.
[2] ZHANG Lin,TANG Yawen,WANG Jiantao,WANG Yan. Research progress on probiotics for the prevention and treatment of oral and gastrointestinal chemoradiotherapy mucositis [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(8): 567-571.
[3] ZHANG Shuguang,YIN Xiteng,XU Wenguang,HAN Wei,LIU Zhe. Clinical analysis of 22 cases of lymphoepithelial carcinoma of parotid gland [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(6): 400-405.
[4] LI Ming,NAN Xinrong,YUAN Zhenying,TANG Zhangui. Accuracy analysis of MRI in the depth of invasion assessment of tongue squamous cell carcinoma [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(5): 322-327.
[5] LING Yunxiao,WANG Jiantao,WANG Yan. Research progress on biomarkers related to radiotherapy and/or chemotherapy-induced oral mucositis [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(4): 260-266.
[6] SHI Yangyang,ZHOU Xuedong,CHENG Lei,REN Biao. The relationship between Candida albicans infection and oral cancer [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(2): 119-123.
[7] JI Ling,WANG Jiahe,WANG Jiantao,Wang Yan. The role of Toll-like receptors in chemoradiotherapy-induced gastrointestinal mucositis [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(2): 124-129.
[8] SUN Zhongyi,CHEN Yiming,WANG Yi,JI Tong. 55 cases of perioperative mortality in oral maxillofacial head and neck cancer patients: a retrospective analysis [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(9): 575-580.
[9] LIU Enyan,HE Bing,LI Mingyun. Research progress on epigallocatechin-3-gallate in the prevention and treatment of oral cancer [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(7): 468-471.
[10] ZOU Xiaolong,CHEN Yuan,WANG Yan,WANG Jiantao. Research progress on animal models of oral mucositis caused by radiotherapy and chemotherapy [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(5): 322-326.
[11] DING Feng,SHI Shaojie,SONG Yingliang. Research progress of superhydrophilic implants [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(4): 252-256.
[12] ZHANG Yu,JI Tong. Application of Indocyanine green in visual treatment of oral cancer [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(2): 118-122.
[13] HUANG Qiuyu,DENG Yijun,WU Weiqin,HE Xingfang. Selection of perioperative venous access for simultaneous repair and reconstruction of oral cancer after radical resection [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(12): 791-795.
[14] JI Tong. Diagnosis and treatment of head and neck osteosarcoma [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2019, 27(9): 545-550.
[15] LIN Shigeng,WANG Tao,WANG Hong,SUN Yin,FAN Song. Application of extended clavicular epithelial flap in postoperative defect repair in elderly patients with oral cancer [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2019, 27(8): 500-504.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] ZHU Song-song, HU Jing. The application of distraction osteogenesis in the temporomandibular joint ankylosis and secondary dentofacial deformities[J]. journal1, 2016, 24(1): 6 -10 .
[2] XU Jing. The influence of the impacted mandibular third molar extraction on the distal periodontal tissue of the mandibular second molar[J]. journal1, 2016, 24(1): 11 -14 .
[3] ZHONG Jiang-long, PAN Ji-yang, CHEN Wei-liang. The evaluation of Eagle syndrome treatment by surgery combined with antidepressant therapy[J]. journal1, 2016, 24(1): 26 -28 .
[4] CHEN Xi, SUN Qin-zhou. The study of colorimetric board of porcelain fused to metal restoration for moderate to severe dental fluorosis[J]. journal1, 2016, 24(1): 33 -36 .
[5] OUYANG Ke-xiong1, LIANG Jun, ZOU Rui, LI Zhi-qiang, BAI Zhi-bao, PIAO Zheng-guo, ZHAO Jian-Jiang.. Ion Torrent RNA-Seq detection and analysis of the long non-coding RNA in tongue squamous cell carcinoma[J]. journal1, 2016, 24(1): 15 -19 .
[6] YU Pei, XUE Jing, ZHANG Xiao-wei, ZHENG Cang-shang. The influence of the roughness of zirconia ceramic surface on microbial attachment[J]. journal1, 2016, 24(1): 20 -25 .
[7] LIU Fang. Clinical assessment of two fissure sealant techniques in children’s dental caries prevention[J]. journal1, 2016, 24(1): 44 -45 .
[8] . [J]. journal1, 2016, 24(1): 49 -52 .
[9] LU Jian-rong, BAN Hua-jie, WANG Dai-you, ZHOU Hui-hui, LONG Ru, QIN Shu-hua. Clinical observation of sternocleidomastoid muscle flaps combined with artificial biological membrane reparing the defects after parotidectomy[J]. journal1, 2016, 24(1): 29 -32 .
[10] LI Bin, HE Xiao-ning, GAO Yuan, HU Yu-ping. Clinical analysis of pain after two kinds of apical stop preparation[J]. journal1, 2016, 24(1): 40 -43 .
This work is licensed under a Creative Commons Attribution 3.0 License.