Prevention of Depression in Patients Being Treated for Head and Neck Cancer

预防头颈癌患者的抑郁症

• 批准号: 7319120
• 负责人: WILLIAM J. BURKE
• 金额: $ 39.35万
• 依托单位: UNIVERSITY OF NEBRASKA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-04 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7319120
• 关键词: Accounting; Adherence; Adverse effects; Aftercare; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Antidepressive Agents; Cancer Patient; Cancer Prognosis; Citalopram; Clinical; Coupled; Depressed mood; Development; Diagnosis; Double-Blind Method; Head and Neck Cancer; Incidence; Interruption; Intervention; Lead; Length of Stay; Major Depressive Disorder; Malignant Neoplasms; Malignant neoplasm of larynx; Medical; Mental Depression; Newly Diagnosed; Patients; Placebo Control; Placebos; Prevention; Prophylactic treatment; Public Health; Publishing; Quality of life; Radiation; Radiation therapy; Randomized; Rate; Recurrence; Research Personnel; Risk; Score; Severities; Testing; Time; Tobacco; Tobacco use; Tongue; Week; cancer diagnosis; cancer therapy; double-blind placebo controlled trial; head and neck cancer patient; impression; improved; outcome forecast; pilot trial; prevent; programs; prophylactic; suicidal patient; suicide rate

DESCRIPTION (provided by applicant): Treatment for head and neck cancer (HNC) is arduous and debilitating. As a result, up to 40% of patients develop depression which is rarely recognized or treated. Untreated depression in cancer patients lengthens hospital stays, and reduces adherence with medical treatment, quality of life, and survival. Patients with HNC typically develop depression within the first 3 months of their diagnosis. Developing depression can lead to interruptions or delays in cancer treatment which in turn may diminish the overall prognosis. Depression can also lead to suicide; patients with cancers of the larynx and tongue account for 2 of the 3 highest suicide rates in cancer patients. We are proposing a groundbreaking approach to the problem of depression in HNC. Patients with HNC have the greatest risk for depression in the several months after diagnosis and during treatment for their cancer. We seek to prevent major depression before it can develop by initiating prophylactic treatment with the antidepressant citalopram soon after the diagnosis of HNC is made, thus potentially avoiding many serious sequelae including treatment interruption or delays. Depression also has an enormous impact on quality of life in patients with HNC. Additionally, an overwhelming majority of HNC patients use alcohol and tobacco, and despite adverse effects on prognosis, it is often difficult for them to decrease use of these substances. We will therefore evaluate whether prophylactic use of citalopram can preserve quality of life during and after treatment for HNC and reduce alcohol and tobacco use by these patients. We are therefore proposing a randomized, double blind, placebo-controlled trial investigating the prophylactic utility of the antidepressant citalopram in nondepressed patients who are about to begin treatment for newly diagnosed or recurrent head and neck cancer. We will evaluate whether such prophylactic treatment can significantly reduce the development of major depression, improve adherence to cancer treatment, preserve quality of life and reduce tobacco and alcohol use. This proposal has considerable relevance to public health in that it not only tests whether depression can be prevented in patients with HNC during treatment but also examines whether this intervention can also improve timely completion of the cancer therapy. Additionally, we will examine whether the quality of life of such patients can be better preserved during treatment and whether alcohol and tobacco use can be diminished. If successful, this approach may be applicable to other medical illnesses that have high rates of comorbid depression.

描述（由申请人提供）：头颈癌 (HNC) 的治疗是艰巨且令人衰弱的。因此，高达 40% 的患者患有抑郁症，但很少被识别或治疗。癌症患者的抑郁症未经治疗会延长住院时间，降低医疗依从性、生活质量和生存率。 HNC 患者通常在诊断后的前 3 个月内出现抑郁症。患上抑郁症可能会导致癌症治疗中断或延迟，进而可能会降低整体预后。抑郁症也可能导致自杀；自杀率最高的 3 名癌症患者中，喉癌和舌癌患者占其中 2 名。我们正在提出一种突破性的方法来解决 HNC 的抑郁问题。 HNC 患者在诊断后的几个月和癌症治疗期间患抑郁症的风险最大。我们力求在 HNC 诊断后立即开始使用抗抑郁药西酞普兰进行预防性治疗，以预防重度抑郁症的发生，从而有可能避免许多严重的后遗症，包括治疗中断或延误。抑郁症还对 HNC 患者的生活质量产生巨大影响。此外，绝大多数 HNC 患者都会饮酒和吸烟，尽管对预后有不利影响，但他们通常很难减少这些物质的使用。因此，我们将评估预防性使用西酞普兰是否可以保持 HNC 治疗期间和治疗后的生活质量并减少这些患者的饮酒和吸烟。因此，我们提出一项随机、双盲、安慰剂对照试验，研究抗抑郁药西酞普兰对即将开始治疗新诊断或复发头颈癌的非抑郁患者的预防作用。我们将评估这种预防性治疗是否可以显着减少重度抑郁症的发展，提高癌症治疗的依从性，保持生活质量并减少吸烟和饮酒。该提案与公共健康具有相当大的相关性，因为它不仅测试了 HNC 患者在治疗期间是否可以预防抑郁症，而且还检验了这种干预措施是否也可以提高癌症治疗的及时完成率。此外，我们还将研究治疗期间是否可以更好地保持此类患者的生活质量以及是否可以减少饮酒和吸烟。如果成功，这种方法可能适用于抑郁症发病率较高的其他疾病。