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: 7676214
• 负责人: WILLIAM J. BURKE
• 金额: $ 40.42万
• 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/7676214
• 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; 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; Newly Diagnosed; Patients; Placebo Control; Placebos; Prevention; Prophylactic treatment; Public Health; Publishing; Quality of life; Radiation; Radiation therapy; Randomized; Recurrence; Research Personnel; Risk; Severities; Testing; Time; Tobacco; Tobacco use; Tongue; cancer diagnosis; cancer therapy; depressed; depression; double-blind placebo controlled trial; head and neck cancer patient; impression; improved; outcome forecast; pilot trial; premature; prevent; programs; prophylactic; reduced alcohol use; suicidal patient; suicide rate; treatment adherence

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）的治疗艰巨而令人衰弱。结果，多达40％的患者患抑郁症很少被识别或治疗。癌症患者未经治疗的抑郁症可以延长住院时间，并降低了医疗，生活质量和生存的依从性。 HNC患者通常在诊断后的头三个月内出现抑郁症。发展抑郁会导致癌症治疗中的中断或延迟，进而会减少整体预后。抑郁症也会导致自杀；患有喉和舌头癌症的患者在癌症患者中占3个最高自杀率中的2例。我们提出了针对HNC抑郁症问题的开创性方法。 HNC患者在诊断后的几个月和治疗癌症治疗时患抑郁症的风险最大。我们寻求预防大抑郁症，然后在诊断出HNC后不久就通过抗抑郁药西妥拉兰进行预防性治疗而发展，从而有可能避免许多严重的后遗症，包括治疗中断或延迟。抑郁症对HNC患者的生活质量也具有巨大影响。此外，绝大多数HNC患者都使用酒精和烟草，尽管对预后不利影响，但他们通常很难减少对这些物质的使用。因此，我们将评估预防性对西可毒蛋白洛兰的使用是否可以保留HNC治疗期间和治疗后的生活质量，并减少这些患者的酒精和烟草使用。因此，我们提出了一项随机，双盲的，安慰剂对照试验，调查了未抑郁的患者抗抑郁药的预防性效用，他们即将开始治疗新诊断为新诊断或复发的头部和颈部癌。我们将评估这种预防性治疗是否可以显着减少严重抑郁症的发展，提高对癌症治疗的依从性，保留生活质量并减少烟草和饮酒。该提案与公共卫生具有很大的相关性，因为它不仅可以在治疗期间测试HNC患者是否可以预防抑郁症，而且还检查了该干预措施是否还可以改善及时完成癌症治疗。此外，我们将研究此类患者的生活质量是否可以在治疗期间更好地保存，以及是否可以减少酒精和烟草使用。如果成功的话，这种方法可能适用于其他合并抑郁症率高的医学疾病。