Fear Of Cancer Recurrence Relates To The Efficacy Of Immunotherapy And Quality Of Life In Patients With NSCLC

Objective: Lung cancer is an important part of global cancer incidence and the main cause of cancer-related deaths.With the world’s attention to primary prevention of cancer and the progress of treatment methods,the incidence rate of lung cancer has declined year by year,and the survival time has been prolonged year by year,which has led to a rapid increase in the number of lung cancer patients and survivors.Today,immunotherapy has become an important part of anti-tumor therapy for many lung cancer patients without clinical targets,and has brought excellent clinical efficacy to many patients.However,the economic burden of immunotherapy,frequent follow-up and examination,inconclusive treatment endpoint,and inevitable drug resistance have all brought huge psychological challenges to lung cancer patients.However,patients with advanced lung cancer often have experienced multiple treatments,which may have planted the seeds of psychological problems in the early stage.Fear of Cancer Recurrence(FCR)is a negative psychological state prevalent in all stages of anti-tumor treatment of various cancer patients.Low level of cancer recurrence fear has no significant impact on the quality of life of patients,and is conducive to the maintenance of follow-up behavior of patients;A high degree of fear of cancer recurrence will seriously affect the quality of life of patients and may interfere with the correct treatment of patients.Previous studies have suggested that short-term negative psychological state can inhibit the cellular immunity of the body,while long-term negative psychological state can also inhibit the cellular and humoral immunity of the body.However,it is not known whether the adverse effects of this negative psychology on the immune system of the body will extend to the efficacy of immunotherapy for tumor patients.The purpose of this study was to explore the relationship between the fear of cancer recurrence and the efficacy and quality of life of patients with advanced non-small cell lung cancer who received immunotherapy.Methods: A total of 124 patients with non-small cell lung cancer who received standard immunotherapy were included in this study.The Chinese version of the Cancer Worry Scale(CWS)was used to evaluate the fear of cancer recurrence.According to the CWS score,patients were divided into high FCR(CWS ≥ 14)group and low FCR(CWS<14)group.The clinical characteristics of participants were collected at the baseline,and the quality of life of patients with non-small cell lung cancer was assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30);Follow up 4-6 standard courses of treatment,or after tumor progression,collect quality of life data again,and use the solid tumor response evaluation criteria(RECIST)standard to evaluate the efficacy of immunotherapy and calculate the disease control rate(DCR)and the objective response rate(ORR).Results: Compared with the lower FCR group.,there was worse immunotherapy efficacy in patients in the high-FCR group(ORR 12.8%,DCR 45.9% vs.ORR 16%,DCR 90%,Z=-5.26,p<0.000).There was a decline in quality of life in patients both groups,and there was a worse decline in the high-FCR group,and there was a negative correlation between the patient’s QOL and the level of FCR.Conclusions: Our research has preliminarily proved that FCR has a negative impact on the immunotherapeutic effect and quality of life of NSCLC patients.The results of this study provide the reasons why clinical workers need to pay attention to patients’ FCR level and the necessity of taking psychological intervention measures to reduce patients’ FCR from the perspective of anti-tumor treatment efficacy,and indicate the possibility of the internal relationship between immunotherapy and FCR.