抑郁和焦虑在患有癌症的老年人中普遍存在，但往往得不到充分治疗。老年人发生化疗毒性 (CT) 的风险也增加。本研究评估了抑郁和焦虑症状对患有癌症的老年人的严重 CT 风险的影响。这是对评估老年评估驱动干预 (GAIN) 与标准护理 (SOC) 的随机试验 (2:1) 的二次分析减少患有癌症的老年人的 3 级 CT。通过心理健康量表 13 评估心理健康状况。CT 根据国家癌症研究所不良事件通用术语标准 4.0 版进行分级。共有 605 名患者入组（402 名 GAIN；203 名 SOC）。总体而言，35% 的人感到沮丧，47% 的人感到焦虑。 SOC 组抑郁症患者的 CT 增加（70.7% vs. 54.3%；p = .02），但 GAIN 组则没有增加（54.3% vs. 48.5%；p = .27）。 CT 更有可能出现在患有抑郁症的 SOC 患者中（比值比 [OR]，2.03；95% CI，1.10-3.72）。在调整癌症和衰老研究组毒性评分（OR，1.98；95% CI，1.07-3.65）以及人口、疾病和治疗因素（OR，2.00；95% CI，1.03-3.85）后，这种关联仍然存在。 GAIN 组中抑郁症和 CT 不相关（OR，1.26；95% CI，0.84-1.91）。焦虑和 CT 在两组中均不相关。对于患有癌症的老年人来说，抑郁症状升高与严重 CT 风险增加相关，而 GAIN 可以缓解这种风险。这表明治疗抑郁症状可能会降低毒性风险。需要未来的研究来确认和调查针对抑郁症的干预措施对结果的影响。© 2024 作者。 《癌症》由 Wiley periodicals LLC 代表美国癌症协会出版。

Depression and anxiety are prevalent in older adults with cancer but are often undertreated. Older adults are also at increased risk of chemotherapy toxicity (CT). This study evaluated the impact of depression and anxiety symptoms on severe CT risk in older adults with cancer.This is a secondary analysis of a randomized trial (2:1) evaluating geriatric assessment-driven intervention (GAIN) versus standard of care (SOC) to reduce grade 3+ CT in older adults with cancer. Mental health was assessed via the Mental Health Inventory 13. CT was graded by National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0.A total of 605 patients enrolled (402 GAIN; 203 SOC). Overall, 35% were depressed and 47% were anxious. Patients with depression had increased CT in the SOC arm (70.7% vs. 54.3%; p = .02) but not in the GAIN arm (54.3% vs. 48.5%; p = .27). CT was more likely in SOC patients with depression (odds ratio [OR], 2.03; 95% CI, 1.10-3.72). This association persisted after adjusting for Cancer and Aging Research Group toxicity score (OR, 1.98; 95% CI, 1.07-3.65) and for demographic, disease, and treatment factors (OR, 2.00; 95% CI, 1.03-3.85). Depression and CT were not associated in the GAIN arm (OR, 1.26; 95% CI, 0.84-1.91). Anxiety and CT were not associated in either arm.Elevated depression symptoms are associated with increased risk of severe CT in older adults with cancer, which was mitigated with GAIN. This suggests that treating depression symptoms may lower toxicity risk. Future studies are needed to confirm and investigate the impact of depression-specific interventions on outcomes.© 2024 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.