Avaliação da qualidade de vida e sintomas de ansiedade e depressão em pacientes com metástases cerebrais

Abstract

Brain metastases are the most common cancer-related neurological complication and represent the most common brain cancer. Between 20-40% of cancer patients develop brain metastases. Patients newly diagnosed with brain metastases often present with some degree of neurocognitive dysfunction, and therefore have complex symptomatic experiences, a limited life expectancy and a deterioration in their quality of life. The aim of the study is to evaluate the quality of life and the presence of symptoms of anxiety and depression in patients with brain metastases. The study is an analytical and observational cross-sectional study. The study sample consisted of 16 patients diagnosed with brain metastases between August 2021 and August 2023. The following were assessed: neurological symptoms; Kamofsky Performance Status (KPS); Eastern Cooperative Oncology Group (ECOG); Hospital Anxiety and Depression Scale (HADS); Barthel Index; Functional Assessment of Cancer Therapy-Brain (FACT-Br). The average age of the sample was 53.9 years, of the total number of patients 37.5% were male and 62.5% female. The most common preoperative symptoms were motor deficits (62.5%), headaches (56.3%) and seizures (43.8%). The mean KPS was 64.38 (± 16.72). The mean ECOG was 2.13 (± 1.15). The average Barthel index was 58.44 (± 32.95). The mean scores for anxiety and depression on the HADS scale were 4.82 (± 5.23) and 3.55 (± 4.39), respectively, with a prevalence of possible/probable: anxiety of 27%, and depression of 18%. The average FACT-Br was 129.03 (± 46.88). When correlating functional capacity scores with the presence of anxiety and/or depression, there was a non-significant negative correlation between ECOG and anxiety (p=0.965) and between KPS and anxiety the correlation was positive, but not significant (p=0.902). When the Fact-Br subscales were correlated with the KPS, ECOG and Barthel, there was no statistically significant correlation between the variables. We conclude that our sample, although small, showed symptoms of anxiety and moderate quality of life in the preoperative period, which demonstrates the need for a care plan that goes beyond offering clinical and surgical resources to cope with the disease. No significant correlations were found, despite the fact that there is a significant relationship in literature between quality of life, functional capacity and symptoms of anxiety and depression, which may be explained by the small sample size.