Univariate And Multivariate Analysis Of Psychological And Quality Of Life In Children And Adolescents With Brain Tumor During Radiotherapy

Study objectivesTo describe the changes in psychology and quality of life of pediatric and adolescent brain tumor patients during and after the end of radiotherapy,and to assess the relationship between psychology and quality of life,to explore the predictors of patients’ psychological status and quality of life,and to provide a scientific basis for the corresponding clinical interventions,and finally to analyze the changes in immune function of patients before and after radiotherapy and the relationship with psychological status and quality of life,to provide a clinical reference for the effect of radiotherapy on immune function Finally,we analyzed the changes in immune function before and after radiotherapy,and the relationship between immune function and psychological status and quality of life,and provided clinical reference for the effect of radiotherapy on immune function.Materials and MethodsThis is a prospective,observational clinical study that included pediatric and adolescent primary brain tumor patients who underwent radiotherapy at the Department of Radiotherapy,Southern Hospital of Southern Medical University from October 1,2021 to December 1,2022,using the same questionnaire to collect patients’demographic and clinical characteristics and family functioning before radiotherapy,and to collect patients’ immune function before the start of radiotherapy,at the 3rd week after the start of radiotherapy and at the end of radiotherapy,and at Psychological,quality of life,nutritional indicators,MMSE scale,and psychological scale information of patients’ parents were collected before the start of radiotherapy and at the end of radiotherapy and 3 months after the end of radiotherapy,and immune function indicators of patients were collected before the start of radiotherapy and at the end of radiotherapy.Results1.A total of 44 patients were included through the inclusion and exclusion criteria.Patients had high depression scores(median 8,quartiles 5.5-15.5)and anxiety scores(41.03±15.21)before radiotherapy and had the highest scores at 3 months after radiotherapy.Patients’ cognitive function scores were slightly lower(P>0.05)at 3 months after radiotherapy compared to before.The nausea scale score gradually decreased and was the lowest after radiotherapy(median 70,quartiles 60-100)and continued to affect even up to 3 months after radiotherapy(P>0.05).2.Within 3 months after radiotherapy,the anxiety score was negatively correlated with BMI(r=-0.358,P<0.05)and upper arm circumference(r=-0.33 7,P<0.05),and negatively correlated with nutrition scale and mGPS(r<0).Family function was positively correlated with anxiety score(r=0.288,P<0.05).It was negatively correlated with pain(r=-0.341,P<0.05)and social mental health scores(r=-0.31,P<0.05).3.Anxiety and depression scores were all negatively correlated with quality of life.Among them,anxiety(r=-0.676,P<0.001)and depression(r=-0.540,P<0.001)had the highest correlation with cognitive function.4.After radiotherapy,suppression of T-cell induced subpopulation was positively correlated with the cognitive function scale(r=0.336,P=0.045),HLA-DR+T4 cells/T4 cells were negatively correlated with the total CDI score(r=-0.355,P=0.031),double positive T cells/total T cells were positively correlated with the motor peace scale(r=0.461,P=0.002),NLR was negatively correlated with nausea scale was negatively correlated(r=-0.352,P=0.008).ConclusionThe anxiety and depression levels of patients before radiotherapy and 3 months after radiotherapy were higher than those during radiotherapy.At the same time,the cognitive function began to decline 3 months after radiotherapy,and the difference of anxiety and depression within 3 months after radiotherapy was positively correlated with the difference of cognitive function.Nutrition,family function and immune function are important factors affecting the psychological and quality of life of children and adolescents with primary brain tumors.During radiotherapy,medical staff should strengthen the psychological counseling of children and adolescents before and after radiotherapy,and evaluate the nutrition,family function and immune function of patients,so as to take corresponding intervention measures to improve the quality of life of patients.