Abstract
BACKGROUND: Non-small cell lung cancer (NSCLC) presents with a range of symptoms and is associated with a poor prognosis. Although both immunotherapy and chemotherapy improve survival, they are still associated with psychological disorders due to the reduced quality of life. This study aimed to investigate the levels of anxiety and depression in Greek patients with NSCLC receiving second-line chemotherapy compared to second-line immunotherapy. MATERIALS AND METHODS: This is a comparative, prospective, non-randomized follow-up study in which measurement scales have been used to compare data from NSCLC patients in two hospitals in Athens, Greece. All patients completed a demographic data form in the first therapy cycle, while the hospital anxiety and depression scale (HADS) (value range 0-21) was completed from treatment cycle 1 to treatment cycle 6. RESULTS: Of the 111 selected patients, the majority (75.7%) were men, with a mean age of 66.5±9.2 years. Second-line chemotherapy was received by 61 patients and second-line immunotherapy by 50 patients. According to HADS, from treatment cycle 1 to treatment cycle 6, the mean anxiety score decreased from 4.83±5.1 to 3.2±3.8 (p=0.287), while the mean depression score decreased from 5.64±5.53 to 4.61±4.75 (p=0.113). Depressive symptoms were statistically significantly higher in patients who received chemotherapy from the fourth cycle onwards (p<0.05), but in any of the study groups, the value did not exceed the critical threshold of seven points. In the anxiety subscale, after cycle 3 there was a significant decrease (p=0.014) of a similar degree (p=0.608) in both groups. CONCLUSIONS: The present study was the first attempt to investigate differences in psychological symptoms between treatment groups in Greek NSCLC patients. Anxiety and depression levels did not appear to be serious problems in the chemotherapy and immunotherapy group of patients.