Predictors of depression in breast cancer patients treated with radiation: Role of prior chemotherapy and nuclear factor kappa B

Mylin A. Torres, Thaddeus W. Pace, Tian Liu, Jennifer C. Felger, Donna Mister, Gregory H. Doho, Jordan N. Kohn, Andrea M. Barsevick, Qi Long, Andrew H. Miller

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

BACKGROUND Depression is common during and after breast cancer treatment. However, the role of specific therapeutic modalities and related biologic mechanisms remains unclear. Radiation is an essential component of breast-conserving therapy and may contribute to depression in patients with breast cancer through the activation of inflammatory pathways. METHODS Depressive symptoms and inflammatory mediators, including nuclear factor kappa B (NF-κB), were assessed at baseline (before radiation), during radiation, and 6 weeks after radiation in 64 women who had stage 0 through IIIA breast cancer. RESULTS No significant increases in depressive symptoms occurred during or after radiation, although a number of patients exhibited moderate-to-severe depression throughout the study. Multivariate analyses of baseline factors predictive of depression revealed that educational status, perceived stress, prior chemotherapy, and peripheral blood NF-κB DNA binding all were independent predictors of persistent depressive symptoms after radiation (all P <.05). Of these factors, only prior chemotherapy was associated with inflammatory mediators, including NF-κB DNA binding, soluble tumor necrosis factor-alpha receptor 2, and interleukin-6, which, in univariate analyses predicted depressive symptoms after radiation (all P <.05). Chemotherapy-treated patients also exhibited an over-representation of gene transcripts regulated by NF-κB. CONCLUSIONS Radiation was not associated with increased depressive symptoms in the current study, but of disease and treatment-related factors, prior chemotherapy predicted significant depression after radiation. Longitudinal studies are warranted to investigate the relationship among prior chemotherapy, inflammation, and persistent depression after breast cancer treatment.

Original languageEnglish (US)
Pages (from-to)1951-1959
Number of pages9
JournalCancer
Volume119
Issue number11
DOIs
StatePublished - Jun 1 2013
Externally publishedYes

Keywords

  • breast cancer
  • chemotherapy
  • depression
  • inflammation
  • nuclear factor kappa B
  • radiation

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Torres, M. A., Pace, T. W., Liu, T., Felger, J. C., Mister, D., Doho, G. H., Kohn, J. N., Barsevick, A. M., Long, Q., & Miller, A. H. (2013). Predictors of depression in breast cancer patients treated with radiation: Role of prior chemotherapy and nuclear factor kappa B. Cancer, 119(11), 1951-1959. https://doi.org/10.1002/cncr.28003