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Master Thesis

Impact du stress psychologique dans l'apparition des tumeurs cérébrales de haut grade de type glioblastome

Abstract : Background: glioblastoma is the most frequent histological type among gliomas and the risk factors are mostly unknown. The growing interest of patients and caregivers for the involvement of psychological stress in cancer led us to carry out this study. The objective is to assess the stress prevalence prior to diagnosis of glioblastoma IDH wild-type. Materials and method: this prospective single-center study is based on a consecutive enrollment of new cases of glioblastoma IDH wild-type diagnosed between December 2019 and March 2021 at the University Hospital of Bordeaux. The clinical, radiological, pathological, socio-demographic data as well as the oncological treatment carried out and the data on progression-free survival and overall survival were collected from the patients' charts. Thanks to a standardized stress self-assessment questionnaire, we searched for recent acute stress in the two years preceding the diagnosis as well as the level of stressors exposure and the intensity of the stress level prior to the diagnosis. Statistical analysis were based on the Chi-square test and the Kaplan-Meier survival estimator. Results: sixty-four patients with a median age of 66 were included and the clinical presentation was equally distributed between sensory-motor deficit, cognitive impairment and epilepsy. No risk factor for glioblastoma was found in these patients and their general condition was maintained (PS 0 or 1) in 70% of cases. Thirty patients (47%) underwent a diagnostic biopsy while 34 patients (53%) underwent surgical excision. Forty patients (62.5%) reported the presence of low-intensity acute stress or no acute stress in the 2 years preceding the diagnosis, mainly relating to the loss of a loved one or to family health problems. Among working professionals, 20 patients (67.5%) reported low-intensity work stress. A history of depression was found in 30% of cases and 19% of patients were taking psychotropic medication at diagnosis. The frontal lobe was affected in 25 patients (39.1%) but the frontal location of the tumor did not appear to significantly increase the level of stress (p = 0.121) or depression (p = 0.973). Likewise, the use of beta-blockers did not significantly change the stress level of the patients (p = 0.754). After recombination between the different categories, 36 patients (56.3%) presented a low stressor / low stress profile. For patients who identified recent acute stress, the average time between stress and the onset of the first symptom was 11 months. The average time between first symptom and pathological diagnosis was 1.7 months. The progression-free survival at 6 months was 45.3% and the median overall survival was estimated at 16.5 months. There does not seem to be a significant association between stress and tumor progression (p = 0.612) or overall survival (p = 0.933). Conclusion: a majority of patients in this study had low exposure to stressors as well as low stress level. Psychological stress does not appear to impact the emergence of brain tumors or the survival of patients with glioblastoma.
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Submitted on : Thursday, October 14, 2021 - 2:09:58 PM
Last modification on : Wednesday, November 24, 2021 - 3:16:18 AM
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  • HAL Id : dumas-03378046, version 1



Quentin Durrechou. Impact du stress psychologique dans l'apparition des tumeurs cérébrales de haut grade de type glioblastome. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03378046⟩



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