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Volume 29
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Article

Psychoneurological Symptoms and Biomarkers of Stress and Inflammation in Newly Diagnosed Head and Neck Cancer Patients: A Network Analysis

by
Angelina M. M. Santoso
1,2,
Femke Jansen
2,3,*,
Carel F. W. Peeters
4,5,
Robert J. Baatenburg de Jong
6,
Ruud H. Brakenhoff
2,3,
Johannes A. Langendijk
7,
C. René Leemans
2,3,
Robert P. Takes
8,
Chris H. J. Terhaard
9,
Annemieke van Straten
1 and
Irma M. Verdonck-de Leeuw
1,2,3
1
Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
2
Cancer Center Amsterdam Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
3
Department of Otolaryngology—Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
4
Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
5
Mathematical & Statistical Methods Group (Biometris), Wageningen University & Research, P.O. Box 16, 6700 AA Wageningen, The Netherlands
6
Department of Otolaryngology and Head and Neck Surgery, Erasmus Cancer Institute, Erasmus MC, 3015 GD Rotterdam, The Netherlands
7
Department of Radiation Oncology, University of Groningen, University Medical Centre Groningen, 9713 GZ Groningen, The Netherlands
8
Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, 6525 GA Nijmegen, The Netherlands
9
Department of Radiotherapy, University Medical Center, 3584 CX Utrecht, The Netherlands
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2022, 29(10), 7109-7121; https://doi.org/10.3390/curroncol29100559
Submission received: 21 August 2022 / Revised: 22 September 2022 / Accepted: 24 September 2022 / Published: 28 September 2022
(This article belongs to the Section Head and Neck Oncology)
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Abstract

Psychoneurological symptoms are commonly reported by newly diagnosed head and neck cancer (HNC) patients, yet there is limited research on the associations of these symptoms with biomarkers of stress and inflammation. In this article, pre-treatment data of a multi-center cohort of HNC patients were analyzed using a network analysis to examine connections between symptoms (poor sleep quality, anxiety, depression, fatigue, and oral pain), biomarkers of stress (diurnal cortisol slope), inflammation markers (c-reactive protein [CRP], interleukin [IL]-6, IL-10, and tumor necrosis factor alpha [TNF-α]), and covariates (age and body mass index [BMI]). Three centrality indices were calculated: degree (number of connections), closeness (proximity of a variable to other variables), and betweenness (based on the number of times a variable is located on the shortest path between any pair of other variables). In a sample of 264 patients, poor sleep quality and fatigue had the highest degree index; fatigue and CRP had the highest closeness index; and IL-6 had the highest betweenness index. The model yielded two clusters: a symptoms—cortisol slope—CRP cluster and a IL-6—IL-10—TNF-α—age—BMI cluster. Both clusters were connected most prominently via IL-6. Our findings provide evidence that poor sleep quality, fatigue, CRP, and IL-6 play an important role in the interconnections between psychoneurological symptoms and biomarkers of stress and inflammation in newly diagnosed HNC patients.
Keywords: sleep quality; depression; anxiety; pain; fatigue; biomarker; inflammation; cortisol; head and neck cancer; network analysis sleep quality; depression; anxiety; pain; fatigue; biomarker; inflammation; cortisol; head and neck cancer; network analysis

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MDPI and ACS Style

Santoso, A.M.M.; Jansen, F.; Peeters, C.F.W.; Baatenburg de Jong, R.J.; Brakenhoff, R.H.; Langendijk, J.A.; Leemans, C.R.; Takes, R.P.; Terhaard, C.H.J.; van Straten, A.; et al. Psychoneurological Symptoms and Biomarkers of Stress and Inflammation in Newly Diagnosed Head and Neck Cancer Patients: A Network Analysis. Curr. Oncol. 2022, 29, 7109-7121. https://doi.org/10.3390/curroncol29100559

AMA Style

Santoso AMM, Jansen F, Peeters CFW, Baatenburg de Jong RJ, Brakenhoff RH, Langendijk JA, Leemans CR, Takes RP, Terhaard CHJ, van Straten A, et al. Psychoneurological Symptoms and Biomarkers of Stress and Inflammation in Newly Diagnosed Head and Neck Cancer Patients: A Network Analysis. Current Oncology. 2022; 29(10):7109-7121. https://doi.org/10.3390/curroncol29100559

Chicago/Turabian Style

Santoso, Angelina M. M., Femke Jansen, Carel F. W. Peeters, Robert J. Baatenburg de Jong, Ruud H. Brakenhoff, Johannes A. Langendijk, C. René Leemans, Robert P. Takes, Chris H. J. Terhaard, Annemieke van Straten, and et al. 2022. "Psychoneurological Symptoms and Biomarkers of Stress and Inflammation in Newly Diagnosed Head and Neck Cancer Patients: A Network Analysis" Current Oncology 29, no. 10: 7109-7121. https://doi.org/10.3390/curroncol29100559

APA Style

Santoso, A. M. M., Jansen, F., Peeters, C. F. W., Baatenburg de Jong, R. J., Brakenhoff, R. H., Langendijk, J. A., Leemans, C. R., Takes, R. P., Terhaard, C. H. J., van Straten, A., & Verdonck-de Leeuw, I. M. (2022). Psychoneurological Symptoms and Biomarkers of Stress and Inflammation in Newly Diagnosed Head and Neck Cancer Patients: A Network Analysis. Current Oncology, 29(10), 7109-7121. https://doi.org/10.3390/curroncol29100559

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