Psychological resilience as a predictor of quality of life in ultrasound-guided chemotherapy: A retrospective cohort study
Abstract
Background: Psychological resilience may regulate the metabolism of chemotherapy drugs through neuroendocrine mechanisms, but its role in the local administration mode remains unclear. This study explores the influence of the psychological resilience level of breast cancer patients on the pharmacokinetics of ultrasound-guided intratumoral injection of paclitaxel. Methods: A retrospective analysis was conducted on 120 breast cancer patients who received intratumoral paclitaxel treatment. They were divided into the high resilience group and the low resilience group (60 cases in each group) according to the Connor-Davidson Resilience Scale (CD-RISC). The peripheral blood drug concentration was detected, the pharmacokinetic parameters AUC0-10h (ng·h/mL), Cmax (ng/mL), Tmax (h), and t1/2 (h) were calculated, and the differences in molecular subtypes were analyzed. The European Organization for Research and Treatment of Cancer Quality of Life Core Scale Chinese version was utilized to evaluate the quality of life (QOL) of patients. Result: There were statistically significant differences between the high-resilience group and the low-resilience group in terms of smoking history (p = 0.047), ALT (p = 0.046), and the prevalence of hypertension (p = 0.032). Psychological resilience may affect the metabolism and elimination of drugs, resulting in greater drug exposure and longer half-life in the low psychological resilience group. In both the Luminal and HER2+ subtypes, the AUC₀-₁₀ₕ in the low resilience group was significantly higher than that in the high resilience group. The CD-RISC score was significantly negatively correlated with the AUC of paclitaxel (r = -0.672, p < 0.001). For every 10-point increase in the CD-RISC score, the overall QOL of patients can improve by 4.3 points, and the symptoms of fatigue and pain are significantly reduced. Conclusion: Psychological resilience may optimize the local efficacy by reducing systemic leakage of paclitaxel, especially in HER2-positive patients. The CD-RISC score may be used as an auxiliary predictive indicator for individualized local chemotherapy.
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