Background Patients with gynecological cancer are prone to anxiety, and many of them are accompanied by hypertension, which seriously affects the quality of life (QOL). The study was to explore the interaction of anxiety and hypertension on QOL, and the moderating effect of perceived social support (PSS) in the impact of anxiety and hypertension on QOL of patients with gynecological cancer. Methods A cross-sectional study was conducted in 2020, and 566 patients have been collected from the Affiliated Hospital of China Medical University. The Self-Rating Anxiety Scale (SAS), the Functional Assessment of Cancer Therapy Genera tool (FACT-G), and the Multidimensional Scale of Perceived Social Support Scale (MSPSS) were used. The interaction was analyzed by additive model, and the moderating effect was conducted by regression analysis and the simple slope analysis. Results We found that 68.8% of patients had poor QOL due to the interaction between anxiety and hypertension. The relative excess risk ratio (RERI) was 22.238 (95%CI:44.119–88.596); the attribution ratio (AP) was 0.688 (95%CI:0.234–1.142); The interaction index (S) was 3.466 (95%CI: 0.823–14.435). The interaction items of PSS and anxiety were negatively correlated with QOL (β = -0.219, P < 0.01) and explained an additional 4.0% variance (F = 68.649, Adjusted R2 = 0.399, ΔR2 = 0.040, P < 0.01); PSS and blood pressure interaction item was not associated with QOL (β = 0.013, F = 55.138, Adjusted R2 = 0.365, ΔR2 = 0.001, P = 0.730). Conclusions When anxiety and hypertension coexist, the QOL was affected. PSS played a moderating role in the impact of anxiety on QOL. Healthcare providers should take intervention measures to improve patients’ social support to reduce the impact of anxiety on QOL.

Gynecological cancer patients are prone to anxiety, accompanied by hypertension symptoms, which seriously affect the quality of life (QOL). The study was to explore the interaction of anxiety and hypertension on QOL, and the moderating effect of social support in the impact of anxiety and hypertension on QOL of gynecological cancer patients. A cross-sectional study was conducted in 2020, and 566 patients have been collected from the Affiliated Hospital of China Medical University. The Self-Rating Anxiety Scale (SAS), the Functional Assessment of Cancer Therapy Genera tool (FACT-G), and the Multidimensional Scale of Perceived Social Support Scale (MSPSS) were used. The interaction was analyzed by additive model, and the moderating effect was conducted by regression analysis and the simple slope analysis. We found that 68.8% of patients had poor QOL due to the interaction between anxiety and hypertension. The relative excess risk ratio (RERI) was 22.238 (95%CI:44.119–88.596); the attribution ratio (AP) was 0.688 (95%CI:0.234–1.142); The interaction index (S) was 3.466 (95%CI: 0.823–14.435). The interaction items of social support and anxiety were negatively correlated with QOL (β=-0.219, P < 0.01) and explained an additional 4.0% variance (F = 68.649, Adjusted R2 = 0.399, ΔR2 = 0.040, P < 0.01); Social support and blood pressure interaction item was not associated with QOL (β = 0.013, F = 55.138, Adjusted R2 = 0.365, ΔR2 = 0.001, P = 0.730). When anxiety and hypertension coexist, the QOL was seriously decreased. Social support played a moderating role in the impact of anxiety on QOL. Medical staffs should take intervention measures to improve patients’ social support to reduce the impact of anxiety on QOL.

Background and purpose: Programmed death-1 (PD-1) inhibitor has been approved as second or later-line treatment in advanced gastric cancer (AGC). The study aimed to compare the clinical outcomes of PD-1 inhibitor plus chemotherapy (combination therapy) with chemotherapy monotherapy as second or later-line treatment in AGC. Methods: The clinical data of patients with AGC with human epidermal growth factor receptor (her2) negative and receiving combination therapy or chemotherapy monotherapyas second or later-line treatment was retrospectively collected. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and the occurrence of adverse reactions (AEs) were evaluated between two groups. Result: A total of 107 patients were enrolled in current study. Fifty-seven patients received combination therapy, and fifty patients received chemotherapy monotherapy. After at least 2 cycles of treated, ORR and DCR in combination therapy group were higher than monotherapy group (37.1% vs 4.3%, P<=0.001; 82.3% vs53.2%, P<=0.001). Median PFS and median OS in combination therapy group were significantlly longer than monotherapy group (9.20 months vs 3.07 months, P<=0.001; 10.47 months vs 7.80 months, P<=0.001). The rate of any grade AEs in combination therapy group was significantlly higher than monotherapy group (98.4% vs 85.1%, P=0.024). There was no treatment-related death in two groups. Conclusions: Compared with chemotherapy monotherapy, the PD-1 inhibitor combined with chemotherapy as second or later-line treatment in Her2 negative AGC can prolong OS and PFS and improve DCR. However, the incidence of all AEs in combination therapy group was significantly higher than chemotherapy monotherapy group.

Rationale:The therapeutic value of immune checkpoint inhibitors (ICIs) in a variety of tumors has been found and recognized, and although ICIs have improved the prognosis of many patients with advanced tumors, these drugs sometimes cause immunerelated adverse events (irAEs).