ArticleInternational journal of radiation oncology, biology, physics2026
Associations of Biological Aging With Perceived Stress in Patients With Head and Neck Cancer Undergoing Intensity Modulated Radiation Therapy: A Longitudinal Study.
Article in International journal of radiation oncology, biology, physics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
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Authors and funding
13 authors.
Funding
Abstract
purposeAccelerated biological aging increases morbidity and mortality in patients with head and neck cancer (HNC) undergoing intensity modulated radiation therapy (IMRT). Stress from HNC and IMRT may exacerbate this process, yet the link between biological aging and perceived stress during treatment remains unclear. The purpose of this study was to examine associations between biological aging and perceived stress in HNC patients receiving IMRT across 4 time points: pre-IMRT, the end of IMRT, and 3 and 12 months post-IMRT. METHODS AND MATERIALS: This prospective longitudinal study assessed perceived stress using the Perceived Stress Scale and various biological aging markers, including epigenetic age acceleration, Pace of Aging Calculated from the Epigenome (DunedinPACE), Klemera-Doubal biological age, phenotypic age (PhenoAge), homeostatic dysregulation, and inflammatory markers (interleukin [IL]-6, IL-1β, IL-10, IL-1ra, C-reactive protein, soluble tumor necrosis factor receptor (TNF) 2, and TNF-α). Linear mixed-effects models examined associations between each biological aging marker and perceived stress over time.
resultsAmong 146 HNC patients (mean age ± SD, 59.12 ± 10.05 years; 73% male; 81% non-Hispanic White), perceived stress increased during treatment, declined significantly posttreatment, and remained lower than the baseline level. Higher perceived stress was significantly associated with increased DunedinPACE (estimate = 10.82; 95% CI, 4.49, 17.15; p = .001), Klemera-Doubal biological age (estimate = 0.03; 95% CI, 0.01, 0.05; p = .003), PhenoAge (estimate = 0.25; 95% CI, 0.06, 0.44; p = .011), C-reactive protein (estimate = 1.42; 95% CI, 0.35, 2.48; p = .009), TNF-α (estimate = -3.92; 95% CI, -7.53, -0.31; p = .033), and IL-1ra (estimate = 4.89, 95% CI, 2.24, 7.54; p < .001) over time, after adjusting for covariates (eg, age, sex, race, marital status, income, tumor human papillomavirus status, and treatment).
conclusionsThe strong association between biological aging and perceived stress suggests a critical role for stress in accelerating aging among patients with HNC. Future research should aim to investigate stress-inflammation management to decelerate aging and improve survival in these vulnerable cancer populations.
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