{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T22:50:01Z","timestamp":1767826201028,"version":"3.49.0"},"reference-count":34,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T00:00:00Z","timestamp":1675641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Introduction: Cancer patients are known to experience sleep disturbances that differ between disease stages and treatments. Regarding lung cancer patients and immunotherapy, information on their sleep disturbances has been recently acquired, but no comparison has been made between different treatment modalities. Patients and Methods: We recruited 98 non-small cell lung cancer patients; 49 had programmed death-ligand 1 expression of \u226550% and received immunotherapy as first-line treatment and 49 had programmed death-ligand 1 expression in the range from 0\u201349 and received chemotherapy as first-line treatment. All patients were stage IV, but with no bone metastasis. Sleep disturbances were recorded through polysomnography and sleep questionnaires. Results: For immunotherapy patients with PD-L1 expression \u2265 50%, the disease response was rapid and the sleep disturbances decreased rapidly. On the other hand, for chemotherapy patients, the sleep disturbances remained for all those patients that had partial response and stable disease. It was noticed that chemotherapy drugs induce severe adverse effects. Discussion: In our study, it was observed that patients with complete response had reduced sleep disturbances in the case of immunotherapy patients. However, sleep disturbances continued for several patients in the chemotherapy group due to the adverse effects of chemotherapy drugs. In conclusion: Immunotherapy drugs on their own do not induce sleep disturbances and, through treatment response, alleviate sleep disturbances in lung cancer patients.<\/jats:p>","DOI":"10.3390\/curroncol30020155","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T06:22:25Z","timestamp":1675664545000},"page":"1999-2006","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Immunotherapy and Chemotherapy Versus Sleep Disturbances for NSCLC Patients"],"prefix":"10.3390","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5119-2207","authenticated-orcid":false,"given":"Paul","family":"Zarogoulidis","sequence":"first","affiliation":[{"name":"Pulmonary Department, General Clinic Euromedica Private Hospital, 851 05 Thessaloniki, Greece"},{"name":"3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Petridis","sequence":"additional","affiliation":[{"name":"Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, 574 00 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoforos","family":"Kosmidis","sequence":"additional","affiliation":[{"name":"3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Sapalidis","sequence":"additional","affiliation":[{"name":"3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lila","family":"Nena","sequence":"additional","affiliation":[{"name":"Laboratory of Social Medicine, Medical School, Democritus University of Thrace, 691 00 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Matthaios","sequence":"additional","affiliation":[{"name":"Oncology Department, General Hospital of Rhodes, 851 00 Rhodes, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7215-2191","authenticated-orcid":false,"given":"Konstantinos","family":"Porpodis","sequence":"additional","affiliation":[{"name":"Pulmoanry Department, G. Papanikolaou General Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paschalis","family":"Kakavelas","sequence":"additional","affiliation":[{"name":"Intensive Care Unit (ICU), General Clinic Euromedica, 153 43 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paschalis","family":"Steiropoulos","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Medical School, Democritus University of Thrace, 691 00 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,6]]},"reference":[{"key":"ref_1","first-page":"e29381","article-title":"The 50-Year Journey of Lung Cancer Screening: A Narrative Review","volume":"14","author":"Parekh","year":"2022","journal-title":"Cureus"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.7150\/jca.67113","article-title":"Radial Endobronchial Ultrasound for Lung Cancer Diagnosis: Tips and Tricks","volume":"13","author":"Zarogoulidis","year":"2022","journal-title":"J. Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Zarogoulidis, P., Kosmidis, C.S., Hohenforst-Schmidt, W., Matthaios, D., Sapalidis, K., Petridis, D., Perdikouri, E.I., Courcoutsakis, N., Hatzibougias, D., and Arnaoutoglou, C. (2022). Radial-EBUS: CryoBiopsy Versus Conventional Biopsy: Time-Sample and C-Arm. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19063569"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"7","DOI":"10.7150\/jca.13081","article-title":"Radial Endobronchial Ultrasound (EBUS) Guided Suction Catheter-Biopsy in Histological Diagnosis of Peripheral Pulmonary Lesions","volume":"7","author":"Zaric","year":"2016","journal-title":"J. Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.7150\/jca.74022","article-title":"\u201cOne Shot\u201d Sample Evaluation of 22G, 22G upgraded, 21G and 19G needle for Endobronchial Ultrasound-EBUS-TBNA","volume":"13","author":"Oikonomidou","year":"2022","journal-title":"J. Cancer"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3084","DOI":"10.7150\/jca.75589","article-title":"Cryo-Biopsy versus 19G needle versus 22G needle with EBUS-TBNA endoscopy","volume":"13","author":"Oikonomidou","year":"2022","journal-title":"J. Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"4739","DOI":"10.7150\/jca.35898","article-title":"EBUS-TNBA 22G samples: Comparison of PD-L1 expression between DAKO and BIOCARE((R))","volume":"10","author":"Sapalidis","year":"2019","journal-title":"J. Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"5874","DOI":"10.7150\/jca.59892","article-title":"Priority of PET-CT vs. CT Thorax for EBUS-TBNA 22G vs. 19G: Mesothorax Lymphadenopathy","volume":"12","author":"Zarogoulidis","year":"2021","journal-title":"J. Cancer"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"945602","DOI":"10.3389\/fmed.2022.945602","article-title":"Positron emission tomography imaging of lung cancer: An overview of alternative positron emission tomography tracers beyond F18 fluorodeoxyglucose","volume":"9","author":"Zhu","year":"2022","journal-title":"Front. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1002\/jhm.397","article-title":"Sleep in hospitalized medical patients, part 2: Behavioral and pharmacological management of sleep disturbances","volume":"4","author":"Young","year":"2009","journal-title":"J. Hosp. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1080\/07420528.2022.2108438","article-title":"The mediating roles of depression, anxiety, and psychological pain in the relationship between chronotype and suicide in patients with depressive disorder","volume":"39","author":"Uzer","year":"2022","journal-title":"Chronobiol. Int."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2431","DOI":"10.1200\/JCO.2008.16.2008","article-title":"Losing sleep over cancer","volume":"26","author":"Spiegel","year":"2008","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"10732748221133752","DOI":"10.1177\/10732748221133752","article-title":"Effects of an Intrathecal Drug Delivery System Connected to a Subcutaneous Port on Pain, Mood and Quality of Life in End Stage Cancer Patients: An Observational Study","volume":"29","author":"Giglio","year":"2022","journal-title":"Cancer Control J. Moffitt Cancer Cent."},{"key":"ref_14","first-page":"S389","article-title":"Treatment of non-small cell lung cancer (NSCLC)","volume":"5","author":"Zarogoulidis","year":"2013","journal-title":"J. Thorac. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"736","DOI":"10.7150\/jca.7734","article-title":"Molecular Targeted Drugs and Biomarkers in NSCLC, the Evolving Role of Individualized Therapy","volume":"4","author":"Domvri","year":"2013","journal-title":"J. Cancer"},{"key":"ref_16","first-page":"256","article-title":"Following the crumbs: From tissue samples, to pharmacogenomics, to NSCLC therapy","volume":"2","author":"Domvri","year":"2013","journal-title":"Transl. Lung Cancer Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3384","DOI":"10.1111\/1759-7714.14697","article-title":"Investigation of poor predictive factors in extensive stage small cell lung cancer under etoposide-platinum-atezolizumab treatment","volume":"13","author":"Lim","year":"2022","journal-title":"Thorac. Cancer"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Economou, N.T., Ilias, I., Velentza, L., Papachatzakis, Y., Zarogoulidis, P., Kallianos, A., and Trakada, G. (2018). Sleepiness, fatigue, anxiety and depression in Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea\u2014Overlap\u2014Syndrome, before and after continuous positive airways pressure therapy. PloS ONE, 13.","DOI":"10.1371\/journal.pone.0197342"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"946307","DOI":"10.3389\/fonc.2022.946307","article-title":"Insomnia in patients treated with checkpoint inhibitors for cancer: A meta-analysis","volume":"12","author":"Kiss","year":"2022","journal-title":"Front. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1055\/s-2004-829632","article-title":"Greek version of the Epworth Sleepiness Scale","volume":"8","author":"Tsara","year":"2004","journal-title":"Sleep Breath."},{"key":"ref_21","first-page":"1831","article-title":"Psychometric evaluation and feasibility of the Greek Pittsburgh Sleep Quality Index (GR-PSQI) in patients with cancer receiving chemotherapy","volume":"19","author":"Kotronoulas","year":"2011","journal-title":"Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer"},{"key":"ref_22","first-page":"725","article-title":"Immune factors or depression? Fatigue correlates in Parkinson\u2019s disease","volume":"45","author":"Katsarou","year":"2007","journal-title":"Rev. De Neurol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1093\/occmed\/kqx086","article-title":"The MRC breathlessness scale","volume":"67","author":"Williams","year":"2017","journal-title":"Occup. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1111\/j.1759-7714.2012.00156.x","article-title":"Subjective sleep quality in lung cancer patients before and after chemotherapy","volume":"4","author":"Zarogoulidis","year":"2013","journal-title":"Thorac. Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"3602","DOI":"10.2174\/1381612827999210111193133","article-title":"Nutrition and NSCLC; Should We Administer Food Supplements?","volume":"27","author":"Zarogoulidis","year":"2021","journal-title":"Curr. Pharm. Des."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"632","DOI":"10.2174\/13892010113146660229","article-title":"Time recall; future concept of chronomodulating chemotherapy for cancer","volume":"14","author":"Zarogoulidis","year":"2013","journal-title":"Curr. Pharm. Biotechnol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Seifen, C., Huppertz, T., Matthias, C., and Gouveris, H. (2021). Obstructive Sleep Apnea in Patients with Head and Neck Cancer-More than Just a Comorbidity?. Medicina, 57.","DOI":"10.3390\/medicina57111174"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"100474","DOI":"10.1016\/j.esmoop.2022.100474","article-title":"Incidence of fatigue associated with immune checkpoint inhibitors in patients with cancer: A meta-analysis","volume":"7","author":"Kiss","year":"2022","journal-title":"ESMO Open"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.pan.2018.02.006","article-title":"Celecoxib suppresses proliferation and metastasis of pancreatic cancer cells by down-regulating STAT3\/NF-kB and L1CAM activities","volume":"18","author":"Zuo","year":"2018","journal-title":"Pancreatol. Off. J. Int. Assoc. Pancreatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s12964-021-00721-2","article-title":"Circadian clock: A regulator of the immunity in cancer","volume":"19","author":"Zhang","year":"2021","journal-title":"Cell Commun. Signal. CCS"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3517","DOI":"10.1200\/JCO.2011.36.1154","article-title":"Inflammation and behavioral symptoms after breast cancer treatment: Do fatigue, depression, and sleep disturbance share a common underlying mechanism?","volume":"29","author":"Bower","year":"2011","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.jpsychores.2006.11.008","article-title":"Sleep quality in advanced cancer patients","volume":"62","author":"Mystakidou","year":"2007","journal-title":"J. Psychosom. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1093\/sleep\/30.6.737","article-title":"The relationship of subjective sleep quality, pain, and quality of life in advanced cancer patients","volume":"30","author":"Mystakidou","year":"2007","journal-title":"Sleep"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1188\/06.ONF.761-769","article-title":"Sleep-wake disturbances and quality of life in patients with advanced lung cancer","volume":"33","author":"Vena","year":"2006","journal-title":"Oncol. Nurs. Forum"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/30\/2\/155\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:25:25Z","timestamp":1760120725000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/30\/2\/155"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,6]]},"references-count":34,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["curroncol30020155"],"URL":"https:\/\/doi.org\/10.3390\/curroncol30020155","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,6]]}}}