Psychosocial distress in cancer patients undergoing radiotherapy: a prospective national cohort of 1042 patients in Germany

J Cancer Res Clin Oncol. 2023 Sep;149(11):9017-9024. doi: 10.1007/s00432-023-04837-5. Epub 2023 May 10.

Abstract

Purpose: Psychosocial distress is common among cancer patients in general, but those undergoing radiotherapy may face specific challenges. Therefore, we investigated the prevalence and risk factors for distress in a large national cohort.

Methods: We performed a secondary analysis of a multicenter prospective cross-sectional study which surveyed cancer patients at the end of a course of radiotherapy using a patient-reported questionnaire. Distress was measured with the distress thermometer (DT), using a cut-off of ≥ 5 points for clinically significant distress. Univariate analyses and multivariate multiple regression were used to assess associations of distress with patient characteristics. A two-sided p-value < 0.05 was considered statistically significant.

Results: Out of 2341 potentially eligible patients, 1075 participated in the study, of which 1042 completed the DT. The median age was 65 years and 49% (511/1042) of patients were female. The mean DT score was 5.2 (SD = 2.6). Clinically significant distress was reported by 63% (766/1042) of patients. Of the patient characteristics that were significantly associated with distress in the univariate analysis, a lower level of education, a higher degree of income loss, lower global quality of life, and a longer duration of radiotherapy in days remained significantly associated with higher distress in the multivariate analysis. Yet effect sizes of these associations were small.

Conclusion: Nearly two in three cancer patients undergoing radiotherapy reported clinically significant distress in a large multicenter cohort. While screening and interventions to reduce distress should be maintained and promoted, the identified risk factors may help to raise awareness in clinical practice.

Trial registry identifier: DRKS: German Clinical Trial Registry identifier: DRKS00028784.

Keywords: Oncology; Psychosocial distress; Quality of life; Radiotherapy; Supportive care.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Female
  • Germany / epidemiology
  • Humans
  • Male
  • Neoplasms* / complications
  • Neoplasms* / epidemiology
  • Neoplasms* / radiotherapy
  • Prospective Studies
  • Quality of Life* / psychology
  • Stress, Psychological / epidemiology
  • Stress, Psychological / etiology
  • Surveys and Questionnaires

Associated data

  • DRKS/DRKS00028784