Background/Aim: Quality of life of patients with lung cancer can be impaired by psychological distress. This study evaluated prevalence of and risk factors for emotional distress in patients undergoing radiotherapy or chemoradiotherapy. Patients and Methods: Fourteen potential risk factors were retrospectively investigated in 144 patients. Emotional distress was evaluated with the National Comprehensive Cancer Network Distress Thermometer. Values of p<0.0036 (Bonferroni correction) were considered significant. Results: At least one emotional problem (worry, fear, sadness, depression, nervousness, loss of interest) was reported by the majority of patients (N=93, 65%). Prevalence of these problems was 37%, 38%, 31%, 15%, 32% and 23%, respectively. Physical problems were significantly associated with worry (p=0.0029), fear (p=0.0030), sadness (p<0.0001), depression (p=0.0008), nervousness (p<0.0001), and loss of interest (p<0.0001). Age ≤69 years was associated with worry (p=0.0003), and female sex with fear (p=0.0002) and sadness (p=0.0026). Trends were found for associations of age with sadness (p=0.045), female sex with nervousness (p=0.034), and chemoradiotherapy with worry (p=0.027). Conclusion: Many patients with lung cancer experience emotional distress. Early psycho-oncological assistance may be important, particularly for high-risk patients.Lung cancer is the second most common type of cancer worldwide with more than two million new cases per year (1). Many of these patients receive radiotherapy or chemoradiotherapy, either following surgery or as definitive treatment. The latter group mainly includes patients with small-cell lung cancer (SCLC) or unresectable non-small cell lung cancer (NSCLC) and patients not suitable for surgery due to poor performance score or advanced age. For patients with early-stage NSCLC who are not eligible for or do not wish surgical resection, stereotactic body radiation therapy (SBRT) is a standard of care (2).Radiotherapy and chemoradiotherapy can be associated with significant acute and late toxicities, which may lead to emotional distress for patients recommended to receive one of these treatments (3-7). The prevalence of emotional distress, namely anxiety and depression, prior to radiotherapy for lung cancer ranges between 4% and 21% (8-10). In another study, anxiety (which generally includes worry and fear) and depression were reported by 53.6% and 65.5%, respectively, of those patients who received radiotherapy (11). Because of the inconsistency of the data in the literature, additional studies investigating the prevalence of emotional distress in patients with lung cancer are required. Moreover, the other aspects of emotional distress included in the National Comprehensive Cancer Network Distress Thermometer, i.e. sadness, nervousness, and loss of interest in usual activities, should be addressed (12). The current study evaluated the prevalence of all six aspects of emotional distress of the Distress Thermometer in a cohort of patients selected for radiotherapy or chemor...
Background/Aim: Anticipation of chemoradiation has been reported to cause psychosocial distress in patients with rectal cancer. This study provides additional data regarding prevalence and risk factors of emotional distress in patients who received chemoradiation for rectal or anal cancer. Patients and Methods: Sixty-four patients were analyzed for emotional distress utilizing 12 factors. When applying the Bonferroni correction, p-values <0.0042 were considered significant. Results: Worry, fears, sadness, depression, nervousness, and loss of interest in usual activities were reported by 31%, 47%, 33%, 11%, 47%, and 19% of patients, respectively. More physical problems were associated with fears (p=0.0030) and loss of interest (p=0.0021). Strong trends were observed for associations between female sex and sadness (p=0.0098) and between lower performance score and worry (p=0.0068) or fears (p=0. 0064). Conclusion: A considerable proportion of patients reported emotional distress prior to chemoradiation for rectal or anal cancer. High-risk patients may benefit from early psycho-oncological support.Concurrent chemoradiation is a standard of care for many patients with rectal or anal cancer (1-3). Often associated with significant side effects, chemoradiation for rectal or anal cancer may cause significant emotional distress (4). In a previous study, the recommendation for neoadjuvant chemoradiation caused more pronounced psychosocial distress than other factors in patients with resectable rectal cancer (5). Despite this finding, there is a lack of data investigating the prevalence of emotional distress and corresponding risk factors in patients with rectal or anal cancer scheduled for chemoradiation. The present study was performed to generate additional data for this situation and identify patients who are predisposed to experience emotional distress.
Estimating post-treatment ambulatory status can improve treatment personalization of patients irradiated for malignant spinal cord compression (MSCC). A new clinical score was developed from data of 283 patients treated with radiotherapy alone in prospective trials. Radiotherapy regimen, age, gender, tumor type, interval from tumor diagnosis to MSCC, number of affected vertebrae, other bone metastases, visceral metastases, time developing motor deficits, ambulatory status, performance score, sensory deficits, and sphincter dysfunction were evaluated. For factors with prognostic relevance in the multivariable logistic regression model after backward stepwise variable selection, scoring points were calculated (post-radiotherapy ambulatory rate in % divided by 10) and added for each patient. Four factors (primary tumor type, sensory deficits, sphincter dysfunction, ambulatory status) were used for the instrument that includes three prognostic groups (17–21, 22–31, and 32–37 points). Post-radiotherapy ambulatory rates were 10%, 65%, and 97%, respectively, and 2-year local control rates were 100%, 75%, and 88%, respectively. Positive predictive values to predict ambulatory and non-ambulatory status were 97% and 90% using the new score, and 98% and 79% using the previous instrument. The new score appeared more precise in predicting non-ambulatory status. Since patients with 32–37 points had high post-radiotherapy ambulatory and local control rates, they may not require surgery.
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