Patient-reported symptoms during radiotherapy

Körner, Philipp; Ehrmann, Katja; Hartmannsgruber, Johann; Metz, Michaela; Steigerwald, Sabrina; Flentje, Michael; Oorschot, Birgitt van

doi:10.1007/s00066-017-1146-5

Cited by 26 publications

(14 citation statements)

References 28 publications

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“…A substantial number of cancer patients report short- and long-term psychological distress due to the disease, active treatment, and treatment consequences [2, 3]. Between 22% and 35% of radiotherapy outpatients report clinically relevant psychological distress [4–7].…”

Section: Introductionmentioning

confidence: 99%

“…Despite improved survival rates over the past two decades due to diagnostic and therapeutic advances, cancer remains the second leading cause of death worldwide [ 1 ]. A substantial number of cancer patients report short- and long-term psychological distress due to the disease, active treatment, and treatment consequences [ 2 , 3 ]. Between 22% and 35% of radiotherapy outpatients report clinically relevant psychological distress [ 4 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Cancer patients’ wish for psychological support during outpatient radiation therapy

Riedl

Gastl

Gamper³

et al. 2018

Strahlenther Onkol

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BackgroundCancer patients frequently suffer from physical and psychosocial impairments due to their disease and its treatment. Psychooncology (PO) can help to cope with stress resulting from outpatient radiotherapy (RT) treatment. There are currently few data regarding patients’ wishes for PO support. The aim of this study was to investigate the number of patients with a wish for PO, treatment paths, and predictors of the wish for PO among cancer patients at the beginning of RT.MethodsThe results of routine psychological stress screening (Hornheide screening instrument; cut-off  ≥ 4) of 944 cancer patients between 2015 and 2017 were analyzed in a retrospective cross-sectional study. Predictors for a wish for PO support were identified by stepwise binary logistic regression, in which sociodemographic and treatment data were included in addition to the screening items.ResultsAround 20% of patients had above-average stress levels and 13% expressed a wish for PO support (participation rate was approximately 55%). Low emotional wellbeing (OR = 11.3) and lack of social support (OR = 9.4) were strong predictors for this treatment wish. Among patients with pancreatic cancer, head and neck tumors, and hematologic disease, there was a substantial difference between the degree of psychological stress and the wish for treatment. Patients with urological (23.5%) and lung tumors (20.9%) most frequently expressed a wish for PO support.ConclusionPatient-reported psychosocial problems were better predictors of a wish for PO support than sociodemographic or clinical data. Stress screening should thus be implemented in clinical routine.Electronic supplementary materialThe online version of this article (10.1007/s00066-018-1288-0) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cancer patients’ wish for psychological support during outpatient radiation therapy

Riedl

Gastl

Gamper³

et al. 2018

Strahlenther Onkol

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“…The Edmonton Symptom Assessment System (ESAS) is a short, one-sheet questionnaire addressing the well-being and the major symptoms, e.g., pain and nausea, on a numeric scale of zero-10 [ 1 ]. It has been employed in different clinical settings, including the registration of the patient-reported symptoms before the palliative radiotherapy [ 2 - 4 ]. The main purpose is to improve the clinical care, e.g., by adjusting medications and referring the patients to palliative care specialists, psycho-oncologists and other experts who might be able to enhance the quality of life [ 5 - 6 ].…”

Section: Introductionmentioning

confidence: 99%

Frequency and Prognostic Impact of Consistently Low Edmonton Symptom Assessment System Score in the Patients Treated with Palliative Radiotherapy

Nieder¹,

Kämpe²

2018

Cureus

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IntroductionOur department's standard work-flow includes assessment of all the patients with the Edmonton Symptom Assessment System (ESAS), a one-sheet questionnaire addressing 11 major symptoms and wellbeing on a numeric scale of zero-10, before the palliative radiotherapy (PRT). Based on previous research, we hypothesized that the patients with minimal or moderate total symptom burden might have better overall survival after the PRT than those with at least one higher symptom score.MethodsWe performed a retrospective analysis of 94 patients and calculated actuarial survival from the first day of the PRT (Kaplan-Meier method). We identified the patients with the score zero for all ESAS items (no symptoms), at least one item with score one-two (minimal symptoms), and at least one item with the score three (moderate symptoms).ResultsHigh proportions of the patients had ESAS scores zero- two for nausea (80%), sadness/depression (65%) and constipation (64%). The mean values were often in the range of two-four. Only one patient reported scores of zero throughout the questionnaire. He was treated for hematuria, a symptom that is not part of the ESAS. Three patients reported scores of zero-two throughout the questionnaire. Except for the performance status zero-one, their baseline characteristics were heterogeneous. Two patients reported scores not exceeding three for all items. These patients had excellent performance status, too. None of the six patients (6%) with relatively low ESAS scores of zero-three received care by the hospital's multidisciplinary palliative team. Only one was using opioid analgesics. The median survival for this small subset of six patients was six months, identical to the result for all the patients with higher symptom burden (p = 0.62).ConclusionThe proportion of the patients with ESAS scores zero-three throughout the questionnaire was 6%, which resulted in the limited statistical power for the survival comparisons. The survival outcomes were similar. Before PRT, 94% of the patients reported at least one ESAS item of severity four-10. The symptoms not included in the questionnaire, e.g., hematuria might result in erroneous assignment to the low-symptom-burden group and obscure the prognostic impact of low ESAS symptom burden.

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“…Such reirradiation often results in a clinical benefit, e.g., pain relief. In general, patients scheduled for radiotherapy have reported heightened levels of anxiety and/or depression [ 5 - 6 ], and current studies are looking at different interventions that might reduce these symptoms [ 7 - 8 ]. Relatively few studies have examined quality of life and patient-reported symptoms, including but not limited to anxiety and depression, before palliative reirradiation [ 2 , 9 - 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…In order to test this hypothesis, a retrospective, single-institution study was performed, which employed previously collected questionnaires (Edmonton symptom assessment system, ESAS). This short, one-sheet questionnaire has been used by different radiotherapy departments and addresses major symptoms and wellbeing on a numeric scale of 0-10 (highest symptom severity 10), including anxiety and depression [ 6 , 11 - 13 ].…”

Section: Introductionmentioning

confidence: 99%

Levels of Anxiety and Depression Before Palliative Reirradiation Are Comparable to Those Before First Palliative Radiotherapy

Nieder¹,

Kämpe²

2018

Cureus

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Introduction: The purpose of this study was to evaluate whether or not patients scheduled for the reirradiation of a previously treated target volume report reduced levels of anxiety and depression, compared to patients receiving their first course of palliative radiotherapy, e.g., because they are familiar with the process of treatment planning and delivery.Methods: A retrospective comparison of two groups of patients (37% reirradiated, overall 102 patients), which scored their symptoms before palliative radiotherapy with the Edmonton symptom assessment system (ESAS).Results: The two groups differed significantly with regard to the incidence of bone metastases, which was higher in the reirradiation group. Mean anxiety and depression scores were not significantly different between the two groups. The same was true for the proportion of patients with symptom scores ≥4. Analyses limited to patients treated for bone metastases revealed no significant differences either. Survival was similar, too.Conclusion: The facts that similar ESAS scores of anxiety and depression were observed and that prognosis was comparable suggest that the magnitude of these symptoms might be associated with the presence of incurable cancer itself (or the related somatic symptom burden) rather than the setting in which palliative radiotherapy is performed.

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Patient-reported symptoms during radiotherapy

Cited by 26 publications

References 28 publications

Cancer patients’ wish for psychological support during outpatient radiation therapy

Cancer patients’ wish for psychological support during outpatient radiation therapy

Frequency and Prognostic Impact of Consistently Low Edmonton Symptom Assessment System Score in the Patients Treated with Palliative Radiotherapy

Levels of Anxiety and Depression Before Palliative Reirradiation Are Comparable to Those Before First Palliative Radiotherapy

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