TY - JOUR
T1 - Patient-reported distress and survival among patients receiving definitive radiation therapy
AU - Habboush, Yacob
AU - Shannon, Robert P.
AU - Niazi, Shehzad K.
AU - Hollant, Laeticia
AU - Single, Megan
AU - Gaines, Katherine
AU - Smart, Bridget
AU - Chimato, Nicolette T.
AU - Heckman, Michael G.
AU - Buskirk, Steven J.
AU - Vallow, Laura A.
AU - Tzou, Katherine S.
AU - Ko, Stephen J.
AU - Peterson, Jennifer L.
AU - Biers, Heather A.
AU - Day, Atiya B.
AU - Nelson, Kimberly A.
AU - Sloan, Jeff A.
AU - Halyard, Michele Y.
AU - Miller, Robert C.
N1 - Publisher Copyright:
© 2017 The Authors on behalf of the American Society for Radiation Oncology
PY - 2017/4
Y1 - 2017/4
N2 - Objective Patient-reported distress (PRD) has not been well assessed in association with survival after radiation therapy (RT). The aims of this study were to evaluate the association between PRD level and survival after definitive RT and to identify the main causes of distress in definitive RT patients. Methods and materials A total of 678 consecutive patients receiving definitive RT at our institution from April 2012 through May 2015 were included. All patients answered a PRD questionnaire that contained 30 items related to possible causes of distress, which could be rated from 1 (no distress) to 5 (high distress). Additionally, patients were asked to rate their overall distress level from 0 (no distress) to 10 (extreme distress). This overall distress level was our primary patient-reported distress measure and was examined as a continuous variable and as a categorical variable with 3 PRD levels (low, 0-3 [n = 295]; moderate, 4-6 [n = 222]; and high, 7-10 [n = 161]). Results As a continuous variable in multivariable Cox regression analysis, a higher overall PRD level was associated with poorer survival after RT (hazard ratio [HR], 1.39; P = .004). As a categorical variable, compared with patients with low distress, survival was poorer for patients with moderate distress (HR, 1.62; P = .038) or high distress (HR, 1.49; P = .12), but the latter difference was not significant. When the moderate and high distress levels were combined, survival was significantly poorer compared with the low distress level (HR, 1.57; P = .034). The top 5 specific causes of distress that patients mentioned were “How I feel during treatment,” “Fatigue,” “Out-of-pocket medical costs,” “Pain that affects my daily functioning,” and “Sleep difficulties.” Conclusions PRD before or during RT is a prognostic factor associated with decreased survival. Distress screening guidelines and interventions should be implemented for patients receiving definitive RT.
AB - Objective Patient-reported distress (PRD) has not been well assessed in association with survival after radiation therapy (RT). The aims of this study were to evaluate the association between PRD level and survival after definitive RT and to identify the main causes of distress in definitive RT patients. Methods and materials A total of 678 consecutive patients receiving definitive RT at our institution from April 2012 through May 2015 were included. All patients answered a PRD questionnaire that contained 30 items related to possible causes of distress, which could be rated from 1 (no distress) to 5 (high distress). Additionally, patients were asked to rate their overall distress level from 0 (no distress) to 10 (extreme distress). This overall distress level was our primary patient-reported distress measure and was examined as a continuous variable and as a categorical variable with 3 PRD levels (low, 0-3 [n = 295]; moderate, 4-6 [n = 222]; and high, 7-10 [n = 161]). Results As a continuous variable in multivariable Cox regression analysis, a higher overall PRD level was associated with poorer survival after RT (hazard ratio [HR], 1.39; P = .004). As a categorical variable, compared with patients with low distress, survival was poorer for patients with moderate distress (HR, 1.62; P = .038) or high distress (HR, 1.49; P = .12), but the latter difference was not significant. When the moderate and high distress levels were combined, survival was significantly poorer compared with the low distress level (HR, 1.57; P = .034). The top 5 specific causes of distress that patients mentioned were “How I feel during treatment,” “Fatigue,” “Out-of-pocket medical costs,” “Pain that affects my daily functioning,” and “Sleep difficulties.” Conclusions PRD before or during RT is a prognostic factor associated with decreased survival. Distress screening guidelines and interventions should be implemented for patients receiving definitive RT.
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U2 - 10.1016/j.adro.2017.03.004
DO - 10.1016/j.adro.2017.03.004
M3 - Article
AN - SCOPUS:85017522020
SN - 2452-1094
VL - 2
SP - 211
EP - 219
JO - Advances in Radiation Oncology
JF - Advances in Radiation Oncology
IS - 2
ER -