Prospective Study of Psychosocial Distress Among Patients Undergoing Radiotherapy for Head and Neck Cancer

Allen M. Chen, Richard L S Jennelle, Victoria Grady, Adrienne Tovar, Kris Bowen, Patty Simonin, Janice Tracy, Dale McCrudden, Jonathan R. Stella, Srinivasan Vijayakumar

Research output: Contribution to journalArticle

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Abstract

Purpose: To determine the prevalence of psychosocial distress among patients undergoing radiotherapy (RT) for head and neck cancer and to examine the association between depression and anxiety and demographic and medical variables. Methods and Materials: A total of 40 patients (25 men and 15 women) with nonmetastatic head and neck cancer were enrolled in this prospective study and underwent RT administered with definitive (24 patients) or postoperative (16 patients) intent. Twenty patients (50%) received concurrent chemotherapy. All patients completed the Hospital Anxiety and Depression Scale and Beck Depression Inventory-II instrument before RT, on the last day of RT, and at the first follow-up visit. The effect of patient-, tumor-, and treatment-related factors on psychosocial distress was analyzed. Results: The prevalence of mild to severe pre-RT depression was 58% and 45% using the Hospital Anxiety and Depression Scale-D and Beck Depression Inventory-II scale, respectively. The prevalence of severe pre-RT anxiety was 7%. The depression levels, as determined by the Hospital Anxiety and Depression Scale and Beck Depression Inventory-II instrument increased significantly during RT and remained elevated at the first follow-up visit (p < 0.001 for both). The variables that were significantly associated with post-RT depression included a greater pre-RT depression level, employment status (working at enrollment), younger age (<55 years), single marital status, and living alone (p < 0.05, for all). Conclusion: The results of our study have shown that an alarming number of patients undergoing RT for head and neck cancer have symptoms suggestive of psychosocial distress even before beginning treatment. This proportion increases significantly during RT. Studies investigating the role of antidepressants and/or psychiatric counseling might be warranted in the future.

Original languageEnglish (US)
Pages (from-to)187-193
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume73
Issue number1
DOIs
StatePublished - Jan 1 2009

Fingerprint

Head and Neck Neoplasms
radiation therapy
Radiotherapy
cancer
Prospective Studies
Depression
anxiety
Anxiety
Equipment and Supplies
Marital Status
chemotherapy
Antidepressive Agents
Psychiatry
Counseling
proportion
tumors
Demography
Psychology
Drug Therapy

Keywords

  • Anxiety
  • Depression
  • Head-and-neck cancer
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Prospective Study of Psychosocial Distress Among Patients Undergoing Radiotherapy for Head and Neck Cancer. / Chen, Allen M.; Jennelle, Richard L S; Grady, Victoria; Tovar, Adrienne; Bowen, Kris; Simonin, Patty; Tracy, Janice; McCrudden, Dale; Stella, Jonathan R.; Vijayakumar, Srinivasan.

In: International Journal of Radiation Oncology Biology Physics, Vol. 73, No. 1, 01.01.2009, p. 187-193.

Research output: Contribution to journalArticle

Chen, AM, Jennelle, RLS, Grady, V, Tovar, A, Bowen, K, Simonin, P, Tracy, J, McCrudden, D, Stella, JR & Vijayakumar, S 2009, 'Prospective Study of Psychosocial Distress Among Patients Undergoing Radiotherapy for Head and Neck Cancer', International Journal of Radiation Oncology Biology Physics, vol. 73, no. 1, pp. 187-193. https://doi.org/10.1016/j.ijrobp.2008.04.010
Chen, Allen M. ; Jennelle, Richard L S ; Grady, Victoria ; Tovar, Adrienne ; Bowen, Kris ; Simonin, Patty ; Tracy, Janice ; McCrudden, Dale ; Stella, Jonathan R. ; Vijayakumar, Srinivasan. / Prospective Study of Psychosocial Distress Among Patients Undergoing Radiotherapy for Head and Neck Cancer. In: International Journal of Radiation Oncology Biology Physics. 2009 ; Vol. 73, No. 1. pp. 187-193.
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abstract = "Purpose: To determine the prevalence of psychosocial distress among patients undergoing radiotherapy (RT) for head and neck cancer and to examine the association between depression and anxiety and demographic and medical variables. Methods and Materials: A total of 40 patients (25 men and 15 women) with nonmetastatic head and neck cancer were enrolled in this prospective study and underwent RT administered with definitive (24 patients) or postoperative (16 patients) intent. Twenty patients (50{\%}) received concurrent chemotherapy. All patients completed the Hospital Anxiety and Depression Scale and Beck Depression Inventory-II instrument before RT, on the last day of RT, and at the first follow-up visit. The effect of patient-, tumor-, and treatment-related factors on psychosocial distress was analyzed. Results: The prevalence of mild to severe pre-RT depression was 58{\%} and 45{\%} using the Hospital Anxiety and Depression Scale-D and Beck Depression Inventory-II scale, respectively. The prevalence of severe pre-RT anxiety was 7{\%}. The depression levels, as determined by the Hospital Anxiety and Depression Scale and Beck Depression Inventory-II instrument increased significantly during RT and remained elevated at the first follow-up visit (p < 0.001 for both). The variables that were significantly associated with post-RT depression included a greater pre-RT depression level, employment status (working at enrollment), younger age (<55 years), single marital status, and living alone (p < 0.05, for all). Conclusion: The results of our study have shown that an alarming number of patients undergoing RT for head and neck cancer have symptoms suggestive of psychosocial distress even before beginning treatment. This proportion increases significantly during RT. Studies investigating the role of antidepressants and/or psychiatric counseling might be warranted in the future.",
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