Disruption to radiation therapy sessions due to anxiety among patients receiving radiation therapy to the head and neck area can be predicted using patient self-report measures

Psychooncology. 2011 Dec;20(12):1334-41. doi: 10.1002/pon.1854. Epub 2010 Sep 27.


Objective: This analysis sought to determine whether patient self-report measures were associated with disruption to radiation therapy sessions due to anxiety among cancer patients undergoing radiation therapy to the head and neck region.

Method: A cohort of patients undergoing radiation therapy to the head and neck region at a major regional radiation oncology treatment centre (ROTC) in Australia completed self-report measures of anxiety, history of panic and fears relevant to use of an immobilising mask. The treating Radiation Therapist (RT) rated the level of session disruption due to patient anxiety during the Computerised Tomography/Simulation (CT/Sim) (baseline) session and first treatment session.

Results: Complete data were obtained for 90 patients. RTs rated 11 and 24% of patients as having some level of session disruption session due to anxiety at baseline and Treatment 1, respectively. Five factors were significantly associated with session disruption at baseline in bivariate analyses: currently taking psycho-active medication (p=0.008); fear of enclosed spaces (p=0.006); fear of face being covered up (p=0.006); fear of movement restriction (p=0.041) and ever had an anxiety attack (p=0.034). Sensitivity ranged from 0.57 to 0.75 and specificity ranged from 0.68 to 0.90. Only session disruption at baseline predicted disruption at Treatment 1 (p<0.01).

Conclusions: This study offers some preliminary insights into the prevalence of patient anxiety severe enough to cause session disruption and patient self-report measures which might be used to flag patients for prophylactic treatment. Further development and replication in a larger sample is warranted before introduction of these measures into routine practice.

MeSH terms

  • Aged
  • Anxiety / epidemiology
  • Anxiety / etiology*
  • Anxiety / prevention & control
  • Anxiety / psychology
  • Fear / psychology
  • Female
  • Head and Neck Neoplasms / psychology*
  • Head and Neck Neoplasms / radiotherapy
  • Humans
  • Immobilization / psychology
  • Male
  • Patient Compliance / psychology
  • Prevalence
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Psychological Tests
  • Self Report