Distress Screening in Head and Neck Cancer Patients Planned for Cancer-Directed Radiotherapy

Laryngoscope. 2021 Sep;131(9):2023-2029. doi: 10.1002/lary.29491. Epub 2021 Mar 15.

Abstract

Objective/hypothesis: To estimate the prevalence of baseline clinically significant distress (distress score ≥ 4) in head and neck cancer patients planned and treated with radical intent radiotherapy using the National Comprehensive Cancer Network Distress Thermometer (DT) and assess factors predictive of distress.

Study design: Cross-sectional study.

Methods: This was a cross-sectional study evaluating distress in 600 head and neck cancer patients undergoing radiation therapy. The DT was used to screen patients for distress at baseline before radiotherapy.

Results: The median distress score of the entire cohort was 4 interquartile range (IQR) (IQR: 3-5), and 340 patients (56.7%) had clinically significant distress. On univariate analysis, the causal factors predictive of distress were low socioeconomic status (P = .04), presence of proliferative growth at presentation (P = .008), site of the tumor (oral cavity, P = .02), comorbidity (P = .04), and presence of Ryle's tube or tracheostomy tube at baseline (P = .01). Low socioeconomic status was significant (P = .04) on multivariate analysis for high levels of distress.

Conclusions: Among head and neck cancer patients, 56% of patients had clinically significant baseline distress, and patients with low socioeconomic status had high distress. There is a need for interventions to mitigate distress.

Level of evidence: 4 Laryngoscope, 131:2023-2029, 2021.

Keywords: Distress; Head and neck cancer; chemotherapy; distress thermometer; radiotherapy; surgery.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Comorbidity
  • Cross-Sectional Studies
  • Drug Therapy / methods
  • Female
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Male
  • Mass Screening / standards*
  • Middle Aged
  • Multivariate Analysis
  • Predictive Value of Tests
  • Prevalence
  • Psychological Distress
  • Radiotherapy / adverse effects
  • Radiotherapy / psychology*
  • Self Report / statistics & numerical data*
  • Social Class
  • Visual Analog Scale