Psychological Treatment for Patients Receiving Radiation: Results of NRG Oncology/RTOG 0841. Journal Article

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Authors: Small, W; Pugh, SL; Wagner, LI; Kirshner, J; Sidhu, K; Bury, MJ; DeNittis, AS; Alpert, TE; Tran, B; Bloom, BF; Mai, J; Bruner, DW
Article Title: Psychological Treatment for Patients Receiving Radiation: Results of NRG Oncology/RTOG 0841.
Abstract: PURPOSE: YYYY assessed the feasibility of a depression screening procedure in patients receiving radiation therapy (RT). As a secondary endpoint, availability and barriers to psychosocial care data was collected in hopes of providing recommendations for improved psychosocial care among patients receiving RT. METHODS: Patients starting RT were prospectively recruited and assessed with self-reported distress screening tools. Patients exceeding a validated cut off and a sample of patients that screened negative received the Structured Clinical Interview for DSM-IV (SCID) mood disorder modules via telephone. During that SCID evaluation patients completed a validated scale ranking interview on barriers to psychosocial care and interest in various psychosocial intervention modalities. RESULTS: 463 patients from 35 community-based and 2 academic RT oncology sites were recruited. Of the 455 eligible, 75 (16%) exceeded screening cut-offs for depressive symptoms. 78 patients completed the SCID, most were women (76%), white (88%), and had breast cancer (55%). Overall, the most common barriers to treatment, regardless of insurance, was costs (58%), daily responsibilities (44%) and physical health symptoms (38%). What compounds the barriers is that patients from RT facilities without mental health services were significantly more likely to report difficulty with physical health problems, specifically serious illness and walking, compared to those treated at RT facilities with services (p= 0.013 and p=0.039 respectfully). Overall, there was interest in obtaining psychosocial services with face to face counseling at the cancer center and printed educational materials as the most commonly preferred interventions. Patients with difficult barriers to psychosocial interventions were significantly less interested in support away from the cancer center (p=0.016), telephone and internet counselling (p=0.0062 p=0.011) and internet support (p=0.0048). CONCLUSION: Radiation oncology patients are interested in obtaining psychosocial services but face barriers to access to mental health services including cost, debilitating symptoms and time constraints that prevent adequate care.
Journal Title: International journal of radiation oncology, biology, physics
ISSN: 1879-355X; 0360-3016
Publisher: Elsevier Inc  
Date Published: 2021