Psychosocial Distress of Head Neck Cancer (HNC) Patients Receiving Radiotherapy: A Systematic Review

Abstract

Background: Head and Neck Cancer (HNC) patients are at increased risk of psychosocial distress compared with patients with other forms of cancer. Various symptoms of the disease and side effects of treatment are attributing factors for distress. This systematic review aimed to identify the prevalence of psychosocial distress among HNC patients receiving radiotherapy. Methods: The following search engines from 2000-2021 were searched: PubMed, CINAHL, Cochrane, Web of Science, ProQuest, Scopus, and Embase. Citation checking and extensive reference checking were also conducted. Cross-sectional, longitudinal, cohort, exploratory and prospective, repeated measure studies published in English were included. Newcastle Ottawa Scale assessed the quality, and the data were extracted on a validated data extraction form. Results: Out of 782 articles, eleven records met the eligibility criteria, including 776 HNC patients receiving radiotherapy. Data were synthesized and summarized descriptively as measurements were not homogenous. Prevalence estimates of depression or depressive symptoms were calculated. Outcomes were measured with various measuring tools and reported in frequency, percentage, mean, and standard deviation in various studies. All studies reported depression ranging from 9.8% to 83.8%, and pooled estimated prevalence of depression among HNC patients receiving radiotherapy is 63% (95% CI 42-83) with significant heterogeneity (I 2 = 97.66%; p<0.001). An increase in the trend is observed along with treatment progression. Another three studies reported anxiety along with depression. Physical symptoms, body image, low social support, fatigue specific radiotherapy regimens were the predictive factors of depression. Conclusion: HNC patients are psychosocially distressed during radiotherapy, and the distress is steadily increased during the therapy. The predictive factors could serve as potential areas of intervention and supportive therapy during radiotherapy.

Dentists Role in Psychological Screening and Management of Head-and-neck Cancer Patients Undergoing Radiotherapy – Narrative Review

“…However, psychological morbidity often remains undiagnosed due to normalising emotional distress and its social stigma. [ 15 , 16 ] The inability of health-care professionals to give importance to the psychosocial component of a disease further adds to the problem. [ 17 ]…”

Effectiveness of Comprehensive Intervention Programme on Quality of life, fatigue, self-efficacy, and psychosocial distress among head and neck cancer patients receiving radiotherapy

“…Self-efficacy was measured through Cancer Behavior Inventory (CBI)—Brief form [ 23 ] with approval from PsychooncologyNDU.Wordpress.COM. A psychosocial distress scale was developed by the researcher [ 24 ] after extensive literature review [ 17 ]. The tool has 21 items with three responses “never,” “sometimes,” and “always.” The maximum possible score was 42 and minimum score was zero.…”

“…Hence, these psychosocial comorbidities in HNC patients must therefore be prevented, identified, and treated [ 14 ]. Depression is observed among 9.8 to 83.8% of patients, with a pooled estimated frequency of 63% (95% CI = 42–83) among HNC patients receiving radiation, with the heterogeneity ( I 2 = 97.66 percent; p < 0.001 which is statistically significant [ 17 ]. Enhancing the QOL of HNC patients by providing supportive care is the top priority in the healthcare [ 18 ].…”

Metabolite Biomarkers of Prolonged and Intensified Pain and Distress in Head and Neck Cancer Patients Undergoing Radio- or Chemoradiotherapy by Means of NMR-Based Metabolomics—A Preliminary Study

“…The rate of recognized distress/depression among HNSCC patients may range from 9.8% to 83.8%, and the pooled estimated prevalence of depression among patients receiving radiotherapy is 63% with a significant heterogeneity among the studies [ 5 ]. HNSCC patients are twice as likely to commit suicide compared to other cancer patients [ 6 ] or seven times more compared to the general population [ 7 , 8 ]. The areas of patient experience, such as poor overall quality of life, pain, eating and speech problems, are associated with survival in head and neck cancer (HNC) [ 9 , 10 , 11 , 12 ].…”