Screening for psychological distress before radiotherapy for painful bone metastases may be useful to identify patients with high levels of distress

Psychosocial distress in cancer patients undergoing radiotherapy: a prospective national cohort of 1042 patients in Germany

PURPOSE

Psychosocial distress is common among cancer patients in general, but those undergoing radiotherapy may face specific challenges. Therefore, we investigated the prevalence and risk factors for distress in a large national cohort.

METHODS

We performed a secondary analysis of a multicenter prospective cross-sectional study which surveyed cancer patients at the end of a course of radiotherapy using a patient-reported questionnaire. Distress was measured with the distress thermometer (DT), using a cut-off of ≥ 5 points for clinically significant distress. Univariate analyses and multivariate multiple regression were used to assess associations of distress with patient characteristics. A two-sided p-value < 0.05 was considered statistically significant.

RESULTS

Out of 2341 potentially eligible patients, 1075 participated in the study, of which 1042 completed the DT. The median age was 65 years and 49% (511/1042) of patients were female. The mean DT score was 5.2 (SD = 2.6). Clinically significant distress was reported by 63% (766/1042) of patients. Of the patient characteristics that were significantly associated with distress in the univariate analysis, a lower level of education, a higher degree of income loss, lower global quality of life, and a longer duration of radiotherapy in days remained significantly associated with higher distress in the multivariate analysis. Yet effect sizes of these associations were small.

CONCLUSION

Nearly two in three cancer patients undergoing radiotherapy reported clinically significant distress in a large multicenter cohort. While screening and interventions to reduce distress should be maintained and promoted, the identified risk factors may help to raise awareness in clinical practice.

TRIAL REGISTRY IDENTIFIER

DRKS: German Clinical Trial Registry identifier: DRKS00028784.

Analgesia and curative effect of pamidronate disodium combined with chemotherapy on elderly patients with advanced metastatic bone cancer

The curative effect and adverse reactions of pamidronate disodium in elderly patients with advanced metastatic bone cancer were evaluated. A total of 160 elderly patients with advanced metastatic bone cancer admitted to Affiliated Hospital of Nantong University from February 2012 to January 2015, were divided into the chemotherapy group (n=60) that received routine therapy and the pamidronate disodium group (n=100) that received pamidronate disodium therapy based on the chemotherapy. Pain relief, analgesic time, analgesic duration and side effects were compared between the two groups after treatment. The effect of pain relief in the pamidronate disodium group was significantly higher than that in the chemotherapy group (P<0.001). The total effective rate of the pamidronate disodium group was significantly higher than that of the chemotherapy group (P<0.001). The analgesic onset time in the pamidronate disodium group was earlier than in the chemotherapy group (P<0.001). The analgesic duration in the pamidronate disodium group was longer than that in the chemotherapy group (P<0.001). The incidence of adverse reactions and complications after treatment in the pamidronate disodium group was significantly less than that in the chemotherapy group (P<0.001). The results indicated that pamidronate disodium is effective in the treatment of elderly patients with advanced metastatic bone cancer and patients are less prone to adverse reactions, complications and pain, which is worthy of clinical application.