Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul 15;110(4):962-972.
doi: 10.1016/j.ijrobp.2021.02.005. Epub 2021 Feb 7.

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

William Small Jr  1 , Stephanie L Pugh  2 , Lynne I Wagner  3 , Jeffrey Kirshner  4 , Kulbir Sidhu  5 , Martin J Bury  6 , Albert S DeNittis  7 , Tracy E Alpert  4 , Binh Tran  8 , Beatrice F Bloom  9 , Julie Mai  10 , Deborah Watkins Bruner  11
Affiliations

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

William Small Jr et al. Int J Radiat Oncol Biol Phys. .

Abstract

Purpose: NRG/RTOG 0841 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 were collected in hopes of providing recommendations for improved psychosocial care among patients receiving RT.

Methods and materials: Patients starting RT were prospectively recruited and assessed with self-reported distress screening tools. Patients exceeding a validated cutoff and a sample of patients who 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: A total of 463 patients from 35 community-based and 2 academic RT oncology sites were recruited. Of the 455 eligible, 75 (16%) exceeded screening cutoffs for depressive symptoms. From this group, 78 patients completed the SCID; most were female (76%), white (88%), and had breast cancer (55%). Overall, the most common barriers to treatment, regardless of insurance, were costs (58%), daily responsibilities (44%), and physical health symptoms (38%). 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 with those treated at RT facilities with services (P = .013 and P = .039, respectively). 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 = .016), telephone and Internet counseling (P = .0062 &P = .011), and Internet support (P = .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.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest:

Dr. Alpert, Dr. Tran, Dr. Bloom, Dr. Sidhu, Dr. DeNittis, Dr. Mai, Dr. Kirshner, Dr. Bury, and Dr. Bruner has nothing to disclose. Dr. Small Jr reports personal fees from Carl Zeiss, other from Varian, other from Merck, other from NRG Oncology, outside the submitted work. Dr. Wagner reports personal fees from Celgene Inc, outside the submitted work. Dr. Pugh reports other from Pfizer, other from Millennium, outside the submitted work.

Figures

Fig 1.
Fig 1.
Consort diagram. Abbreviation: SCID = Structured Clinical Interview for DSM-IV.
See this image and copyright information in PMC

Comment in

  • In Regard to Small et al.
    Al-Rashdan A. Al-Rashdan A. Int J Radiat Oncol Biol Phys. 2021 Oct 1;111(2):577-578. doi: 10.1016/j.ijrobp.2021.05.129. Int J Radiat Oncol Biol Phys. 2021. PMID: 34473977 No abstract available.
  • In Reply to Al-Rashdan.
    Small W Jr, Wagner LI, Bruner DW. Small W Jr, et al. Int J Radiat Oncol Biol Phys. 2021 Oct 1;111(2):578. doi: 10.1016/j.ijrobp.2021.05.130. Int J Radiat Oncol Biol Phys. 2021. PMID: 34473978 No abstract available.

References

    1. Adler NE, Page A, and Institute of Medicine Committee on Psychosocial Services to Cancer Patients/Families in a Community Setting. Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. Washington, DC: National Academies Press; 2008. - PubMed
    1. Krebber AM, Buffart LM, Kleijn G, et al. Prevalence of depression in cancer patients: A meta-analysis of diagnostic interviews and selfreport instruments. Psychooncology 2014;23:121–130. - PMC - PubMed
    1. Satin JR, Linden W, Phillips MJ. Depression as a predictor of disease progression and mortality in cancer patients. Cancer 2009;115:5349–5361. - PubMed
    1. Wagner LI, Pugh SL, Small W Jr, et al. Screening for Depression in Cancer Patients Receiving Radiotherapy: Feasibility and Identification of Effective Tools on NRG Oncology RTOG Trial 0841. Cancer 2017; 123:485–493. - PMC - PubMed
    1. Jacobsen PB, Ransom S. Implementation of NCCN distress management guidelines by member institutions. J Natl Compr Canc Netw 2007;5:99–103. - PubMed