Radiation Oncology/Supportive care/Stress

Stress and Radiation Oncology

• South Florida -- usual care vs. self-administered training
  • Randomized. 310 patients, prior to start of RT. Randomized to Arm 1) usual care or 2) self-administered stress management training. QOL assessments
  • 2007 PMID 17876009 -- "Self-administered stress management training in patients undergoing radiotherapy." (Krischer MM, J Clin Oncol. 2007 Oct 10;25(29):4657-62.)
    • Outcome: No difference; subset analysis showed improvement in patients with >average psychological distress
    • Conclusion: Self-administered stress management effective only in stressed patients

• Hamburg, 2007 (Germany)(1991-1993) -- control vs. psychotherapeutic support
  • Randomized. 271 patients, prelim Dx of esophagus, stomach, liver/GB, pancreas, or CRC randomly assigned to standard care vs. formal psychotherapeutic support during hospital stay. 25% cross-over
  • 2007 PMID 17602075 -- "Impact of psychotherapeutic support for patients with gastrointestinal cancer undergoing surgery: 10-year survival results of a randomized trial." (Kuchler T, J Clin Oncol. 2007 Jul 1;25(19):2702-8.)
    • Outcome: 10-year survival: psychotherapy 21% vs. control 10% (SS). Local disease 57% vs. 21%; regional disease 13% vs. 2%; DM 5% vs. 5%
    • Conclusion: Benefit of formal psychotherapeutic support during inpatient stay