ESTRO 2024 - Abstract Book

S1869

Clinical - Mixed sites, palliation

ESTRO 2024

Material/Methods:

A single-center cross-sectional study was performed to assess patient-reported decision regret after radiotherapy in a tertiary cancer center. Inclusion criteria were i) previous radiotherapy for a malignant disease, ii) age of ≥18 years, iii) the ability to understand the German questionnaires, and iv) informed consent to study participation. Patients who attended radiotherapy follow-up appointments between July 10, 2023 and August 18, 2023 were eligible for the study. The German version of the 5-item Ottawa Decision Regret Scale (DRS), which has previously been validated concerning decision regret in patient caregivers [1], was used in this study. DRS scores range from 0 to 100, with 0 indicating no regret and 100 indicating a high degree of regret. Following the previous validation study of the Ottawa DRS [2], degree of decision regret was subdivided into absent (0 points), mild (1-25 points), and strong (>25 points) decision regret. In addition, patients were asked to indicate the comprehensibility of the DRS. In order to find determinants of decision regret, patient-reported psychosocial outcome measures were collected. Quality of life was measured with the EORTC QLQ-C30, and distress was assessed with the Distress Thermometer ranging from 0 (no distress) to 10 (extreme distress). Depression and anxiety were measured using the PHQ-9 and GAD-7 questionnaires, respectively. Patients' experiences concerning participation in the decision-making process were examined using the PEF-FB-9 questionnaire, and patient satisfaction with care during radiotherapy was quantified with the REPERES questionnaire. Assessment of social support was performed with the SSUK-8, while health literacy was assessed with the HLS-EU-Q16. Out of 320 eligible patients, 212 participated in the study, of which 207 answered the DRS. Median age at radiotherapy was 64 years (IQR, 56-72 years). Gender was balanced (105 female and 102 male patients), and most common cancer types were breast cancer (n=84; 41%) and prostate cancer (n=57; 28%). Radiotherapy was performed with curative intent in 188 patients (91%), and with palliative intent in 19 patients (9%). Median number of treatment fractions was 25 (IQR, 18-31). Concomitant systemic treatment including hormone deprivation therapy was applied in 99 patients (48%), and the majority of treatment courses were performed on an outpatient basis (n=171; 83%). Median time between radiotherapy and completion of questionnaires amounted to 23 months (IQR, 1-38 months). Comprehensibility of the DRS was rated as good or very good by 98% (196 of 201 patients). Median DRS amounted to 5 points (IQR, 0-20). Ninety patients (43%) reported no decision regret, 79 (38%) mild decision regret, and 38 (18%) strong decision regret regarding their course of radiotherapy. Decision regret inversely correlated with global quality of life (Pearson’s r= -0.26, p <0.001), patient involvement in the decision-making process (r=-0.22, p =0.001), satisfaction with care (r=-0.36, p <0.001), social support (r=-0.33 p <.001), and health literacy (r=- 0.29, p <0.001). There was a positive correlation of decision regret with distress (r=0.17, p <0.05), depression (r=0.27, p <0.001), and anxiety (r=0.23, p <0.01). Patients with good ECOG performance status ( p <0.001, chi-square test), with breast cancer ( p <0.01) and with outpatient treatment ( p <0.01) reported significantly lower rates of strong decision regret. Results:

Conclusion:

In this large cross-sectional analysis, the German version of the DRS was successfully used for the first time in a broad spectrum of patients who had been treated with radiotherapy. Decision regret is a relevant issue after radiotherapy for a significant number of cancer patients. Patients found the German version of the DRS to be well understandable, suggesting its usability in the future. Further studies focusing on risk factors for decision regret in