Zh Zhelev Kiril, Conev Nikolay V, Zahariev Zahari I, Mihaylova Iglika S, Tonev Ivan D, Sht Donev Ivan
Department of Radiotherapy and Radiosurgery, "Heart and Brain Center of Clinical Excellence", Pleven, Bulgaria, Pierre Curie, str., 2, Postal Code 5800.
Clinic of Medical Oncology, UMHAT "St. Marina, Varna, Bulgaria, Hristo Smirnenski, str. 1, Postal Code 9000.
Tech Innov Patient Support Radiat Oncol. 2024 Jul 1;31:100258. doi: 10.1016/j.tipsro.2024.100258. eCollection 2024 Sep.
The aim of this study was to explore the potential relationship between the time estimation and psychological distress in patients with solid tumors prior to starting radiotherapy.
In this multicenter study were included a total of 344 patients with solid tumors (197 with and 147 without metastatic disease). The time estimation was assessed by evaluating each subjects prospective estimation of how fast 1 min passed compared to the actual time. The median value (35sec) of subjective perception of time was used to group cases into two categories for experience of time. We used the National Comprehensive Cancer Network Distress Thermometer at the beginning of treatment to determine the levels of distress, where it measures distress on a scale from 0 to 10. Patients scoring 4 or above (73.5 %) were regarded as having high levels of distress.
The time estimation distributions significantly changed according to the level of distress. ROC analysis revealed that at the optimal cut off value of time estimation, patients with low and high distress levels can be discriminated with an AUC = 0.80 (95 % CI: 0.75- 0.85, p < 0.001) and with a sensitivity of 77.8 % and specificity of 73.3 %. In a multivariate logistic regression model, fast time estimation was an independent predictor of high levels of distress (OR 0.136; 95 % CI, 0.072---0.256, p < 0.001).
Time estimation is a novel potent indicator of high levels of distress in cancer patients prior starting of radiotherapy.
本研究旨在探讨实体瘤患者在开始放疗前时间估计与心理困扰之间的潜在关系。
在这项多中心研究中，共纳入了344例实体瘤患者（197例有转移疾病，147例无转移疾病）。通过评估每个受试者对1分钟流逝速度与实际时间相比的前瞻性估计来评估时间估计。主观时间感知的中位数（35秒）用于将病例分为两类以进行时间体验分组。在治疗开始时，我们使用美国国立综合癌症网络苦恼温度计来确定苦恼水平，该温度计在0至10的量表上测量苦恼程度。得分4分及以上（73.5%）的患者被视为苦恼程度高。
时间估计分布根据苦恼水平有显著变化。ROC分析显示，在时间估计的最佳截断值时，低苦恼水平和高苦恼水平的患者可以被区分，AUC = 0.80（95% CI：0.75 - 0.85，p < 0.001），敏感性为77.8%，特异性为73.3%。在多变量逻辑回归模型中，快速时间估计是苦恼程度高的独立预测因素（OR 0.136；95% CI，0.072 - 0.256，p < 0.001）。
时间估计是癌症患者放疗开始前苦恼程度高的一种新的有效指标。
