Tews Anna-Maria, Hinz Andreas, Magnus Valentin, Boide Anna, Mehnert-Theuerkauf Anja, Seidel Clemens, Nicolay Nils Henrik, Rühle Alexander
Department of Radiation Oncology, University Medical Center Leipzig, Leipzig, Germany.
Comprehensive Cancer Center Central Germany, Partner Site Leipzig, Leipzig, Germany.
Clin Transl Radiat Oncol. 2025 Jun 27;54:101005. doi: 10.1016/j.ctro.2025.101005. eCollection 2025 Sep.
Head-and-neck cancer patients often face decisions between treatment options with similar oncological outcomes. In this context, decision regret becomes a central concern, particularly within the framework of shared decision-making. This study aims to assess the prevalence of decision regret and identify associated risk factors among head-and-neck cancer patients.
This cross-sectional observational study included patients who underwent curative radiotherapy for head-and-neck cancer. Decision regret was assessed using the Decision Regret Scale (DRS). Additional patient-reported outcomes included health-related quality of life (HRQoL), psychological distress, anxiety, depression, and fear of cancer progression (FoP).
Of 300 eligible patients, 192 participated and filled out the DRS. The median age was 59 years (IQR, 45-65), and the median time between the end of radiotherapy and study participation was 45.5 months (IQR, 24-68.5). No decision regret (0 points) in terms of radiotherapy was reported by 27 %, mild regret (1-25 points) by 34 %, and high regret (>25 points) by 39 %. The mean (SD) DRS score regarding radiotherapy, systemic treatment, and surgery was 23.6 (22.4), 20.8 (19.3), and 20.9 (22.2), respectively. Decision regret was associated with HRQoL ( = -0.34, < 0.001), distress ( = 0.25, < 0.001), anxiety ( = 0.20, < 0.01), depression ( = 0.19, < 0.01), and FoP ( = 0.29, < 0.001). In the multiple regression, a poorer ECOG status (β = 0.18, < 0.01), lower HRQoL (β = -0.22, < 0.01), and higher FoP (β = 0.19, < 0.05) were associated with decision regret.
More than one-third of head-and-neck cancer patients report high decision regret. These findings highlight the need for enhanced shared decision-making to mitigate decision regret in head-and-neck oncology.
头颈癌患者常常要在具有相似肿瘤学结局的治疗方案之间做出抉择。在此背景下，决策遗憾成为一个核心问题，尤其是在共同决策的框架内。本研究旨在评估头颈癌患者中决策遗憾的发生率，并确定相关风险因素。
这项横断面观察性研究纳入了接受头颈癌根治性放疗的患者。使用决策遗憾量表（DRS）评估决策遗憾。患者报告的其他结局包括健康相关生活质量（HRQoL）、心理困扰、焦虑、抑郁以及癌症进展恐惧（FoP）。
在300名符合条件的患者中，192名参与并填写了DRS。中位年龄为59岁（四分位间距，45 - 65岁），放疗结束至参与研究的中位时间为45.5个月（四分位间距，24 - 68.5个月）。27%的患者报告在放疗方面无决策遗憾（0分），34%的患者有轻度遗憾（1 - 25分），39%的患者有高度遗憾（>25分）。关于放疗、全身治疗和手术的DRS平均（标准差）得分分别为23.6（22.4）、20.8（19.3）和20.9（22.2）。决策遗憾与HRQoL（r = -0.34，P < 0.001）、困扰（r = 0.25，P < 0.001）、焦虑（r = 0.20，P < 0.01）、抑郁（r = 0.19，P < 0.01）和FoP（r = 0.29，P < 0.001）相关。在多元回归分析中，较差的东部肿瘤协作组（ECOG）状态（β = 0.18，P < 0.01）、较低的HRQoL（β = -0.22，P < 0.01）和较高的FoP（β = 0.19，P < 0.05）与决策遗憾相关。
超过三分之一的头颈癌患者报告有高度决策遗憾。这些发现凸显了加强共同决策以减轻头颈肿瘤学中决策遗憾的必要性。
