Decision regret in patients with head-and-neck cancer undergoing radiotherapy

Purpose: 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 regre...

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Main Authors: Anna-Maria Tews, Andreas Hinz, Valentin Magnus, Anna Boide, Anja Mehnert-Theuerkauf, Clemens Seidel, Nils Henrik Nicolay, Alexander Rühle
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Clinical and Translational Radiation Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405630825000977
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author Anna-Maria Tews
Andreas Hinz
Valentin Magnus
Anna Boide
Anja Mehnert-Theuerkauf
Clemens Seidel
Nils Henrik Nicolay
Alexander Rühle
author_facet Anna-Maria Tews
Andreas Hinz
Valentin Magnus
Anna Boide
Anja Mehnert-Theuerkauf
Clemens Seidel
Nils Henrik Nicolay
Alexander Rühle
author_sort Anna-Maria Tews
collection DOAJ
description Purpose: 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. Methods: 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). Results: 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 (r = -0.34, p < 0.001), distress (r = 0.25, p < 0.001), anxiety (r = 0.20, p < 0.01), depression (r = 0.19, p < 0.01), and FoP (r = 0.29, p < 0.001). In the multiple regression, a poorer ECOG status (β = 0.18, p < 0.01), lower HRQoL (β = -0.22, p < 0.01), and higher FoP (β = 0.19, p < 0.05) were associated with decision regret. Conclusions: 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.
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spelling doaj-art-1ecd57cd0e324db1a230134a30cb84552025-08-20T03:38:59ZengElsevierClinical and Translational Radiation Oncology2405-63082025-09-015410100510.1016/j.ctro.2025.101005Decision regret in patients with head-and-neck cancer undergoing radiotherapyAnna-Maria Tews0Andreas Hinz1Valentin Magnus2Anna Boide3Anja Mehnert-Theuerkauf4Clemens Seidel5Nils Henrik Nicolay6Alexander Rühle7Department of Radiation Oncology, University Medical Center Leipzig, Leipzig, GermanyComprehensive Cancer Center Central Germany, Partner Site Leipzig, Leipzig, Germany; Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, GermanyDepartment of Radiation Oncology, University Medical Center Leipzig, Leipzig, GermanyDepartment of Radiation Oncology, University Medical Center Leipzig, Leipzig, Germany; Comprehensive Cancer Center Central Germany, Partner Site Leipzig, Leipzig, GermanyComprehensive Cancer Center Central Germany, Partner Site Leipzig, Leipzig, Germany; Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, GermanyDepartment of Radiation Oncology, University Medical Center Leipzig, Leipzig, Germany; Comprehensive Cancer Center Central Germany, Partner Site Leipzig, Leipzig, GermanyDepartment of Radiation Oncology, University Medical Center Leipzig, Leipzig, Germany; Comprehensive Cancer Center Central Germany, Partner Site Leipzig, Leipzig, GermanyDepartment of Radiation Oncology, University Medical Center Leipzig, Leipzig, Germany; Comprehensive Cancer Center Central Germany, Partner Site Leipzig, Leipzig, Germany; Corresponding author.Purpose: 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. Methods: 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). Results: 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 (r = -0.34, p < 0.001), distress (r = 0.25, p < 0.001), anxiety (r = 0.20, p < 0.01), depression (r = 0.19, p < 0.01), and FoP (r = 0.29, p < 0.001). In the multiple regression, a poorer ECOG status (β = 0.18, p < 0.01), lower HRQoL (β = -0.22, p < 0.01), and higher FoP (β = 0.19, p < 0.05) were associated with decision regret. Conclusions: 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.http://www.sciencedirect.com/science/article/pii/S2405630825000977RadiotherapyChemotherapySurgeryHead-and-neck cancerDecision regretPsycho-oncology
spellingShingle Anna-Maria Tews
Andreas Hinz
Valentin Magnus
Anna Boide
Anja Mehnert-Theuerkauf
Clemens Seidel
Nils Henrik Nicolay
Alexander Rühle
Decision regret in patients with head-and-neck cancer undergoing radiotherapy
Clinical and Translational Radiation Oncology
Radiotherapy
Chemotherapy
Surgery
Head-and-neck cancer
Decision regret
Psycho-oncology
title Decision regret in patients with head-and-neck cancer undergoing radiotherapy
title_full Decision regret in patients with head-and-neck cancer undergoing radiotherapy
title_fullStr Decision regret in patients with head-and-neck cancer undergoing radiotherapy
title_full_unstemmed Decision regret in patients with head-and-neck cancer undergoing radiotherapy
title_short Decision regret in patients with head-and-neck cancer undergoing radiotherapy
title_sort decision regret in patients with head and neck cancer undergoing radiotherapy
topic Radiotherapy
Chemotherapy
Surgery
Head-and-neck cancer
Decision regret
Psycho-oncology
url http://www.sciencedirect.com/science/article/pii/S2405630825000977
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