Abstract

Muneeb Uddin Karim¹, Bilal Mazhar Qureshi¹, Asim Hafiz¹, Nasir Ali¹, Sehrish Abrar¹, Haissan Iftikhar¹, Ahmed Nadeem Abbasi¹

¹The Aga Khan University, Oncology, Karachi, Pakistan

To determine the burden of anxiety and depression among patients undergoing radiation therapy for primary head and neck cancer in a tertiary care hospital

This was a prospective study carried out at the section of Radiation Oncology, Department of Oncology, Aga Khan University Hospital, Karachi, from 1^st March 2016 till January 2017. Thirty-seven (37) adult patients with histologically proven head and neck cancer, receiving radiation therapy with curative intent having ECOG performance status of 0-2 were enrolled in the study based upon the inclusion and exclusion criteria. Data was recorded for chemotherapy, surgery and other demographic features. Patients were evaluated at the start of treatment, during the last week of radiation and at first follow-up after completion of radiation treatment by the investigator for the frequency of anxiety and depression by voluntarily completing brief self-reporting questionnaire of Aga Khan University Anxiety and Depression scale called AKUADS. 

Out of 37 patients with head and neck cancer enrolled in the study, 56.7% (21) had cancer of the oral cavity, 21.6% (9) of laryngeal and 5.4% (2) hypo-pharyngeal carcinoma, 5.4% (2) of paranasal sinus cancer and 8.1% (3) of the salivary gland. There were 73% (27) patients who had undergone surgery and 70.3% (26) patients received chemotherapy. During radiation treatment, 57.6% of patients were found to have anxiety and depression. At the initial visit 5 (13.5%) patients, 15 (40.5%) at last week of radiotherapy and 8 (21.6%) at the first post-treatment follow up visit were found to be positive for anxiety and depression.  There was a significantly increased mean depression score at the last week of radiation therapy when compared to the start of radiation (p<0.001). However, even though there was a trend observed towards poorer mean depression scores at first follow-up after radiation therapy, but it did not reach statistical significance compared to baseline depression scores (p=0.08).

The frequency of anxiety and depression among patients undergoing radiation therapy for primary head and neck cancer was found to be significantly high during the last week of radiation treatment. There was a higher incidence among patients who had surgery and chemotherapy along with radiation therapy for the head and neck. Based on these results, it is recommended that psychiatric support during radiation therapy may play an integral role in improving the quality of life of the patients during the treatment.