Originally published as JCO Early Release 10.1200/JCO.2006.09.0126 on September 17 2007

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Self-Administered Stress Management Training in Patients Undergoing Radiotherapy

Mindy M. Krischer, Ping Xu, Cathy D. Meade, Paul B. Jacobsen

From the Department of Pediatrics, University of South Florida and the Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL

Address reprint requests to Paul B. Jacobsen, PhD, H. Lee Moffitt Cancer Center, 12902 Magnolia Dr, MRC-PSY, Tampa, FL 33612; e-mail: paul.jacobsen{at}moffitt.org

Purpose This study sought to continue research on psychosocial interventions for patients being treated with radiation therapy across multiple centers and to replicate positive findings of a single-center study of patients being treated with chemotherapy. The primary objective of this study was to determine if a stress management intervention was effective in improving quality of life and decreasing psychological distress in patients undergoing radiotherapy for cancer.

Patients and Methods A total of 310 patients about to begin radiotherapy treatment were randomly assigned to receive usual care only or self-administered stress management training. Quality-of-life assessments occurred at baseline and for 3 weeks after the beginning of radiotherapy treatment.

Results Overall, patients assigned to receive stress management training did not report significantly less psychological distress on the Medical Outcomes Study 36-Item Short Form (SF-36) Mental Component Summary Scale than did those assigned to usual care. When divided into subgroups based on the SF-36 Mental Component Summary Scale scores immediately after their first radiotherapy treatment, patients with above-average levels of psychological distress (scores 50) who were randomly assigned to the intervention condition reported significant improvement in their distress compared with those assigned to usual care only on the SF-36 Mental Health Subscale and the Center for Epidemiologic Studies Depression Scale.

Conclusion This study found that self-administered stress management training is effective only in those radiotherapy patients with initially higher levels of psychological distress. Additional research should examine the benefits of stress management training targeted specifically to patients experiencing heightened distress.

published online ahead of print at www.jco.org on September 17, 2007

Supported by National Cancer Institute Grant No. CA81920.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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