UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Prevalence of depressive and anxiety symptoms in patients with head and neck cancer undergoing radiotherapy: A systematic review and meta-analysis of longitudinal studies

Jiménez-Labaig, Pablo; Aymerich, Claudia; Rullan, Antonio; Cacicedo, Jon; Braña, Irene; Nutting, Christopher; Newbold, Kate; ... Catalan, Ana; + view all (2025) Prevalence of depressive and anxiety symptoms in patients with head and neck cancer undergoing radiotherapy: A systematic review and meta-analysis of longitudinal studies. Radiotherapy and Oncology , 202 , Article 110649. 10.1016/j.radonc.2024.110649.

[thumbnail of Rullan_RadiotherapyMentalHealth_Final.pdf] Text
Rullan_RadiotherapyMentalHealth_Final.pdf
Access restricted to UCL open access staff until 28 November 2025.

Download (521kB)

Abstract

Background and purpose: Patients with head and neck cancer (HNC) are particularly vulnerable to mental health concerns. Radiotherapy (RT) remains a key treatment modality for these malignancies, offering high chances of cure. However, the effects on mental health are not well defined. We aim to characterize longitudinally the prevalence and risk of depressive and anxiety symptoms over the course of RT in patients with HNC. // Material and methods: A literature search was performed from database inception until November 1st, 2024. PROSPERO/MOOSE-compliant and pre-registered (PROSPERO:CRD42023441432) systematic review identified studies longitudinally reporting in patients with HNC undergoing curative intent RT. Pooled prevalence and odds ratio of clinically significant anxiety and depressive symptoms between different treatment timepoints were estimated using random-effects meta-analysis. // Results: 18 studies (total sample 1,920, mean age 59.9[SD = 3.17], 22.2 % female, 93.0 % white ethnicity) were included. Before RT, a pooled prevalence of depressive symptoms of 18.1 % (95 % confidence intervals [CI] = 13.1 %-24.4 %) was found. Short-term after completing RT (≤3 months), the prevalence of depressive symptoms peaked to 26.1 % (95 %CI = 18.9 %-35.0 %), decreasing in long-term (≥6 months) assessments to 16.4 % (95 %CI = 12.6 %-21.0 %). Anxiety symptoms continuously decreased from baseline (pooled prevalence 29.9 % [95 %CI = 27.3 %–32.7 %]) to 17.4 % (95 %CI = 12.1 %-24.5 %) in the long-term. Female and married patients showed higher prevalence of depressive symptoms. Those who underwent surgery showed a lower prevalence of anxiety symptoms. // Conclusions: High prevalence of clinically significant depressive and anxiety symptoms were found in patients with HNC undergoing RT, from baseline to long-term follow-up. The weeks following completion of RT are key, as depressive symptoms increase in this period. Screening and interventions prior to, during, and especially immediately post-RT would be beneficial.

Type: Article
Title: Prevalence of depressive and anxiety symptoms in patients with head and neck cancer undergoing radiotherapy: A systematic review and meta-analysis of longitudinal studies
DOI: 10.1016/j.radonc.2024.110649
Publisher version: https://doi.org/10.1016/j.radonc.2024.110649
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Radiotherapy; radiation; head and neck cancer; mental health; longitudinal; depression; anxiety; meta-analysis; psychological well-being; toxicities
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
URI: https://discovery.ucl.ac.uk/id/eprint/10203143
Downloads since deposit
Loading...
2Downloads
Download activity - last month
Loading...
Download activity - last 12 months
Loading...
Downloads by country - last 12 months
Loading...

Archive Staff Only

View Item View Item