Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Distress trajectories and geographic inequities during radiotherapy: Analysis of nationally collected routine distress scr (142959)

Chindhu Shunmuga Sundaram 1 2 , Haryana Dhillon 1 , Samantha Redfearn 3 , Jemma Gilchrist 3 , Peter O'Brien 3 , Cath Adams 3 , Puma Sundaresan 4
  1. Faculty of Science, School of Psychology, Psycho-Oncology Co-operative Research Group, The University of Sydney, Sydney, NSW, Australia
  2. Radiation Oncology Network, Western Sydney Local Health District, Sydney, NSW, Australia
  3. GenesisCare, Sydney, NSW, Australia
  4. Radiation oncology, GenesisCare, Sydney, NSW, Australia

Background:
Psychological distress is common after a cancer diagnosis and routine distress screening is recommended. Understanding of distress trajectories during radiation therapy (RT) and whether these differ by demographics and treatment characteristics is limited. We examined distress trajectories during RT for differences by patient and treatment characteristics.

 

Methods:
We analysed paired Distress Thermometer (DT) scores routinely collected at start (T1) and end (T2) of RT from patients treated at a multi-centre corporate RT provider. Distress was categorised as low (0–3), moderate (4–6), or high (7–10). Clinically meaningful change was defined as ≥2-point change. Patients were grouped by age (<50, 50–70, >70 years), treatment intent (curative vs palliative), home and treatment location (metropolitan [M] vs regional/remote [RR]), travel for treatment, and whether they had a nursing “well-being plan” documented (yes/no).

 

Results:
Of 31,363 patients from 54 centres across Australia, 18.6% (n=5834) reported high distress and 9.2% (n=8063) moderate distress at T1. Overall, 45.9% (n=14,392) experienced clinically meaningful improvement by T2, while 8.9% (n=2788) deteriorated. Younger respondents (<50 years) reported higher T1 distress but were more likely to improve compared with older respondents (>70 years) (54.4% vs 42%). Older age was associated with reduced odds of improvement (OR=0.89, 95% CI 0.84–0.94, p<0.001). Those treated with palliative intent experienced higher distress at T2. Most had a documented wellbeing plan (82.4%), and this was associated with distress improvement over time (χ²=13.82, p<0.001). Distress improved from T1 to T2 regardless of home location. Patients from RR travelling to M for RT had greater distress reduction from T1 to T2 than those treated close to home (t(21,824)=2.57, p=0.010). 

 

Conclusions:
Distress decreased during RT for most respondents. However, older adults and those receiving palliative treatment may require additional psychosocial support. Routine distress screening provides valuable insights for identifying vulnerable groups and informing targeted supportive care.