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Psychological DistressDistress RTNCT07698782

Psychological Distress and Clinical Outcomes in Patients Undergoing Radiotherapy

A study testing Systematic monitoring in people with Psychological Distress and Clinical Outcomes, run by Chulabhorn Cancer Center at 1 site in Thailand.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of this observational study is to understand the emotional and physical burden (distress) experienced by cancer patients as they go through radiotherapy treatmen. Researchers want to learn what specific problems such as physical symptoms, financial worries, or travel issues most affect a patient's well-being… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Systematic monitoring
Could I receive a placebo?
No, everyone receives an active treatment
How many people
374 participants
Where
1 siteThailand
Study dates
2 May 2025to 30 Jun 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients diagnosed with cancer who are receiving treatment through radiotherapy.
  • Individuals aged 18 years or older.
  • Ability to communicate effectively and understand the Thai language.
  • Voluntary agreement to participate in the research project.

Who cannot join

  • Presence of emergency medical conditions or a clinical necessity to receive treatment by other methods.
  • Inability to attend follow-up monitoring assessments as dictated by the study protocol.
  • Participants who request to withdraw from the project during the study period.
  • Failure to complete the full course of radiotherapy treatment due to disease progression.
  • A physician's diagnosis of a brain or neurological condition that interferes with the patient's ability to perceive or assess their own symptoms.

Trial locations and contacts

1 site in 1 country.

Thailand1 site
  • Chulabhorn Hospital

    Bangkok, Bangkok, 10210

Other trials in Thailand

About this study

Official title: Advanced Cancer Stage and Healthcare Coverage Predict Longitudinal Psychological Distress and Clinical Outcomes in Patients Undergoing Radiotherapy

The goal of this observational study is to understand the emotional and physical burden (distress) experienced by cancer patients as they go through radiotherapy treatmen. Researchers want to learn what specific problems such as physical symptoms, financial worries, or travel issues most affect a patient's well-being and how those feelings change over the course of several weeks of care.

The main questions it aims to answer are:

Read more

Does high distress lead to negative clinical results, such as missing radiation appointments, significant weight changes, or needing to be admitted to the hospital unexpectedly? Which groups of patients are at the highest risk for severe distress (for example, those with advanced-stage cancer or those using specific types of health insurance)? What are the most common physical, practical, and emotional problems that cause distress during the different phases of treatment?

Participants will:

Complete a survey about their health history and background before treatment begins.

Rate their distress level on a scale of 0 to 10 (using a tool called a Distress Thermometer) and check off specific concerns from a 42-item list each week during their 2 to 8 weeks of radiotherapy.

Complete one final follow-up assessment one month after finishing their radiotherapy treatment.

Read the detailed description

Study Rationale and Objective: Psychological distress in cancer patients is a recognized catalyst for negative clinical outcomes, yet it remains under-monitored in many tertiary care settings. This research was designed as a prospective longitudinal study to move beyond single-point prevalence surveys and capture the fluctuating nature of distress throughout the radiotherapy (RT) trajectory. The primary objective was to evaluate the longitudinal patterns of distress and identify independent clinical and socioeconomic predictors that correlate with treatment adherence and unplanned healthcare utilization.

Operational Framework: The study tracked a purposive sample of 374 cancer outpatients across eight distinct assessment phases: Baseline (T0): Pre-treatment assessment of demographic, socioeconomic, and clinical status.

Weekly Monitoring (T1-T8): Real-time tracking of distress levels and symptom accumulation throughout the typical 2- to 8-week RT course.

Follow-up (T9): Post-treatment assessment one month after the completion of radiotherapy.

Multidimensional Assessment: Distress was quantified using the NCCN Distress Thermometer (DT), a 0-10 visual analogue scale, with a score≥4 triggering clinical concern. To identify the specific drivers of this distress, participants utilized a 42-item Problem List covering five critical domains:

Physical: Monitoring the accumulation of RT-related side effects such as fatigue, pain, and changes in appearance.

Practical: Identifying logistical barriers, including financial instability (specifically under the Universal Coverage Scheme), transportation difficulties, and work interference.

Psychological: Tracking anxiety, fear, and sadness. Social/Family: Assessing caregiving burdens and relationship stressors. Spiritual: Exploring concerns regarding faith and the meaning of life. Statistical Focus: The study employed multivariate ordinal logistic regression to isolate independent predictors of distress severity while controlling for age and gender. This rigorous analysis aimed to confirm how clinical factors, such as Advanced Cancer Stage (III-IV), and socioeconomic factors, such as Healthcare Coverage type, significantly increase the risk of high psychological burden. By correlating these predictors with tangible clinical outcomes, including significant weight changes, missed appointments, and unplanned hospital admissions, the study provides an evidence-based rationale for a multidisciplinary, holistic nursing approach in oncology departments.

Being tested
Systematic monitoring
Keywords
Psychological Distress, Radiotherapy, Advanced Cancer, NCCN Distress Thermometer, Treatment Adherence, Socioeconomic Factors
Medical subject headings
Treatment Adherence and Compliance

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Systematic monitoringOther

    This study utilizes a standardized longitudinal psychological screening protocol to monitor cancer outpatients across eight distinct phases: a pre-treatment baseline (T0), weekly assessments throughout the 2-to-8-week radiotherapy (RT) course (T1-Tn), and a final follow-up one month post-treatment (T2).

    Participants are screened using the NCCN Distress Thermometer (DT), a 0-10 visual analog scale for global burden, and a 42-item Problem List that identifies specific stressors across five multidimensional domains: physical, psychological, social/family, practical, and spiritual. This longitudinal framework distinguishes the protocol from standard cross-sectional surveys by capturing the real-time accumulation of side effects and secondary distress peaks occurring mid-treatment.

    In accordance with the hospital's clinical trigger model, a DT score of ≥ 4 is established as the threshold for clinically significant distress, which facilitates immediate referral to a multidisciplinary team.

Study groups in NCT07698782
Study groupRoleWhat they receive
Longitudinal monitoring of psychological distress in cancer outpatients undergoing radiotherapyExperimentalThis arm consists of a single purposive cohort of 374 cancer outpatients who are observed across eight distinct phases: a pre-treatment baseline (T0), weekly assessments during the 2-to-8-week radiotherapy course, and a one-month post-treatment follow-up (T2). The focus of this arm is the naturalistic observation of fluctuating psychological distress levels and their correlation with clinical outcomes such as treatment adherence and unplanned hospitalizations.
Receives: Other: Systematic monitoring

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from baseline in psychological distress severity scores as measured by the NCCN Distress Thermometer throughout the radiotherapy course

    The global psychological burden is quantified using the NCCN Distress Thermometer (DT), a single-item visual analog scale ranging from 0 (no distress) to 10 (extreme distress). A score of ≥ 4 is established as the clinical cut-off point, indicating moderate-to-severe distress that warrants multidisciplinary intervention.

    Measured: Participants are assessed at eight distinct time points: Baseline (T0): Prior to the initiation of radiotherapy. Weekly Monitoring (T1-Tn): Once per week throughout the 2-to-8-week Follow-up (T2): One month after completion

Secondary outcomes (1)
  1. Identification of independent predictors of moderate-to-severe psychological distress

    This outcome measure focuses on isolating specific clinical and socioeconomic variables that significantly increase the risk of a patient reaching a Distress Thermometer (DT) score of ≥ 4. The study utilizes multivariate ordinal logistic regression to evaluate the predictive power of factors such as Cancer Stage (III-IV vs. 0-II), Healthcare Coverage type (Universal Coverage Scheme vs. Civil Servant benefits), and Treatment Intent (Palliative vs. Curative). By identifying these independent predictors, the research aims to provide a profile for early identification of high-risk individuals who require immediate multidisciplinary intervention

    Measured: Analysis is conducted using data collected from the pre-treatment baseline (T0) through the completion of the 2-to-8-week radiotherapy course and the one-month post-treatment follow-up (T2)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Jul 2026
  2. Study start2 May 2025
  3. Primary completion27 Oct 2025
  4. Study completion30 Jun 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Not applicable
Intervention model
Single group
Model description
This research is a prospective longitudinal cohort study tracking 374 cancer outpatients throughout their radiotherapy trajectory. The model utilizes a repeated-measures framework to capture the fluctuating nature of psychological distress and its correlation with clinical results. Operational Phases: Baseline (T0): Pre-treatment assessment to establish demographic, clinical, and socioeconomic profiles. Active Monitoring (T1-Tn): Real-time weekly tracking during the 2-8 week radiotherapy course to monitor cumulative side effects and mid-treatment distress peaks. Follow-up (T2): A final assessment conducted one month post-treatment to evaluate recovery or persistent burden. Clinical Trigger Model: Global distress is quantified via the NCCN Distress Thermometer (DT). Specific independent predictors impact the probability of a patient reaching this intervention threshold.
Masking
None (open label)
Enrolment
374 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07698782
Sponsor's protocol ID
039/2564
Acronym
Distress RT
Status last verified
Jul 2026
First submitted
7 Jul 2026
Last updated
13 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Confidentiality Protocols: The study protocol approved by the Institutional Review Board of the Chulabhorn Royal Academy explicitly states that all participant data will be kept strictly confidential and will be presented only as an aggregate overview. Data Protection: All personally identifiable information has been removed from the final dataset to ensure anonymization. Data Destruction: In accordance with the ethical considerations defined in the "Methods for maintaining volunteer confidentiality," the investigators have committed to destroying all recording data and deleting the dataset immediately upon the completion of the research project. Access Restrictions: The protocol specifies that data is stored in a locked secure cabinet accessible only to the primary investigators to prevent unauthorized viewing. Consequently, there is no plan to share individual participant data (IPD) with outside researchers, as doing so would conflict with the established privacy protections.

Publications

  • Bussaba P, Sowanna N, Kanchanasurakit S, Lamkham N, Srivichaiwong N, Limsakul T. Survival Time Difference Between High and Low Symptom Burden Considering Physical and Emotional Symptoms Among Terminal Cancer Patients. J Gen Fam Med. 2026 Feb 27;27(2):e70106. doi: 10.1002/jgf2.70106. eCollection 2026 Mar.

    PubMed 41769304
  • Fabian A, Ruhle A, Domschikowski J, Trommer M, Wegen S, Becker JN, Wurschi G, Boeke S, Sonnhoff M, Fink CA, Kasmann L, Schneider M, Bockelmann E, Treppner M, Mehnert-Theuerkauf A, Krug D, Nicolay NH; Young DEGRO Group. Psychosocial distress in cancer patients undergoing radiotherapy: a prospective national cohort of 1042 patients in Germany. J Cancer Res Clin Oncol. 2023 Sep;149(11):9017-9024. doi: 10.1007/s00432-023-04837-5. Epub 2023 May 10.

    PubMed 37165119
  • Bunchuailua W, Kapol N, Krichanchai S, Krongkaew W, Andres EB. Quality of Life Among Thai Patients With Advanced Cancer: Findings From the APPROACH Study. Asia Pac J Clin Oncol. 2026 Apr;22(2):308-318. doi: 10.1111/ajco.70037. Epub 2025 Oct 23.

    PubMed 41131799
  • Paek SC, Meemon N, Wan TT. Thailand's universal coverage scheme and its impact on health-seeking behavior. Springerplus. 2016 Nov 10;5(1):1952. doi: 10.1186/s40064-016-3665-4. eCollection 2016.

    PubMed 27933235
  • Ownby KK. Use of the Distress Thermometer in Clinical Practice. J Adv Pract Oncol. 2019 Mar;10(2):175-179. Epub 2019 Mar 1.

    PubMed 31538028
  • Park H, Kang D, Lee TH, Oh D. Dynamics in distress and quality of life in patients undergoing radiation therapy: a prospective cohort study. Support Care Cancer. 2025 Apr 14;33(5):379. doi: 10.1007/s00520-025-09371-3.

    PubMed 40229622
  • Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C, Meader N. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011 Feb;12(2):160-74. doi: 10.1016/S1470-2045(11)70002-X. Epub 2011 Jan 19.

    PubMed 21251875
  • Miroshnychenko A, Rae C, Tsangaris E, Breakey VR, D'Agostino N, Klassen AF. Clinical and Demographic Factors Associated with Distress in Adolescent and Young Adults with Cancer. J Adolesc Young Adult Oncol. 2021 Dec;10(6):682-689. doi: 10.1089/jayao.2020.0196. Epub 2021 Apr 12.

    PubMed 33844943

Questions about this trial

What is this clinical trial studying?

A study testing Systematic monitoring in people with Psychological Distress and Clinical Outcomes, run by Chulabhorn Cancer Center at 1 site in Thailand.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 13 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Thailand. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from baseline in psychological distress severity scores as measured by the NCCN Distress Thermometer throughout the radiotherapy course (time frame: Participants are assessed at eight distinct time points: Baseline (T0): Prior to the initiation of radiotherapy. Weekly Monitoring (T1-Tn): Once per week throughout the 2-to-8-week Follow-up (T2): One month after completion). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07698782, which also lists 8 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Jul 2026.

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