Abstract
BackgroundPatients with primary brain tumors are reported to have an elevated level of distress prevalence, due to the functional sequelae and the unfavorable prognosis, but the estimated prevalence of this disorder varies among studies. The Distress Thermometer (DT) is widely used distress screening tools to identify patients suffering from elevated psychosocial distress. The objective of this meta-analysis is to get a summarized estimate of distress prevalence in adult primary brain tumor patients screened by the DT instrument to identify distress in brain tumor patients.MethodWe searched studies published in PubMed, PsycINFO, and Cochrane library through August 2017 and checked related reviews and meta-analyses for eligible studies. Studies were eligible if they were published in the peer-reviewed literature and evaluated distress level by Distress Thermometer. The prevalence of distress symptoms in patients with the intracranial tumor was estimated by study-level characteristics using stratified meta-analysis. The prevalence of distress level or symptoms during the follow-up examination at different time points was detected by secondary analysis of the longitudinal studies included.ResultsTwelve studies including a total of 2145 brain tumor patients were included in this analysis. Eight used a cross-sectional design and four were longitudinal. The pooled prevalence of distress was 38.2% (95% confidence interval (CI) 28.7%–47.7%) for the overall sample. The pooled prevalence of distress DT ≥4 was 41.1% (642/1686, 95% CI 28.6%–53.5%) and the pooled prevalence of distress by DT ≥6 was 29.7% (137/459, 95% CI 19.5%–39.9%). The distress symptom did not decrease in follow-up studies (Relative Increase Ratio:1.02, 95% CI, (0.78, 1.35)). A huge heterogeneity in different studies was detected, and different screening scales were not compared.ConclusionThe high prevalence of distress becomes an enormous challenge for primary brain tumor patients. Routine screening and evaluation of distress in brain tumor patients may assist medical workers to develop proper interventions, which may lead to better quality of life and oncology management.
Highlights
Patients with primary brain tumors are reported to have an elevated level of distress prevalence, due to the functional sequelae and the unfavorable prognosis, but the estimated prevalence of this disorder varies among studies
The high prevalence of distress becomes an enormous challenge for primary brain tumor patients
All studies met the following criteria were eligible for inclusion 1) used an observational or a randomized controlled trial before August 20, 2017; 2) provided distress prevalence in primary brain tumor patients with complication of distress ≥18 years old to ensure they can complete the questionnaire by themselves; 3) evaluated distress level by the National Comprehensive Cancer Network distress thermometer (NCCN-Distress Thermometer (DT)); 4) were published in peerreviewed journals in English language; 5) For longitudinal studies, baseline pre-treatment data were included for the estimate of pooled prevalence of distress symptoms, and data at baseline and after 3 months were analyzed to study prevalence change over time
Summary
Patients with primary brain tumors are reported to have an elevated level of distress prevalence, due to the functional sequelae and the unfavorable prognosis, but the estimated prevalence of this disorder varies among studies. The high emotional distress experience results in significant emotional burden and greatly affected how patients cope with their diseases and their ability to follow treatment recommendations [7, 8]. These complications reduce health-related quality of life (HRQoL) and have a significant negative impact on prognosis as well as survival in brain tumor patients [5, 7]. Different screening standards have been developed for the psychosocial diagnosis and support of cancer patients
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