Cancer Patients' Views on Ultrahypofractionated Radiotherapy: A Questionnaire-Based Survey

Cureus. 2024 Oct 22;16(10):e72093. doi: 10.7759/cureus.72093. eCollection 2024 Oct.

Abstract

Introduction: Ultrahypofractionated (UHF) radiotherapy provides several treatment schedules, including five fractions per week (5/5-UHF), three fractions per week (3/5-UHF), and one fraction per week (1/5-UHF). This study aimed to assess patient preferences for these UHF radiotherapy schedules and offer insights to support patient-centered radiotherapy.

Methods: A questionnaire survey was conducted among cancer patients who had received at least 10 fractions of definitive or palliative radiotherapy, delivered on consecutive weekdays at our institution. The survey was administered during the final week of treatment and included four questions regarding the patients' living conditions and seven questions about their perceptions of radiotherapy, including preferences for UHF radiotherapy schedules.

Results: Between April and July 2023, 71 eligible patients completed the questionnaire. The mean age was 65.2 years; 48 patients (68%) were male, and 36 patients (51%) were inpatients. Thirty-one patients (44%) traveled more than one hour to the hospital, and 34 patients (47%) reported stress from daily hospital visits for radiotherapy. In response to the question, "If you were to receive 5-fraction radiotherapy, would you choose 5/5-UHF, 3/5-UHF, or 1/5-UHF?" 64 patients responded. Among these, 27 (42%) chose 5/5-UHF, 19 (30%) chose 3/5-UHF, and 18 (28%) chose 1/5-UHF. Regarding the question, "Which is more important: a shorter treatment period with the same fractionation or reduced fractionation with the same treatment period?" 31 patients (48%) prioritized shorter treatment periods, while 12 (19%) preferred reduced fractionation. Although approximately half of the patients expressed distress from consecutive days of radiotherapy, the shortest treatment period was generally preferred, even if it involved consecutive sessions. The 1/5-UHF radiotherapy schedule was particularly popular among younger male patients, those with longer travel times, and those working full-time.

Conclusion: These findings suggest that tailoring radiotherapy schedules to patients' social circumstances may enhance overall satisfaction with treatment.

Keywords: alternative schedule; questionnaire survey; stereotactic body radiotherapy; ultrahypofractionated radiotherapy; weekly radiotherapy.