Clinical trial NCT02599506: Fear of Cancer Recurrence (FoR) Trajectory During Radiation Treatment
Official title: Fear of Cancer Recurrence (FoR) Trajectory During Radiation Treatment and Follow-up Into Survivorship of 100 Breast Cancer patients-a Pilot Study
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Breast Cancer
Keywords: breast cancer
fear of recurrence
longitudinal study
radiation therapy
emotional concerns
trajectory
psychological constructs
diary keeping
Lead sponsor: University of St Andrews
Sponsor class: OTHER
Collaborators: name: NHS Lothian
First posted: 2015-11-06
Enrollment: 97
Sex: FEMALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: In this study, 100 breast cancer patients receiving radiotherapy at the Edinburgh Cancer Centre will be recruited.

Brief summary: This pilot study concentrates on studying the trajectory of breast cancer patient's fear of recurrence (FoR) over the course of radiation therapy. The aim is to collect repeated ratings of 100 breast cancer patient's FoR over the course of their treatment. It is hypothesized that cancer patient's FoR level will rise on nearing the termination of the in radiotherapy treatment, and radiotherapist-patient interaction modifies the development of patient's FoR.

Detailed description: The aim of this pilot study is to examine the collection of FoR levels in a longitudinal design with 100 breast cancer patients receiving radiotherapy for their disease. In this study, an intensive longitudinal design will be employed (Bolger \& Laurenceau, 2013). There will be two data collection types. First, will be self-reported questionnaires. Patients will complete questions including three sections: 1) demographic information (i.e. age, education, employment, marital/family status), 2) a 7-item FoR scale (ACCRE FCR) and 3) a 20-item Affect Schedule (PANAS) before first radiation treatment (T1). Throughout the period of treatment, a 3-item FoR questionnaire (ACCRE FCR 3 Items) will be designed as a daily diary to monitor patient's FoR level. Then, at the end of the radiotherapy treatment (T2), PANAS will be measured again. Finally, six-eight weeks after the end of the treatment (T3), all participants will be asked to complete the 7-items FCR questionnaire once again as well as a 5-item EuroQoL EQ-5D-3L scale by telephone.

The second data collection media is audiotape. The conversations between radiotherapist and patient in the weekly review appointment will be recorded and a behavioural coding system (VR-CoDES) will be used to analyse the interactions between patient and radiotherapist.

Data analysis will involve statistical analysis and qualitative methods. Statistical analyses will be conducted using Statistical Package for the Social Sciences (SPSS) Analytics software v.22, Analysis of MOment Structures (AMOS) v.22 and MPlus™ (SEM: Structural Equation Modelling). Initial analysis will plot individual and group average curves over the days that patients are treated. The analysis will develop a statistical model based upon SEM principles of growth curves. Each patient is expected to disclose increased fears of recurrence over the course of treatment. Latent curve modelling will be developed to test the relationship of FoR over the time course of the treatment.

As part of this pilot study the investigators wish to investigate the appropriateness of these models and to test the extent of growth of FoR to the outcome at 6-8 weeks follow up, using the FoR 7 item measure. Covariates will be introduced for control purposes and indicate initial level of negative affectivity (The Positive and Negative Affect Schedule - PANAS), age and initial level of disease severity. Alternative strategies of analysis are considered appropriate and may enable a parallel strategy. This would involve a simpler approach concentrating on the raw data. Linear modelling (multi-level) which will include estimation of linear slopes being used to predict FoR outcome.

Audio recordings of the consultation will be transcribed verbatim in order to investigate how the radiotherapist-patient communication affects the development of FoR.

Eligibility criteria: Inclusion Criteria:

* Female patient who are diagnosed with breast cancer, age 18+

Exclusion Criteria:

* Under 18 years old
* Male
* Known psychiatric illness
* Receiving palliative radiotherapy (non-curative)
* Unable to communicate in English

Primary outcomes:
measure: Fear of Recurrence Level-ACCRE FCR
timeFrame: 6-8 weeks after treatment
Secondary outcomes:
measure: The Positive and Negative Affect Schedule (PANAS)
timeFrame: 4 weeks following baseline visit
measure: 5 EQ-5D-3L
timeFrame: 6-8 weeks after treatment
Other outcomes:
Locations:
city: Edinburgh
country: United Kingdom
facility: NHS Lothian Edinburgh Cancer Centre
Study officials:
affiliation: University of St Andrews
name: Gerald M Humphris, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Crawford JR, Henry JD. The positive and negative affect schedule (PANAS): construct validity, measurement properties and normative data in a large non-clinical sample. Br J Clin Psychol. 2004 Sep;43(Pt 3):245-65. doi: 10.1348/0144665031752934.
citation: Schrag A, Selai C, Jahanshahi M, Quinn NP. The EQ-5D--a generic quality of life measure-is a useful instrument to measure quality of life in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry. 2000 Jul;69(1):67-73. doi: 10.1136/jnnp.69.1.67.
citation: Walters SJ, Brazier JE. Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Qual Life Res. 2005 Aug;14(6):1523-32. doi: 10.1007/s11136-004-7713-0.
citation: Popov V, Ellis-Robinson A, Humphris G. Modelling reassurances of clinicians with hidden Markov models. BMC Med Res Methodol. 2019 Jan 9;19(1):11. doi: 10.1186/s12874-018-0629-0.
citation: Yang Y, Cameron J, Bedi C, Humphris G. Fear of cancer recurrence trajectory during radiation treatment and follow-up into survivorship of patients with breast cancer. BMC Cancer. 2018 Oct 20;18(1):1002. doi: 10.1186/s12885-018-4908-2.
citation: Humphris G, Yang Y, Barracliffe L, Cameron J, Bedi C. Emotional talk of patients with breast cancer during review appointments with therapeutic radiographers: effects on fears of cancer recurrence. Support Care Cancer. 2019 Jun;27(6):2143-2151. doi: 10.1007/s00520-018-4484-7. Epub 2018 Oct 1.