{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T22:50:36Z","timestamp":1790203836270,"version":"4.1.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the dynamic changes of psychological distress and its influencing factors in cancer patients across different phases of radiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a convenience sampling method, 226 esophageal cancer patients receiving radiotherapy at the Oncology Radiotherapy Center of a tertiary (Grade\u2010A) hospital in Henan Province were recruited from September 2022 to October 2023. Psychological distress was assessed using the Distress Thermometer (DT) at four time points: before the first radiotherapy session (T1), at the 15th session (T2), at the end of radiotherapy (T3), and one month after the completion of radiotherapy (T4). Generalized Estimating Equations (GEE) were utilized to analyze the factors related to psychological distress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 199 patients who completed the longitudinal follow-up, the\u00a0mean psychological distress scores were 4.88 \u00b1 1.63(T1); 5.09 \u00b1 1.57(T2); 4.75\u00a0\u00b1 1.56(T3); and 4.06 \u00b1 1.57 (T4) respectively. GEE results indicated that age, monthly household income per capita, tumor stage, concurrent chemoradiotherapy, symptom burden, family support, and illness perception were influencing factors of psychological distress in esophageal cancer patients undergoing radiotherapy (P &amp;lt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Esophageal cancer patients exhibit moderate psychological distress during radiotherapy, with a trend of initial increase followed by a decrease as radiotherapy continues. Based on the changing characteristics and identified influencing factors, the healthcare team should develop dynamic and individualized intervention strategies to reduce patients\u2019 psychological distress.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2025.1582870","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T05:21:37Z","timestamp":1762492897000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Psychological distress and its influencing factors in esophageal cancer patients undergoing radiotherapy: a longitudinal study"],"prefix":"10.3389","volume":"15","author":[{"given":"Jin","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jue","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huimin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1016\/j.acra.2024.08.055","article-title":"Meta-analysis of MRI in predicting early response to radiotherapy and chemotherapy in esophageal cancer","volume":"32","author":"Li","year":"2024","journal-title":"Acad Radiol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-025-07700-y","article-title":"Chronic skin toxicities in breast cancer survivors: a systematic review and meta-analysis of radiotherapy techniques","volume":"212","author":"Lee","year":"2025","journal-title":"Breast Cancer Res Treat"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1002\/pro6.1210","article-title":"Chinese clinical practice guidelines for the prevention and treatment of radiation-induced esophagitis","volume":"7","author":"Yang","year":"2023","journal-title":"Precis Radiat Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2019.0048","article-title":"Distress management, version 3.2019, NCCN clinical practice guidelines in oncology","volume":"17","author":"Riba","year":"2019","journal-title":"J\u00a0Natl Compr Canc Netw"},{"key":"B6","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1186\/s40359-022-00914-5","article-title":"Association between psychological distress of each points of the treatment of esophageal cancer and stress coping strategy","volume":"10","author":"Ohkura","year":"2022","journal-title":"BMC Psychol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1186\/s12957-020-02092-3","article-title":"Perioperative risk factors of psychological distress in patients undergoing treatment for esophageal cancer","volume":"18","author":"Ohkura","year":"2020","journal-title":"World J Surg Oncol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"zraa038","DOI":"10.1093\/bjsopen\/zraa038","article-title":"Psychological distress and health-related quality of life up to 2 years after oesophageal cancer surgery: nationwide population-based study","volume":"5","author":"Liu","year":"2021","journal-title":"BJS Open"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.21873\/invivo.13197","article-title":"Emotional distress prior to chemoradiation for rectal or anal cancer","volume":"37","author":"Rades","year":"2023","journal-title":"In Vivo"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/S0738-3991(03)00021-1","article-title":"Psychological functioning in cancer patients treated with radiotherapy","volume":"52","author":"Stiegelis","year":"2004","journal-title":"Patient Educ Couns"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1037\/tra0001835","article-title":"Trajectory and predictors of psychological distress and posttraumatic growth among rectal cancer patients undergoing combined modality treatment: An exploratory prospective study","volume":"17","author":"Benfante","year":"2025","journal-title":"Psychol Trauma"},{"key":"B12","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1200\/JOP.2014.003392","article-title":"Optimal frequency of psychosocial distress screening in radiation oncology","volume":"11","author":"Hess","year":"2015","journal-title":"J Oncol Pract"},{"key":"B13","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.jpsychores.2016.05.010","article-title":"A longitudinal study on anxiety, depressive and adjustment disorder, suicide ideation and symptoms of emotional distress in patients with cancer undergoing radiotherapy","volume":"87","author":"Hern\u00e1ndez Bl\u00e1zquez","year":"2016","journal-title":"J Psychosom Res"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3967\/bes2025.018","article-title":"Changes in esophageal cancer survival: A global review of survival analysis from cancer registration data over the past three decades","volume":"38","author":"Ye","year":"2025","journal-title":"BioMed Environ Sci"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.apjon.2025.100705","article-title":"Validation and application of the breast cancer distress thermometer in Chinese patients: Cutoff scores and stage-specific manifestations","volume":"12","author":"Qi","year":"2025","journal-title":"Asia Pac J Oncol Nurs"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24920","article-title":"Validation and application of a module of the M. D. Anderson Symptom Inventory for measuring multiple symptoms in patients with gastrointestinal cancer (the MDASI-GI)","volume":"116","author":"Wang","year":"2010","journal-title":"Cancer"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13186","article-title":"Psychometric properties of the Brief Illness Perception Questionnaire (Brief-IPQ) in periodontal diseases","volume":"46","author":"MaChado","year":"2019","journal-title":"J Clin Periodontol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"e0174093","DOI":"10.1371\/journal.pone.0174093","article-title":"Psychometric assessment of the Chinese version of the brief illness perception questionnaire in breast cancer survivors","volume":"12","author":"Zhang","year":"2017","journal-title":"PloS One"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.134.1.1","article-title":"The family APGAR: a proposal for a family function test and its use by physicians","volume":"6","author":"Smilkstein","year":"1978","journal-title":"J Fam Pract"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1380916","article-title":"Trajectory of psychological distress and influencing factors in patients with gynecological cancers: a longitudinal study","volume":"14","author":"Li","year":"2024","journal-title":"Front Oncol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"2153","DOI":"10.1038\/s41598-023-29375-5","article-title":"The relationship of social determinants and distress in newly diagnosed cancer patients","volume":"13","author":"Okeke","year":"2023","journal-title":"Sci Rep"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e70222","DOI":"10.1002\/nop2.70222","article-title":"Patterns of psychological distress of chinese elderly cancer patients: A latent profile analysis","volume":"12","author":"Li","year":"2025","journal-title":"Nurs Open"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-019-05271-5","article-title":"Understanding breast cancer survivors\u2019 financial burden and distress after financial assistance","volume":"28","author":"Semin","year":"2020","journal-title":"Support Care Cancer"},{"key":"B24","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1038\/nature10190","article-title":"City living and urban upbringing affect neural social stress processing in humans","volume":"474","author":"Lederbogen","year":"2011","journal-title":"Nature"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21443","article-title":"The financial burden and distress of patients with cancer: Understanding and stepping-up action on the financial toxicity of cancer treatment","volume":"68","author":"Carrera","year":"2018","journal-title":"CA Cancer J Clin"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e1000316","DOI":"10.1371\/journal.pmed.1000316","article-title":"Social relationships and mortality risk: a meta-analytic review","volume":"7","author":"Holt-Lunstad","year":"2010","journal-title":"PloS Med"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2354.1999.00176.x","article-title":"Relating information needs to the cancer experience: 1. Information as a key coping strategy","volume":"8","author":"van der Molen","year":"1999","journal-title":"Eur J Cancer Care (Engl)"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1000678","article-title":"Early palliative care for patients with metastatic non-small-cell lung cancer","volume":"363","author":"Temel","year":"2010","journal-title":"N Engl J Med"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e84106","DOI":"10.7759\/cureus.84106","article-title":"Yoga as an adjunct intervention for chemotherapy-induced peripheral neuropathy: evidence, challenges, and future directions","volume":"17","author":"Giridharan","year":"2025","journal-title":"Cureus"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.58.6362","article-title":"Early versus delayed initiation of concurrent palliative oncology care: patient outcomes in the ENABLE III randomized controlled trial","volume":"33","author":"Bakitas","year":"2015","journal-title":"J Clin Oncol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.134.1.1","article-title":"Distress in couples coping with cancer: a meta-analysis and critical review of role and gender effects","volume":"134","author":"Hagedoorn","year":"2008","journal-title":"Psychol Bull"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20081","article-title":"Interventions with family caregivers of cancer patients: meta-analysis of randomized trials","volume":"60","author":"Northouse","year":"2010","journal-title":"CA Cancer J Clin"},{"key":"B33","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1200\/JCO.2017.73.7221","article-title":"Role of patient coping strategies in understanding the effects of early palliative care on quality of life and mood","volume":"36","author":"Greer","year":"2017","journal-title":"J Clin Oncol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1080\/08870446.2015.1070851","article-title":"A systematic review and meta-analysis of the Brief Illness Perception Questionnaire","volume":"30","author":"Broadbent","year":"2015","journal-title":"Psychol Health"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.39.5046","article-title":"A new quality standard: the integration of psychosocial care into routine cancer care","volume":"30","author":"Jacobsen","year":"2012","journal-title":"J Clin Oncol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1582870\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T05:21:59Z","timestamp":1762492919000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1582870\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,7]]},"references-count":35,"alternative-id":["10.3389\/fonc.2025.1582870"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1582870","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,7]]},"article-number":"1582870"}}