The relationship between cancer patient's fear of recurrence and radiotherapy: a systematic review and meta-analysis

Objective This review aims to provide an overview of the current knowledge available on the nature and extent of the relationship between external-beam radiotherapy (RT) and fear of cancer recurrence (FoR). Methods PubMed, MEDLINE, and EMBASE databases were searched to identify relevant studies. Systematic review procedures were followed including a quality assessment. Meta-analysis of suitable studies was conducted. Results Twenty-five eligible studies were included in the systematic review, and 15 of them were included in further meta-analysis. Meta-analysis of the available data confirmed a weak relationship between RT and FoR (15 studies, 9567 patients, overall r = 0.053, 95% confidence interval, 0.021-0.085, P = .001). Subgroup analysis based on cancer site (breast cancer versus other types of cancer) revealed that the correlation between RT and FoR was statistically significant in "other cancer" group (P<.001) but was nonsignificant in "breast cancer" group (P=.538). Conclusions While meta-analysis reports a statistically significant association between cancer patient's FoR and the receipt of RT, these results should be interpreted with caution owing to significant variability between studies. Further longitudinal studies should be conducted to address the trajectory of FoR over RT in greater detail.