Decision regret in patients with head-and-neck cancer undergoing radiotherapy.

Purpose: Head-and-neck cancer patients often face decisions between treatment options with similar oncological outcomes. In this context, decision regret becomes a central concern, particularly within the framework of shared decision-making. This study aims to assess the prevalence of decision regret and identify associated risk factors among head-and-neck cancer patients. Methods: This cross-sectional observational study included patients who underwent curative radiotherapy for head-and-neck cancer. Decision regret was assessed using the Decision Regret Scale (DRS). Additional patient-reported outcomes included health-related quality of life (HRQoL), psychological distress, anxiety, depression, and fear of cancer progression (FoP). Results: Of 300 eligible patients, 192 participated and filled out the DRS. The median age was 59 years (IQR, 45-65), and the median time between the end of radiotherapy and study participation was 45.5 months (IQR, 24-68.5). No decision regret (0 points) in terms of radiotherapy was reported by 27 %, mild regret (1-25 points) by 34 %, and high regret (>25 points) by 39 %. The mean (SD) DRS score regarding radiotherapy, systemic treatment, and surgery was 23.6 (22.4), 20.8 (19.3), and 20.9 (22.2), respectively. Decision regret was associated with HRQoL ( Conclusions: More than one-third of head-and-neck cancer patients report high decision regret. These findings highlight the need for enhanced shared decision-making to mitigate decision regret in head-and-neck oncology.