Gender role in radiotherapy: psychosocial differences between males and females during cancer care: Single-centre report on adult and paediatric oncological patients

Purpose: Recent studies indicate that gender plays a role in influencing the side effects and outcomes of radiotherapy (RT), thus highlighting the importance of gender-specific clinical approaches. However, there remains a knowledge gap regarding potential gender differences in the domain of psychosocial profiles during RT. This retrospective analysis examines the psychosocial impact of RT on a cohort of adult and paediatric patients in Italy who received psycho-oncological support during RT from January 2020 to April 2024. Methods: Medical charts of a total of 750 adult (418 females and 332 males) and 145 paediatric patients (78 male and 67 females) were reviewed. In our radiation oncology department, two psycho-oncological pathways are available for adults: 1) dedicated pathways for patients with head and neck, brain, or rectal and anal cancers, where psychological support is provided automatically; and 2) support for other patients upon request or clinical recommendation. For paediatric patients, psychoeducational/psychotherapeutic interventions tailored to the needs of patients/caregivers are initiated at the start of RT to ensure compliance and promote psychological wellbeing. Results: Female adult patients reported higher levels of distress, anxiety, and depression than males, with significant predictors including gender and previous psychological disturbances. Notably, patients undergoing RT with palliative or local-control intent exhibited increased anxiety and depression. In contrast, no significant gender differences in psychosocial distress were observed among paediatric patients. Both genders received consistent psychological support, and familial trauma and RT intent did not significantly affect their scores. Conclusion: In this retrospective analysis, gender is a crucial predictor of psychosocial outcomes in adults undergoing RT, with females experiencing higher distress levels. Prior mental health stability appears protective against anxiety and depression. In paediatric patients, interventions remain effective across genders. Early psychological assessments are essential for both groups to identify patients at risk and enhance coping strategies.