Background/Objectives: Financial toxicity (FT) refers to the financial burden directly or indirectly caused by a patient’s medical care. Patients with head and neck cancer (HNC) are particularly vulnerable to FT due to lower rates of return to work and higher out-of-pocket payments (OOPP). In this cross-sectional study, we assessed the amount and types of OOPP, as well as the prevalence of FT, in HNC patients who had completed curative radiotherapy.Methods: We included HNC patients who underwent curative-intent radiotherapy at four private clinics in Romania, within 12 months of completing treatment. Participants completed a 25-item questionnaire capturing sociodemographic information, insurance status, income, and OOPP. To assess subjective FT, we used the validated nine-item Financial Index of Toxicity (FIT), which measures three FT domains: financial stress, financial strain, and lost productivity. Each domain and the total score range from 0 to 100, with higher scores indicating greater financial toxicity. Descriptive statistics were used to summarize patient characteristics. Pearson’s chi-square,t-tests, and one-way ANOVA were used to assess statistical associations, with a significance threshold ofp< 0.05.Results: Among 113 patients (mean age: 59), the majority were male (74.3%) and married (74.3%), with 40% having completed university or higher education. The most frequent tumor sites were the oropharynx (29 cases), larynx (22), and oral cavity (21). Concurrent chemoradiation was the most common treatment modality (47%). The mean total FT score was 18.8. Overall, 39.8% of patients experienced financial toxicity, and 29.2% scored above the mean in financial stress. Moderate financial strain (score > 21) was reported by 39.8% of participants, and approximately one-third reported loss of productivity. Transportation and nutritional supplements were the most common OOPP categories. Notably, 42% of patients spent at least 400 euros—equivalent to Romania’s monthly minimum income—on transportation during radiotherapy. FT was significantly associated with employment and marital status, but not with tumor site or treatment type.Conclusions: Among Romanian HNC patients treated with curative radiotherapy, we found substantial OOPP, particularly for transportation and nutritional supplements. While overall FT levels were moderate, divorced patients and those retired due to other chronic conditions were the most vulnerable to financial distress. Financial toxicity can directly affect treatment adherence, survival, and quality of life. By integrating financial counseling, social support, and broader coverage of treatment-related expenses, healthcare systems can mitigate FT for these patients.
**背景/目的：** 财务毒性是指由患者医疗直接或间接造成的经济负担。头颈癌患者由于重返工作岗位率较低和自付费用较高，尤其容易受到财务毒性的影响。在这项横断面研究中，我们评估了已完成根治性放疗的头颈癌患者的自付费用金额与类型，以及财务毒性的发生率。 **方法：** 我们纳入了在罗马尼亚四家私人诊所接受根治性放疗、且在完成治疗后12个月内的头颈癌患者。参与者完成了一份包含25个项目的问卷，收集了社会人口学信息、保险状况、收入和自付费用。为评估主观财务毒性，我们使用了经过验证的九项财务毒性指数，该指数测量财务毒性的三个维度：财务压力、财务困境和生产力损失。每个维度及总分范围均为0至100分，分数越高表明财务毒性越严重。采用描述性统计总结患者特征。使用皮尔逊卡方检验、t检验和单因素方差分析评估统计学关联，显著性阈值设定为p < 0.05。 **结果：** 在113名患者（平均年龄59岁）中，大多数为男性（74.3%）和已婚（74.3%），40%拥有大学或更高学历。最常见的肿瘤部位是口咽（29例）、喉（22例）和口腔（21例）。同步放化疗是最常见的治疗方式（47%）。平均总财务毒性得分为18.8分。总体而言，39.8%的患者经历了财务毒性，29.2%的患者在财务压力维度得分高于平均值。39.8%的参与者报告了中度财务困境（得分 > 21分），约三分之一报告了生产力损失。交通和营养补充剂是最常见的自付费用类别。值得注意的是，42%的患者在放疗期间交通费用至少花费了400欧元——相当于罗马尼亚的月最低收入。财务毒性与就业状况和婚姻状况显著相关，但与肿瘤部位或治疗类型无关。 **结论：** 在接受根治性放疗的罗马尼亚头颈癌患者中，我们发现了显著的自付费用，尤其是在交通和营养补充剂方面。虽然总体财务毒性水平为中度，但离婚患者和因其他慢性病退休的患者最容易陷入财务困境。财务毒性可直接影响治疗依从性、生存率和生活质量。通过整合财务咨询、社会支持以及扩大治疗相关费用的覆盖范围，医疗系统可以减轻这些患者的财务毒性。
Patient-Reported Financial Burden in Head and Neck Cancer Undergoing Radiotherapy
肿瘤(癌症)患者之家