Auvinen A, Hakama M, Ala-Opas M, Vornanen T, Leppilahti M, Salminen P, Tammela T L J
Tampere School of Public Health, University of Tampere, Finland.
BJU Int. 2004 Jan;93(1):52-6; discussion 56. doi: 10.1111/j.1464-410x.2004.04554.x.
To determine whether different approaches in the choice of treatment affect the treatment chosen by the patient for prostate cancer.
We conducted a randomized trial with 210 men who had a histologically confirmed diagnosis of prostate cancer in 1993-94 at four major hospitals in Finland. After obtaining informed consent the men were randomized either to an intervention arm, in which there was greater patient participation in the choice of treatment following a structured procedure, or a control arm in which the standard approach, i.e. a standardized treatment protocol, was used. The main outcome measure of the analysis was the primary treatment chosen for prostate cancer.
In the enhanced participation arm patients not eligible for radical prostatectomy chose orchidectomy less frequently and favoured nonsurgical endocrine treatment than in the treatment protocol arm. Radical prostatectomy was the most commonly chosen treatment option in both arms among men with operable cancer. The way treatment options were presented affected the treatment chosen for prostate cancer.
Patients with prostate cancer are willing and able to take an active role in making decisions. The preferences of patients with prostate cancer in the choice of treatment may differ from the priorities of the physicians.
确定治疗选择中的不同方法是否会影响患者对前列腺癌治疗方法的选择。
我们对1993 - 1994年在芬兰四家主要医院经组织学确诊为前列腺癌的210名男性进行了一项随机试验。在获得知情同意后，这些男性被随机分为干预组和对照组。干预组中，患者按照结构化程序更多地参与治疗选择；对照组则采用标准方法，即标准化治疗方案。分析的主要结局指标是为前列腺癌选择的初始治疗方法。
在增强参与组中，不符合根治性前列腺切除术条件的患者选择睾丸切除术的频率低于治疗方案组，且更倾向于非手术内分泌治疗。在可手术治疗的癌症患者中，根治性前列腺切除术是两组中最常选择的治疗方案。治疗方案的呈现方式影响了前列腺癌的治疗选择。
前列腺癌患者愿意且能够在决策中发挥积极作用。前列腺癌患者在治疗选择上的偏好可能与医生的优先考虑不同。
