Lind S E, DelVecchio Good M J, Minkovitz C S, Good B J
Hematology-Oncology Unit, Massachusetts General Hospital, Boston 02114.
Br J Cancer. 1991 Aug;64(2):391-5. doi: 10.1038/bjc.1991.315.
Previous studies have shown that groups of cancer sub-specialists differ in their stated willingness to undergo treatment for diseases lying within their area of expertise. In order to learn whether oncologists feel similarly about other forms of cancer, medical, radiation, and surgical oncologists were asked to fill out a questionnaire indicating whether they would be willing to undergo either chemotherapy or radiation therapy for a variety of common malignancies, or recommend them to a spouse or sibling. Subjects were also asked whether they would undertake an experimental therapy (interleukin-2) for any of three malignancies, or recommend such treatment to a spouse or relative. Fifty-one oncologists (14 radiation oncologists, 14 surgical oncologists, and 23 medical oncologists) were recruited from the staff of four university teaching hospitals. Although they agreed about accepting or declining therapy for some examples, there was considerable heterogeneity in their responses. In only 37% of the 30 cases involving standard therapies did greater than or equal to 85% of the oncologists agree that they would accept or refuse therapy. Only some of the variation of the responses could be attributed to the sub-specialty orientation of the oncologists. Physicians were as willing to recommend standard therapies for themselves as a spouse or sibling. Physicians were also divided in their opinion about whether they would accept a particular experimental therapy if diagnosed with one of three neoplasms. They were significantly more likely, however, to recommend it for a spouse or sibling than to accept it for themselves. Variation in the proportion of patients who receive anti-cancer therapies may relate, in part, to differences in opinion concerning the worth of such therapies among oncologists or primary physicians. This study shows that oncologists are quite heterogeneous with regard to their personal preferences for anti-cancer treatments for a variety of malignancies. Further studies are required to learn if such attitudes (among oncologists or primary physicians) directly affect the administration of such therapies.
以往的研究表明,不同癌症亚专科的医生群体对于是否愿意接受其专业领域内疾病的治疗存在不同态度。为了了解肿瘤学家对于其他癌症形式的看法是否相似,研究人员让医学肿瘤学家、放射肿瘤学家和外科肿瘤学家填写一份问卷,表明他们是否愿意接受针对多种常见恶性肿瘤的化疗或放疗,或者是否会向配偶或兄弟姐妹推荐这些治疗方法。研究对象还被问及是否会接受针对三种恶性肿瘤之一的实验性治疗(白细胞介素 -2),或者是否会向配偶或亲属推荐这种治疗方法。从四家大学教学医院的工作人员中招募了51名肿瘤学家(14名放射肿瘤学家、14名外科肿瘤学家和23名医学肿瘤学家)。尽管他们对于某些病例接受或拒绝治疗的意见一致,但他们的回答存在相当大的差异。在涉及标准治疗的30个病例中,只有37%的病例有85%及以上的肿瘤学家同意他们会接受或拒绝治疗。回答的差异只有部分可以归因于肿瘤学家的亚专科倾向。医生们愿意像为配偶或兄弟姐妹推荐标准治疗一样为自己推荐标准治疗。对于如果被诊断患有三种肿瘤之一是否会接受特定的实验性治疗,医生们的意见也存在分歧。然而,他们更有可能向配偶或兄弟姐妹推荐这种治疗,而不是自己接受这种治疗。接受抗癌治疗的患者比例的差异可能部分与肿瘤学家或初级医生对于此类治疗价值的意见分歧有关。这项研究表明,肿瘤学家对于各种恶性肿瘤的抗癌治疗个人偏好差异很大。需要进一步研究以了解(肿瘤学家或初级医生中的)这种态度是否直接影响此类治疗的实施。