Poole Hospital NHS Foundation Trust, Poole, UK.
Palliat Med. 2009 Oct;23(7):594-600. doi: 10.1177/0269216309105787. Epub 2009 May 14.
Brain metastases are a common complication of non-small cell lung cancer (NSCLC). Prognosis is poor and the effectiveness of whole brain radiotherapy (WBRT) is uncertain for patients with moderate performance status. Studies on WBRT effectiveness have thus far used outcome measures, such as survival, performance status and cognitive function. The aim of this study was to study what patients with recently diagnosed brain metastases from NSCLC want from their treatment. We carried out semistructured interviews with nine patients with brain metastases from NSCLC, for whom the benefit of WBRT is uncertain. Interpretative phenomenological analysis was used. Themes identified included quality versus quantity of life, factors contributing to quality of life (including family, mobility and normality), 'Go for it!' - the desire to try anything, the desire for a cure or 'magic wand', fear and other factors (including family in decision making, information or lack of information, relationship with professionals, experience of steroids and radiotherapy including adverse effects). Quality of life is important to patients, but many are keen to try any treatment which might prolong their life. Understanding patients' values regarding treatment and goals of treatment can help clinicians discuss these issues with patients and provide appropriate information and can aid selection of appropriate outcome measures.
脑转移是非小细胞肺癌（NSCLC）的常见并发症。对于一般体能状态的患者，全脑放疗（WBRT）的疗效不确定，预后较差。迄今为止，关于 WBRT 疗效的研究使用了生存、一般体能状态和认知功能等结果指标。本研究旨在研究最近诊断为 NSCLC 脑转移的患者对治疗的期望。我们对 9 名 NSCLC 脑转移患者进行了半结构化访谈，这些患者的 WBRT 获益不确定。采用解释现象学分析方法。确定的主题包括生活质量与数量、影响生活质量的因素（包括家庭、活动能力和正常生活）、“全力以赴！”——尝试任何方法的愿望、对治愈或“魔杖”的渴望、恐惧和其他因素（包括家庭在决策中的作用、信息或缺乏信息、与专业人员的关系、类固醇和放疗的体验，包括不良反应）。生活质量对患者很重要，但许多患者渴望尝试任何可能延长生命的治疗方法。了解患者对治疗的价值观和治疗目标有助于临床医生与患者讨论这些问题，并提供适当的信息，有助于选择适当的结果指标。
