BC Cancer Agency, Centre for the North, Vancouver, Canada.
Radiother Oncol. 2012 Feb;102(2):210-3. doi: 10.1016/j.radonc.2011.07.028. Epub 2011 Aug 31.
Cure rates of paediatric malignancies have dramatically improved with therapy intensification, at the cost of late treatment side effects. A survey was developed, centred around medulloblastoma scenarios, in order to explore paediatric oncology physicians' views on discussing late effects and involving parents in treatment decisions.
Participants were 59 paediatric radiation and medical oncologists or fellows from USA (22), Canada (18), Europe (16), Australia (2), and Asia (1).
Ninety-five percent of respondents indicated late effects discussion prior to multimodality treatment was important. Of those who supported it, 100%, 83%, 64%, and 48% thought discussing cognitive impairment, infertility, stroke, and seizures as potential late effects was important, respectively. Only 71% of respondents believed parents should be involved in treatment decisions, which did not significantly vary by respondent age, country, specialty, gender, or years in practice.
The majority of oncologists who treat children believe discussing late effects with parents is important. However, there is mixed opinion on which late effects should be discussed and whether parents should be involved in deciding which treatments should be pursued. Research into perceived barriers to shared decision making and effective methods of improving the informed consent process in paediatric malignancies is needed.
随着治疗强度的增加，儿科恶性肿瘤的治愈率显著提高，但也带来了治疗后期的副作用。本研究通过调查，围绕髓母细胞瘤的情况，探讨儿科肿瘤医生对讨论晚期效应和让父母参与治疗决策的看法。
参与者为来自美国（22 名）、加拿大（18 名）、欧洲（16 名）、澳大利亚（2 名）和亚洲（1 名）的 59 名儿科放射肿瘤学家和内科肿瘤学家或研究员。
95%的受访者表示，在进行多模式治疗之前讨论晚期效应很重要。在支持这一观点的受访者中，分别有 100%、83%、64%和 48%的人认为讨论认知障碍、不孕、中风和癫痫等潜在晚期效应很重要。只有 71%的受访者认为父母应该参与治疗决策，但这与受访者的年龄、国家、专业、性别或从业年限无关。
大多数治疗儿童的肿瘤医生认为与父母讨论晚期效应很重要。然而，对于应该讨论哪些晚期效应以及父母是否应该参与决定应该采用哪些治疗方法，存在不同意见。需要研究共同决策的感知障碍以及提高儿科恶性肿瘤知情同意过程的有效方法。
