Bonin Katija, McGuffin Merrylee, Presutti Roseanna, Harth Tamara, Mesci Aruz, Feldman-Stewart Deb, Chow Edward, Di Prospero Lisa, Vesprini Danny, Rakovitch Eileen, Lee Justin, Paszat Lawrence, Doherty Mary, Soliman Hany, Ackerman Ida, Cao Xingshan, Kiss Alex, Szumacher Ewa
Institute of Clinical Evaluative Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Department of Radiation Therapy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
J Cancer Educ. 2018 Feb;33(1):37-43. doi: 10.1007/s13187-016-1016-3.
This study was conducted to elucidate patients with early breast cancer preference for standard whole breast irradiation (WBI) or partial breast irradiation (PBI) following lumpectomy, as well as identify important factors for patients when making their treatment decisions. Based on relevant literature and ASTRO consensus statement guidelines, an educational tool and questionnaire were developed. Consenting, eligible women reviewed the educational tool and completed the trade-off questionnaire. Descriptive statistics were calculated, as well as chi-squares and a logistic regression model. Of the 90 patients who completed the study, 62 % preferred WBI, 30 % preferred PBI, 4 % required more information, and 3 % had no preferences. Of the patients who chose WBI, 58 % preferred hypofractionated RT, whereas 25 % preferred the conventional RT regimen. The majority of patients rated recurrence rate [WBI = 55/55 (100 %), PBI = 26/26 (100 %)] and survival [WBI = 54/55 (98 %), PBI = 26/26 (100 %)] as important factors contributing to their choice of treatment preference. Financial factors [WBI = 21/55 (38 %), PBI = 14/26 (53 %)] and convenience [WBI = 36/54 (67 %), PBI = 18/26 (69 %)] were rated as important less frequently. Significantly, more patients who preferred WBI also rated standard method of treatment as important when compared to patients who preferred PBI [WBI = 52/54 (96 %), PBI = 16/26 (61 %), χ = 16.63, p = 0.001]. The majority of patients with early breast cancer who were surveyed for this study preferred WBI as an adjuvant treatment post lumpectomy, yet there was a sizeable minority who preferred PBI. This was associated with the importance patients place on standard treatment. These results will help medical professionals treat patients according to patient values.
本研究旨在阐明早期乳腺癌患者在乳房肿瘤切除术后对标准全乳照射(WBI)或部分乳腺照射(PBI)的偏好,以及确定患者在做出治疗决策时的重要因素。基于相关文献和美国放射肿瘤学会(ASTRO)共识声明指南,开发了一种教育工具和问卷。同意参与且符合条件的女性查看了教育工具并完成了权衡问卷。计算了描述性统计数据,以及卡方检验和逻辑回归模型。在完成研究的90名患者中,62% 偏好WBI,30% 偏好PBI,4% 需要更多信息,3% 没有偏好。在选择WBI的患者中,58% 偏好低分割放疗,而25% 偏好传统放疗方案。大多数患者将复发率 [WBI = 55/55(100%),PBI = 26/26(100%)] 和生存率 [WBI = 54/55(98%),PBI = 26/26(100%)] 视为影响其治疗偏好选择的重要因素。财务因素 [WBI = 21/55(38%),PBI = 14/26(53%)] 和便利性 [WBI = 36/54(67%),PBI = 18/26(69%)] 被视为重要因素的频率较低。值得注意的是,与偏好PBI的患者相比,更多偏好WBI的患者也将标准治疗方法视为重要因素 [WBI = 52/54(96%),PBI = 16/26(61%),χ = 16.63,p = 0.001]。参与本研究调查的大多数早期乳腺癌患者在乳房肿瘤切除术后偏好WBI作为辅助治疗,但仍有相当一部分人偏好PBI。这与患者对标准治疗的重视程度有关。这些结果将有助于医疗专业人员根据患者价值观治疗患者。