Maguire Rebecca, Hanly Paul, Drummond Frances J, Gavin Anna, Sharp Linda
National College of Ireland, Dublin, Ireland.
University College Cork, Cork, Ireland.
Psychooncology. 2017 Nov;26(11):1825-1831. doi: 10.1002/pon.4384. Epub 2017 Feb 20.
Fear of recurrence (FOR) is a key concern among survivors of all cancers. In prostate cancer, FOR varies with health and treatment type, but little is known about how survivors' appraisals of their treatment, and in particular, their level of regret over treatment decisions may affect this.
A total of 1229 prostate cancer survivors between 2- and 5-years postdiagnosis were invited to complete a postal questionnaire including a FOR scale, Decisional Regret Scale, and the European Organization for Research and Treatment of Cancer QLQ C30 health-related quality of life (HRQoL) instrument. Multiple regression analysis explored the impact of 3 blocks of factors on FOR: (1) demographic characteristics and disease extent, (2) primary treatment received and health status (treatment side effects and HRQoL), and (3) treatment appraisals, specifically satisfaction with information received regarding treatment and level of regret experienced over treatment decisions.
The final multivariable model explained 27% of variance on FOR. Significant correlates of lower FOR included having localised disease, having undergone an invasive treatment, as well as health status (higher HRQoL and fewer ongoing side effects). Beyond this, appraisals of treatment significantly contributed to the model: More decisional regret and lower satisfaction with information received were associated with higher FOR.
These findings suggest that FOR may be mitigated by providing survivors with more information regarding treatment choices and the treatment itself so that men can make well-informed decisions and experience less future regret. Sensitivity analysis for variables predicting FOR among prostate cancer survivors is not suspected of having a recurrence.
对复发的恐惧（FOR）是所有癌症幸存者的一个关键担忧。在前列腺癌中，FOR随健康状况和治疗类型而变化，但对于幸存者对其治疗的评估，尤其是他们对治疗决策的后悔程度如何影响FOR，人们知之甚少。
邀请了1229名确诊后2至5年的前列腺癌幸存者填写一份邮寄问卷，问卷包括一个FOR量表、决策后悔量表，以及欧洲癌症研究与治疗组织的QLQ C30健康相关生活质量（HRQoL）工具。多元回归分析探讨了3组因素对FOR的影响：（1）人口统计学特征和疾病范围，（2）接受的初始治疗和健康状况（治疗副作用和HRQoL），以及（3）治疗评估，特别是对所获得的治疗信息的满意度和对治疗决策所经历的后悔程度。
最终的多变量模型解释了FOR变异的27%。FOR较低的显著相关因素包括患有局限性疾病、接受过侵入性治疗，以及健康状况（较高的HRQoL和较少的持续副作用）。除此之外，治疗评估对模型有显著贡献：更多的决策后悔和对所获得信息的较低满意度与较高的FOR相关。
这些发现表明，通过向幸存者提供更多关于治疗选择和治疗本身的信息，以便男性能够做出明智的决策并减少未来的后悔，可以减轻FOR。对预测前列腺癌幸存者中FOR的变量进行敏感性分析，未怀疑有复发情况。
