在经口机器人手术时代，为口咽癌患者开发一种以患者为中心的在线决策辅助工具。
Development of an online, patient-centred decision aid for patients with oropharyngeal cancer in the transoral robotic surgery era.
作者信息
Lam J S, Scott G M, Palma D A, Fung K, Louie A V
机构信息
Department of Radiation Oncology, and.
出版信息
Curr Oncol. 2017 Oct;24(5):318-323. doi: 10.3747/co.24.3669. Epub 2017 Oct 25.
BACKGROUND
Radiotherapy (rt) has been the standard treatment for early oropharyngeal cancer, achieving excellent outcomes, but with significant toxicities. Transoral robotic surgery (tors) has emerged as a promising alternative. A decision aid (da) can help to establish patient treatment preferences.
METHODS
A da was developed and piloted in 40 healthy adult volunteers. Assuming equal oncologic outcomes of the treatments, participants indicated their preference. The treatment trade-off point was then established, and participant perceptions were elicited.
RESULTS
More than 80% of participants initially selected tors for treatment, regardless of facilitator background. For all participants, the treatment trade-off point changed after an average 15% cure benefit. Treatment toxicities, duration, novelty, and perceptions all influenced treatment selection. All subjects valued the da.
CONCLUSIONS
A da developed for early oropharyngeal cancer treatment holds promise in the era of shared decision-making. Assuming equal cure rates, tors was preferred over rt by healthy volunteers.
背景
放射治疗（RT）一直是早期口咽癌的标准治疗方法，疗效显著，但毒性较大。经口机器人手术（TORS）已成为一种有前景的替代方法。决策辅助工具（DA）有助于确立患者的治疗偏好。
方法
开发了一种决策辅助工具并在40名健康成年志愿者中进行了试点。假设两种治疗方法的肿瘤学结果相同，让参与者表明他们的偏好。然后确定治疗权衡点，并了解参与者的看法。
结果
无论引导者背景如何，超过80%的参与者最初选择TORS进行治疗。对于所有参与者来说，在平均15%的治愈获益后，治疗权衡点发生了变化。治疗毒性、持续时间、新颖性和看法都会影响治疗选择。所有受试者都重视该决策辅助工具。
结论
为早期口咽癌治疗开发的决策辅助工具在共同决策时代具有前景。假设治愈率相同，健康志愿者更倾向于选择TORS而非RT。
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