Department of Pulmonary Diseases, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Expertise Center for Palliative Care, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Expertise Center for Palliative Care, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Clin Lung Cancer. 2021 May;22(3):242-251.e5. doi: 10.1016/j.cllc.2020.06.014. Epub 2020 Jun 21.
Metastatic lung cancer is an incurable disease that can be treated with systemic therapy. These treatments might prolong survival and reduce symptoms, but they may also cause serious adverse effects. We studied the treatment goals of patients with metastasized lung cancer and their oncologists before starting systemic therapy, concordance between patients' and oncologists' goals, and feasibility of these goals.
This research was conducted between November 2016 and April 2018 in 1 academic and 5 nonacademic hospitals across the Netherlands. A total of 266 patients with metastatic lung cancer and their prescribing oncologists (n = 23) filled out a questionnaire about their treatment goals and the estimated feasibility of these goals before treatment was started. Additional interviews were conducted with patients and oncologists.
Patients and oncologists reported quality of life (respectively, 45% and 72%), life prolongation (45% and 55%), decrease in tumor size (39% and 66%), and cure (19% and 2%) as treatment goals. The interviews showed that the latter appeared to be often as motivation to stay alive. Concordances between patients' and oncologists' treatment goals were low (ranging from 24% to 33%). Patients had slightly higher feasibility scores than oncologists (6.8 vs. 5.8 on a 10-point scale). Educational level, age, religious views, and performance status of patients were associated with treatment goals.
Patients and oncologists set various goals for the treatment they receive/prescribe. Low concordance might exist because different goals are set or because the patient misunderstands something. Clear communication about treatment goals should be integrated into clinical care.
转移性肺癌是一种无法治愈的疾病，可以通过全身治疗来治疗。这些治疗方法可能会延长生存期并减轻症状，但也可能会引起严重的不良反应。我们研究了转移性肺癌患者及其肿瘤医生在开始全身治疗前的治疗目标、患者和肿瘤医生目标的一致性以及这些目标的可行性。
这项研究于 2016 年 11 月至 2018 年 4 月在荷兰的 1 所学术医院和 5 所非学术医院进行。共有 266 名转移性肺癌患者及其处方肿瘤医生（n=23）在开始治疗前填写了一份关于他们的治疗目标和这些目标估计可行性的问卷。对患者和肿瘤医生进行了额外的访谈。
患者和肿瘤医生分别报告了生活质量（分别为 45%和 72%）、延长寿命（45%和 55%）、肿瘤缩小（39%和 66%）和治愈（19%和 2%）作为治疗目标。访谈表明，后者似乎常常是为了活着的动力。患者和肿瘤医生的治疗目标一致性较低（范围为 24%至 33%）。患者的可行性评分略高于肿瘤医生（10 分制分别为 6.8 和 5.8）。患者的教育水平、年龄、宗教信仰和表现状态与治疗目标有关。
患者和肿瘤医生为他们接受/规定的治疗设定了各种目标。一致性低可能是因为设定了不同的目标，或者是因为患者误解了某些东西。应该将关于治疗目标的清晰沟通纳入临床护理中。
