Department of Oncology, Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense, Denmark.
REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Nyborg, Denmark.
BMC Palliat Care. 2021 Feb 26;20(1):37. doi: 10.1186/s12904-021-00731-4.
When discussing treatment options and future care, it is important to understand the expectations of patients and family caregivers related to palliative chemotherapy and to identify patterns in patients' quality of life. The study aims were to evaluate differences in treatment expectations and quality of life between patients with thoracic cancer (non-small-cell lung cancer, small-cell lung cancer and mesothelioma) who were < 70 and ≥ 70 years of age and receiving palliative chemotherapy and to assess family caregivers' treatment expectations.
A prospective longitudinal study included patients with thoracic cancer receiving outpatient palliative chemotherapy at a university hospital in Denmark and their family caregivers. Patients' treatment expectations and quality of life were assessed three times during treatment with a survey of treatment expectations and the Functional Assessment of Cancer Therapy - General questionnaire. Family caregivers' treatment expectations were assessed once.
A total of 48 patients and 36 family caregivers participated between 2018 and 2019. No statistically significant age-related differences in treatment expectations and quality of life were identified. 28% of patients aged < 70 years and 7% of those aged ≥70 years expected a cure. Among family caregivers, 36% expected a cure. Across both age groups, mean total quality of life scores significantly decreased from 73.2 at first palliative chemotherapy cycle to 70.5 at third cycle (p = 0.02). No meaningful changes were found in quality of life within either age group. A subgroup analysis found no significant between-group differences in quality of life. Mean physical well-being score for all patients decreased from 20.3 at first cycle to 18.4 at third cycle (p = 0.03) and mean emotional well-being score decreased from 15.4 at first cycle to 14.6 at third cycle (p = 0.04).
This study emphasizes the importance of initiating conversations about treatment expectations and paying attention to expectations that may differ by the age of the patient and between patients and family caregivers. Addressing treatment expectations among patients and family caregivers and monitoring quality of life among patients is important in clinical practice.
在讨论治疗方案和未来护理时，了解患者和家属对姑息化疗的期望，并确定患者生活质量的模式非常重要。本研究旨在评估年龄<70 岁和≥70 岁接受姑息化疗的胸部癌症（非小细胞肺癌、小细胞肺癌和间皮瘤）患者之间治疗期望和生活质量的差异，并评估家属对治疗的期望。
一项前瞻性纵向研究纳入了在丹麦一所大学医院接受门诊姑息化疗的胸部癌症患者及其家属。在治疗过程中，通过治疗期望调查和癌症治疗功能评估-一般问卷，三次评估患者的治疗期望和生活质量。家属的治疗期望只评估一次。
共有 48 名患者和 36 名家属在 2018 年至 2019 年间参与了研究。未发现年龄相关的治疗期望和生活质量差异有统计学意义。28%年龄<70 岁的患者和 7%年龄≥70 岁的患者期望治愈。在家属中，36%期望治愈。在两个年龄组中，总生活质量评分从第一次姑息化疗周期的 73.2 分显著下降到第三次周期的 70.5 分（p=0.02）。在任何一个年龄组中，生活质量都没有明显变化。亚组分析发现生活质量无显著组间差异。所有患者的生理健康评分从第一次周期的 20.3 分降至第三次周期的 18.4 分（p=0.03），情感健康评分从第一次周期的 15.4 分降至第三次周期的 14.6 分（p=0.04）。
本研究强调了讨论治疗期望的重要性，并关注患者年龄和患者与家属之间可能存在的期望差异。满足患者和家属对治疗的期望，监测患者的生活质量，在临床实践中非常重要。
