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.
Med Decis Making. 2021 Jul;41(5):515-526. doi: 10.1177/0272989X21998951. Epub 2021 Mar 30.
Previous studies have investigated patients' treatment goals before starting a treatment for metastatic lung cancer. Data on the evaluation of treatment goals are lacking.
To determine if patients with metastatic lung cancer and their oncologists perceive the treatment goals they defined at the start of systemic treatment as achieved after treatment and if in hindsight they believe it was the right decision to start systemic therapy.
A prospective multicenter study in 6 hospitals across the Netherlands between 2016 and 2018. Following systemic treatment, 146 patients with metastatic lung cancer and 23 oncologists completed a questionnaire on the achievement of their treatment goals and whether they made the right treatment decision. Additional interviews with 15 patients and 5 oncologists were conducted.
According to patients and oncologists, treatment goals were achieved in 30% and 37% for 'quality of life,' 49% and 41% for 'life prolongation,' 26% and 44% for 'decrease in tumor size,' and 44% for 'cure', respectively. Most patients and oncologists, in hindsight, felt they had made the right decision to start treatment even if they had not achieved their goals (72% and 93%). This was related to the feeling that they had to do 'something.'
Before deciding on treatment, the treatment options, including their benefits and side effects, and the goals patients have should be discussed. It is key that these discussions include not only systemic treatment but also palliative care as effective options for doing 'something.'
之前的研究已经调查了开始转移性肺癌治疗前患者的治疗目标。缺乏关于治疗目标评估的数据。
确定转移性肺癌患者及其肿瘤医生是否认为他们在开始系统性治疗时定义的治疗目标在治疗后得到了实现，以及他们是否事后认为开始系统性治疗是正确的决定。
这是一项在 2016 年至 2018 年期间在荷兰 6 家医院进行的前瞻性多中心研究。在系统性治疗后，146 名转移性肺癌患者和 23 名肿瘤医生完成了一份关于他们治疗目标的实现情况以及他们是否做出了正确的治疗决策的问卷。还对 15 名患者和 5 名肿瘤医生进行了额外的访谈。
根据患者和肿瘤医生的说法，治疗目标在以下方面得到了实现：“生活质量”为 30%和 37%，“延长生命”为 49%和 41%，“肿瘤大小缩小”为 26%和 44%，“治愈”为 44%。大多数患者和肿瘤医生事后都认为他们做出了开始治疗的正确决定，即使他们没有实现目标（分别为 72%和 93%）。这与他们必须“做些什么”的感觉有关。
在决定治疗之前，应讨论治疗方案，包括其益处和副作用，以及患者的目标。这些讨论的关键不仅包括系统性治疗，还包括姑息治疗，因为这是“做些什么”的有效选择。
