Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD.
Department of Radiation Oncology, Mayo Clinic, Rochester, MN.
Semin Radiat Oncol. 2022 Jul;32(3):207-220. doi: 10.1016/j.semradonc.2022.01.010.
Breast cancer care is often defined by preference-sensitive decisions, in which no one choice clearly dominates, and the treatment approach is ideally guided by patient values and preferences. In this context, patients are vulnerable to suboptimal decision quality due to the number and complexity of choices. Arriving at a high-quality, patient-centered decision involves both an accurate understanding of the risks and benefits of treatment options, as well as concordance with the patient's preferences and values. These 2 objectives intersect at the informed consent discussion. In radiation oncology, informed consent has an added layer of complexity related to strong desire from patients to receive the most technologically advanced treatment, often out of balance with other rational considerations. These observations highlight challenges and opportunities unique to radiation oncology in improving communication and arriving at a high-quality decision.
乳腺癌的治疗方案通常需要做出偏好敏感型决策，因为没有哪种选择具有明显优势，而治疗方法则理想地取决于患者的价值观和偏好。在这种情况下，由于选择数量多且复杂，患者可能会做出次优的决策质量。做出高质量、以患者为中心的决策需要准确了解治疗方案的风险和益处，并与患者的偏好和价值观相一致。这两个目标在知情同意讨论中交汇。在放射肿瘤学中，知情同意增加了一层与患者强烈希望接受最先进技术治疗相关的复杂性，而这种愿望常常与其他合理考虑因素失衡。这些观察结果突出了放射肿瘤学在改善沟通和做出高质量决策方面所面临的独特挑战和机遇。
