Department of Radiation Oncology (J.J.C.), University of San Francisco, San Francisco, California, USA.
Northwestern Feinberg School of Medicine (C.S.R.), Chicago, Illinois, USA.
J Pain Symptom Manage. 2022 Dec;64(6):567-576. doi: 10.1016/j.jpainsymman.2022.08.011. Epub 2022 Aug 22.
There is a paucity of data describing patients' expectations of goals of palliative radiotherapy (RT) and overall prognosis.
To explore patients' perceptions of and preferences for communication surrounding goals of palliative RT and cancer prognosis.
We conducted a qualitative study utilizing semi-structured interviews with seventeen patients with either bone or lung metastases receiving their first course of palliative RT at a comprehensive cancer center. All patient interviews were recorded, transcribed verbatim, and thematically analyzed.
Themes of goals of palliative RT centered on either restoration, such as through improving quality of life or minimizing pain, or on a desire to combat cancer by eliminating tumor. While most patients perceived that palliative RT would palliate symptoms but not cure their cancer, some patients believed that the goal of palliative RT was to cure. Themes that emerged surrounding patients' understanding of prognosis and what lies ahead included uncertainty and apprehension about the future, a focus on additional treatment, and confronting mortality. Most patients preferred to receive information about goals of treatment and prognosis from their doctors, including radiation oncologists, rather than other members of the medical team. Patients also expressed a desire for written patient education materials on palliative RT.
Unclear perceptions of goals of treatment and prognosis may motivate some patients to pursue unnecessarily aggressive cancer treatments. Patients desire prognostic information from their doctors, including radiation oncologists, who are important contributors to goals of care discussions and may improve patient understanding and well-being by using restorative rather than combat-oriented language.
目前关于患者对姑息性放疗（RT）目标和总体预后的期望的相关数据十分有限。
探讨患者对姑息性 RT 和癌症预后相关沟通内容的看法和偏好。
我们开展了一项定性研究，对 17 名在综合癌症中心接受首次姑息性 RT 的骨转移或肺转移患者进行了半结构化访谈。所有患者访谈均进行录音、逐字转录，并进行主题分析。
姑息性 RT 目标的主题集中在恢复上，例如提高生活质量或减轻疼痛，或通过消除肿瘤来对抗癌症。虽然大多数患者认为姑息性 RT 可以缓解症状但无法治愈癌症，但也有一些患者认为姑息性 RT 的目标是治愈。围绕患者对预后和未来的理解的主题包括对未来的不确定性和担忧、对额外治疗的关注以及面对死亡。大多数患者希望从他们的医生（包括放射肿瘤学家）那里获得有关治疗目标和预后的信息，而不是从医疗团队的其他成员那里获得。患者还希望获得姑息性 RT 的书面患者教育材料。
对治疗和预后目标的认识不清可能会促使一些患者追求不必要的激进癌症治疗。患者希望从他们的医生那里获得预后信息，包括放射肿瘤学家，他们是制定治疗目标的重要参与者，并且通过使用恢复性而不是对抗性的语言，可能会提高患者的理解能力和幸福感。
