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接受放化疗治疗的食管癌患者的体验:一项嵌套在 SCOPE2 试验中的定性研究。

The experiences of patients with oesophageal cancer receiving chemoradiotherapy treatment: a qualitative study embedded in the SCOPE2 trial.

机构信息

Division of Population Medicine, Cardiff University, Cardiff, UK

Cardiff University, Cardiff, UK.

出版信息

BMJ Open. 2024 Sep 23;14(9):e076394. doi: 10.1136/bmjopen-2023-076394.

Abstract

OBJECTIVES

This qualitative study explored patients' experiences and perceptions of the SCOPE2 trial. SCOPE2 examined radiotherapy dose escalation in patients with inoperable oesophageal cancer treated with definitive chemoradiotherapy (dCRT).

SETTING

Recruitment at five clinical sites in England and Wales, UK.

PARTICIPANTS

SCOPE2 trial participants were invited to take part in interviews from across five clinical sites. Participants self-selected to take part in up to three interviews across four different time points: baseline (before treatment) and at 2-3 months, 3-6 months or 6 months+ after baseline. There were five female and five male interview participants.

INTERVENTIONS

Participants were randomised to standard dose dCRT prescribed carboplatin/paclitaxel or cisplatin/capecitabine, or an escalated dose dCRT prescribed carboplatin/paclitaxel or cisplatin/capecitabine.

METHODS

This qualitative study used semistructured longitudinal interviews to explore the impact of treatment on patient outlook and quality of life and the impact of the COVID-19 pandemic. Interview data were thematically analysed.

RESULTS

10 patients participated in 16 longitudinal interviews. Three participants were accompanied by companions. Participants experienced side-effects from radiotherapy and chemotherapy including nausea, throat pain, difficulties eating and regaining appetite, thrombosis and fatigue, although most of these symptoms gradually improved. Participants required more ongoing information and support regarding treatment side-effects and cancer status in order to improve their overall quality of life. Best practice examples involved key contacts providing practical advice and signposting support.

CONCLUSION

Participants of the SCOPE2 trial reported short and longer-term side-effects from chemoradiotherapy, but these usually lessened over time. Participants attempted to be positive about their survival prospects by readjusting their expectations, priorities and lifestyles. Providing patients with ongoing opportunities to discuss detailed and timely information regarding treatment side-effects, aftercare and cancer status could improve the overall health and well-being of patients during oesophageal cancer trials and pathways.

TRIAL REGISTRATION NUMBER

NCT02741856; ISRCTN: 97125464.

摘要

目的

本定性研究探讨了患者对 SCOPE2 试验的体验和看法。SCOPE2 研究了接受根治性放化疗(dCRT)治疗不可手术的食管癌患者的放疗剂量递增。

设置

在英国英格兰和威尔士的五个临床地点进行招募。

参与者

SCOPE2 试验的参与者被邀请在五个临床地点参加访谈。参与者自愿参加多达三次访谈,分为四个不同的时间点:基线(治疗前)和 2-3 个月、3-6 个月或基线后 6 个月以上。有 5 名女性和 5 名男性访谈参与者。

干预措施

参与者随机分配接受标准剂量 dCRT 规定的卡铂/紫杉醇或顺铂/卡培他滨,或递增剂量 dCRT 规定的卡铂/紫杉醇或顺铂/卡培他滨。

方法

本定性研究采用半结构式纵向访谈,探讨治疗对患者前景和生活质量的影响,以及 COVID-19 大流行的影响。对访谈数据进行了主题分析。

结果

10 名患者参加了 16 次纵向访谈。其中 3 名参与者有同伴陪同。参与者经历了放疗和化疗的副作用,包括恶心、喉咙痛、进食困难和食欲恢复、血栓形成和疲劳,尽管大多数这些症状逐渐改善。参与者需要更多关于治疗副作用和癌症状况的持续信息和支持,以提高他们的整体生活质量。最佳实践范例涉及关键联系人提供实用建议和提供支持。

结论

SCOPE2 试验的参与者报告了放化疗的短期和长期副作用,但随着时间的推移,这些副作用通常会减轻。参与者试图通过重新调整他们的期望、优先事项和生活方式来对他们的生存前景保持积极态度。为患者提供持续的机会,讨论有关治疗副作用、护理和癌症状况的详细及时信息,可能会提高患者在食管癌试验和治疗途径中的整体健康和幸福感。

试验注册号

NCT02741856;ISRCTN:97125464。

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