Cruz-Castellanos Patricia, Jiménez-Fonseca Paula, Galán-Moral Rocío, Piera-Molons Nuria, Gustems Marina, Calderon Caterina
Department of Medical Oncology, Hospital General Ciudad Real, Ciudad Real, Spain.
Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain.
Front Psychol. 2024 Oct 9;15:1392567. doi: 10.3389/fpsyg.2024.1392567. eCollection 2024.
This study seeks to compare expectations regarding systemic cancer treatment for advanced lung cancer from the perspectives of both patient and medical oncologist.
A cross-sectional study involving 17 medical oncologists from 13 Spanish hospitals between 2021 and 2022. Patients with advanced, unresectable lung cancer were recruited prior to initiating systemic cancer treatment. Both patients and oncologists completed the NEOetic-EIT and the STAR.
Seventeen medical oncologists specializing in lung cancer participated, with a mean age of 36.2 years (range 28-56); 65% were female. The study included 298 patients with advanced, unresectable lung cancer, predominantly non-small cell type (72%), and most at stage IV (77%). Most patients were retired or unemployed (71%), and married or partnered (77%). Treatment approaches varied, with 44% based on biomarkers. Oncologists had greater expectations of positive outcomes for participants with better baseline prognosis, such as ECOG 0, newly diagnosed, locally advanced, unresectable non-small cell lung cancer, and those receiving biomarker-based treatments. In contrast, patients' treatment expectations did not vary based on sociodemographic or clinical factors. Generally, patients had high expectations of cure, in contrast to oncologists' lower expectations, though both anticipated similar quality-of-life improvements. Patients anticipated more side effects than oncologists. Among oncologists, expectations varied by gender and decreased with age and experience, with no differences detected among patients based on gender, age, or doctor-patient relationship.
This study reveals the complex expectations of patients and oncologists in advanced lung cancer treatment. It underscores the need for effective communication in oncology to align patient expectations with clinical realities.
本研究旨在从患者和肿瘤内科医生的角度比较对晚期肺癌全身癌症治疗的期望。
一项横断面研究，于2021年至2022年期间纳入了来自13家西班牙医院的17名肿瘤内科医生。在开始全身癌症治疗之前招募晚期不可切除肺癌患者。患者和医生均完成了NEOetic-EIT和STAR。
17名专门从事肺癌治疗的肿瘤内科医生参与了研究，平均年龄为36.2岁（范围28 - 56岁）；65%为女性。该研究纳入了298例晚期不可切除肺癌患者，主要为非小细胞类型（72%），且大多数处于IV期（77%）。大多数患者已退休或失业（71%），已婚或有伴侣（77%）。治疗方法各不相同，44%基于生物标志物。对于基线预后较好的参与者，如ECOG 0、新诊断、局部晚期、不可切除的非小细胞肺癌患者以及接受基于生物标志物治疗的患者，肿瘤内科医生对其积极结果的期望更高。相比之下，患者的治疗期望并不因社会人口统计学或临床因素而有所不同。总体而言，患者对治愈的期望较高，而肿瘤内科医生的期望较低，不过双方都预期生活质量会有相似程度的改善。患者预期的副作用比肿瘤内科医生更多。在肿瘤内科医生中，期望因性别而异，且随着年龄和经验的增加而降低，而在患者中未发现基于性别、年龄或医患关系的差异。
本研究揭示了患者和肿瘤内科医生在晚期肺癌治疗中复杂的期望。强调了肿瘤学中有效沟通的必要性，以使患者期望与临床实际情况相一致。
