Lau-Min Kelsey S, Psenka Riley, Holtze Mia, Massad Katina, Hansen Andrea, Lo Stephen B, El-Jawahri Areej, Temel Jennifer S, Parikh Aparna, Nipp Ryan, Traeger Lara
Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States.
Cancer Outcomes Research and Education Program, Massachusetts General Hospital Cancer Center, Boston, MA 02114, United States.
Oncologist. 2025 Jun 4;30(6). doi: 10.1093/oncolo/oyaf128.
Locally advanced rectal cancer (LARC) is treated with combined chemotherapy, radiation, and surgery to maximize the potential for cure. This multimodality treatment approach can result in substantial toxicity for patients, including life-altering changes in bowel, urinary, and sexual function as well as decrements in quality of life (QOL). We explored the lived experiences of patients and caregivers during multimodality treatment for LARC.
We conducted a qualitative study of patients undergoing multimodality treatment for LARC and their designated caregivers. Each participant completed an hour-long individual in-depth interview using a semistructured interview guide covering treatment experiences, coping strategies, and supportive care needs. We transcribed, coded, and analyzed interviews using a thematic analysis approach and constant comparison methods.
We included 21 patients (median age 51 years, 11 women, 17 white, 10 post-surgical resection) and 10 caregivers (6 married/living with patients). We identified five themes among patients and caregivers: (1) the lengthy, complex, and unpredictable nature of multimodality therapy; (2) need to balance receiving detailed information with avoiding information overload; (3) the profound impact that multimodality therapy had on multiple QOL domains; (4) use of coping mechanisms to maintain control and preserve identity; and (5) desire for additional informational and supportive care resources.
Patients and caregivers face important challenges in navigating care for LARC due to the complicated and unpredictable nature of multimodality therapy. Findings from this study should inform the development of interventions to address the immense informational and supportive care needs of patients receiving multimodality treatment for LARC.
局部晚期直肠癌（LARC）采用化疗、放疗和手术联合治疗，以最大限度提高治愈可能性。这种多模式治疗方法可能给患者带来严重毒性，包括肠道、泌尿和性功能的改变以及生活质量（QOL）下降。我们探讨了LARC多模式治疗期间患者及其照顾者的生活经历。
我们对接受LARC多模式治疗的患者及其指定照顾者进行了一项定性研究。每位参与者使用涵盖治疗经历、应对策略和支持性护理需求的半结构化访谈指南，完成了长达一小时的个人深度访谈。我们采用主题分析方法和持续比较法对访谈进行转录、编码和分析。
我们纳入了21名患者（中位年龄51岁，11名女性，17名白人，10名接受手术切除）和10名照顾者（6名与患者结婚/同居）。我们在患者和照顾者中确定了五个主题：（1）多模式治疗漫长、复杂且不可预测的性质；（2）需要在获取详细信息与避免信息过载之间取得平衡；（3）多模式治疗对多个生活质量领域产生的深远影响；（4）使用应对机制来维持控制并保持身份认同；（5）对额外信息和支持性护理资源的需求。
由于多模式治疗复杂且不可预测的性质，患者和照顾者在LARC护理过程中面临重大挑战。本研究结果应为制定干预措施提供参考，以满足接受LARC多模式治疗患者巨大的信息和支持性护理需求。
