Differences in attitude toward adjuvant chemotherapy between colorectal cancer survivors and the medical staff of Japanese hospitals

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• 作者：Yukiya Narita ; Hiroya Taniguchi ; Koji Komori…
• 关键词：Adjuvant chemotherapy ; Colorectal cancer ; Patients-attitudes
• 刊名：International Journal of Clinical Oncology
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：20
• 期：4
• 页码：755-760
• 全文大小：615 KB
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• 作者单位：Yukiya Narita (1)
  Hiroya Taniguchi (1)
  Koji Komori (2)
  Kenya Kimura (2)
  Takashi Kinoshita (2)
  Azusa Komori (1)
  Motoo Nomura (1)
  Shigenori Kadowaki (1)
  Daisuke Takahari (1)
  Takashi Ura (1)
  Masashi Andoh (1)
  Kei Muro (1)
  
  1. Department of Clinical Oncology, Aichi Cancer Center Hospital, 1- Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-681, Japan
  2. Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1- Kanokoden, Chikusa-ku, Nagoya, Aichi, Japan
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Oncology
  Surgical Oncology
  Radiotherapy
  Diagnostic Radiology
  Internal Medicine
  Pathology
  
• 出版者：Springer Japan
• ISSN：1437-7772

文摘

Background Adding oxaliplatin to fluorouracil-based chemotherapy can improve the survival of patients with stage III colorectal cancer by approximately 20?%. Reportedly, cancer patients are much more likely to prefer chemotherapy than medical professionals, although there is only a very small chance of achieving benefits from treatment. However, chronic neurotoxicity may be long lasting after the administration of oxaliplatin-based chemotherapy. This study aimed to evaluate potential side effects and differences in attitude between colorectal cancer patients and medical staff regarding the risk–benefit trade-offs of chemotherapy. Methods Relapse-free colorectal cancer patients who received adjuvant chemotherapy, doctors, and nurses were surveyed using a questionnaire regarding the side effects of chemotherapy and hypothetical clinical scenarios to quantify gains in the risk of relapse that were deemed necessary to make chemotherapy worthwhile. Results Responses were obtained from 147 patients, 54 doctors, and 84 nurses. Of these, 39?% of patients and 85?% of doctors replied that moderate side effects of adjuvant chemotherapy were worthwhile to achieve an absolute gain in the risk of relapse of 10?% from a baseline of 40?%. More severe side effects, as reported by colorectal cancer patients, were not associated with the larger gains necessary to make treatment worthwhile. Seven percent of patients treated with oxaliplatin, 40?% of doctors, and 43?% of nurses replied that side effects associated with oxaliplatin-based chemotherapy were severe. Conclusions Doctors should consider potential heterogeneity in side effects and attitudes regarding the risk–benefit balance of adjuvant chemotherapy, and that patient perspectives should enhance shared decision-making.