对卵巢癌患者行化疗的观点

作     者：Penson R.T. Dignan F. Seiden M.V 王刚 

作者机构：Division of Hematology a nd Oncology Department of Medicine Massachusetts Gen. Hospital 02114 Boston MA United States 

出 版 物：《世界核心医学期刊文摘（妇产科学分册）》 (Core Journal in Obstetrics/Gynecology)

年 卷 期：2005年第1卷第1期

页      面：50-51页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：复发性卵巢癌 姑息性治疗 姑息化疗 标准化疗 横断面调查 慢性疾病 生命延续 无症状患者 毒性反应 探索性研究 

摘      要：Background. Recurrent ovarian cancer (OVCA) has become the model for ca ncer as a chronic disease, yet little is known about what motivates patients and physic ians in treatment choices. Methods. We investigated the attitudes of patients wi th epithelial OVCA and staff towards palliative chemotherapy for recurrent OVCA with a cross-sectional questionnaire study. Results. Instruments were developed and piloted in 15 patients. This exploratory study reflects substantial bias in the sample populations. One hundred twenty-two patients and 37 staff were enro lled in the US and 39 patients and 25 staff were enrolled in the UK. UK patients had a lower educational status (P = 0.001), lower stage disease (P = 0.025), an d less prior lines of chemotherapy (P 0.001). 61%of patients had recurrent OV CA and 67%of staff were physicians. Seventy-three percent of patients recalled a discussion about prognosis and 74%wanted to know details of the prognosis fo r a typical patient (US = UK). Most patients (48%) thought that their physician was realistic, and 57%of staff felt that they were optimistic. The vastmajorit y of both staff and patients thought that patients positively reinterpreted what they were told. Five percent of staff thought that palliative care was incomp atiblewhen considering chemotherapy as an option for their second recurrence o f OVCA, compared with 36%of US patients, significantly more than the 12%of UK patients (P = 0.007). Patients thought that standard chemotherapy for a second r ecurrence of OVCA produced remission in 50%and cure in 15%of patients. Staff r eported 20%and 0%, respectively. Fifty percent of patients and 57%of staff wo uldwant chemotherapy as an asymptomatic patient with a normal CT and a rising CA -125. Patients generally appear to be very tolerant of grade II chemotherapy-i nduced toxicity with staff being less tolerant than patients of nausea, anorexia , diarrhea, and rash. Staff rated life prolongation by 3 months to 1 year very m uch