Influential Factors Impacting Treatment Decision-making and Decision Regret in Patients with Localized or Locally Advanced Prostate Cancer: A Systematic Literature Review.

IF 8.3 1区 医学 Q1 ONCOLOGY
European urology oncology Pub Date : 2024-12-01 Epub Date: 2024-05-13 DOI:10.1016/j.euo.2024.04.016
Benjamin A Gartrell, Angaja Phalguni, Paulina Bajko, Suneel D Mundle, Sharon A McCarthy, Sabine D Brookman-May, Francesco De Solda, Ruhee Jain, Wellam Yu Ko, Guillaume Ploussard, Boris Hadaschik
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引用次数: 0

Abstract

Context: Treatment decision-making (TDM) for patients with localized (LPC) or locally advanced (LAPC) prostate cancer is complex, and post-treatment decision regret (DR) is common. The factors driving TDM or predicting DR remain understudied.

Objective: Two systematic literature reviews were conducted to explore the factors associated with TDM and DR.

Evidence acquisition: Three online databases, select congress proceedings, and gray literature were searched (September 2022). Publications on TDM and DR in LPC/LAPC were prioritized based on the following: 2012 onward, ≥100 patients, journal article, and quantitative data. The Preferred Reporting Items Reviews and Meta-analyses guidelines were followed. Influential factors were those with p < 0.05; for TDM, factors described as "a decision driver", "associated", "influential", or "significant" were also included. The key factors were determined by number of studies, consistency of evidence, and study quality.

Evidence synthesis: Seventy-five publications (68 studies) reported TDM. Patient participation in TDM was reported in 34 publications; overall, patients preferred an active/shared role. Of 39 influential TDM factors, age, ethnicity, external factors (physician recommendation most common), and treatment characteristics/toxicity were key. Forty-nine publications reported DR. The proportion of patients experiencing DR varied by treatment type: 7-43% (active surveillance), 12-57% (radical prostatectomy), 1-49% (radiotherapy), 28-49% (androgen-deprivation therapy), and 21-47% (combination therapy). Of 42 significant DR factors, treatment toxicity (sexual/urinary/bowel dysfunction), patient role in TDM, and treatment type were key.

Conclusions: The key factors impacting TDM were physician recommendation, age, ethnicity, and treatment characteristics. Treatment toxicity and TDM approach were the key factors influencing DR. To help patients navigate factors influencing TDM and to limit DR, a shared, consensual TDM approach between patients, caregivers, and physicians is needed.

Patient summary: We looked at factors influencing treatment decision-making (TDM) and decision regret (DR) in patients with localized or locally advanced prostate cancer. The key factors influencing TDM were doctor's recommendation, patient age/ethnicity, and treatment side effects. A shared, consensual TDM approach between patients and doctors was found to limit DR.

影响局部或局部晚期前列腺癌患者治疗决策和决策后悔的影响因素:系统性文献综述。
背景:前列腺癌局部(LPC)或局部晚期(LAPC)患者的治疗决策(TDM)非常复杂,治疗后决策后悔(DR)也很常见。对推动 TDM 或预测 DR 的因素仍然研究不足:目的:我们进行了两项系统性文献综述,以探讨与TDM和DR相关的因素:检索了三个在线数据库、部分大会论文集和灰色文献(2022 年 9 月)。有关 LPC/LAPC 中 TDM 和 DR 的文献根据以下内容进行优先排序:2012年以后、≥100名患者、期刊论文和定量数据。研究遵循 "优选报告项目"(Preferred Reporting Items Reviews and Meta-analyses)指南。证据综述:75篇文献(68项研究)报道了TDM。有 34 篇文献报道了患者参与 TDM 的情况;总体而言,患者更倾向于主动/分担角色。在 39 个影响 TDM 的因素中,年龄、种族、外部因素(最常见的是医生建议)和治疗特点/毒性是关键因素。有 49 篇文献报道了 DR。出现 DR 的患者比例因治疗类型而异:7-43%(主动监测)、12-57%(根治性前列腺切除术)、1-49%(放疗)、28-49%(雄激素剥夺疗法)和 21-47%(综合疗法)。在42个重要的DR因素中,治疗毒性(性/泌尿/肠功能障碍)、患者在TDM中的角色以及治疗类型是关键因素:影响 TDM 的关键因素是医生建议、年龄、种族和治疗特点。治疗毒性和 TDM 方法是影响 DR 的关键因素。患者摘要:我们研究了影响局部或局部晚期前列腺癌患者治疗决策(TDM)和决策后悔(DR)的因素。影响 TDM 的关键因素是医生的建议、患者的年龄/种族和治疗副作用。研究发现,患者和医生之间共同认可的 TDM 方法可限制 DR。
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来源期刊
CiteScore
15.50
自引率
2.40%
发文量
128
审稿时长
20 days
期刊介绍: Journal Name: European Urology Oncology Affiliation: Official Journal of the European Association of Urology Focus: First official publication of the EAU fully devoted to the study of genitourinary malignancies Aims to deliver high-quality research Content: Includes original articles, opinion piece editorials, and invited reviews Covers clinical, basic, and translational research Publication Frequency: Six times a year in electronic format
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