转移性乳腺癌患者因化疗引起的周围神经病变而决定停止治疗的影响因素：最佳-最差评分

IF 2.8 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Supportive Care in Cancer Pub Date : 2025-05-10 DOI:10.1007/s00520-025-09508-4

Rotana M Radwan, John F P Bridges, Daniel L Hertz, Maryam B Lustberg, Hetal Vachhani, Erin Hickey Zacholski, Vanessa B Sheppard, Teresa M Salgado

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引用次数: 0

摘要

目的：测量影响转移性乳腺癌（mBC）患者因化疗诱导的周围神经病变（CIPN）而决定停止治疗的因素的重要性。方法：在美国的mBC和经历CIPN的女性中进行了一项包含最佳最差量表（BWS）的在线调查。在BWS中，女性选择了影响其决定因CIPN停止治疗的最重要和最不重要的因素。七个因素包括：缓解当前的神经病变症状，降低长期神经病变的风险，有另一种癌症治疗选择，了解停止治疗的风险，从肿瘤科医生、亲人或有类似经历的患者那里获得停止治疗的支持。为了衡量每个因素的重要性，一个条件logit模型估计系数，这些系数随后被重新缩放为重要性分数，总和为100。因变量是在七个选择任务中选择一个最重要或最不重要的因素。结果：样本包括189名女性，平均年龄为52.5岁（SD = 12.65），白人占52.9%，黑人占33.9%，本科及以上学历占64.6%。当面临因CIPN而决定停止治疗时，最重要的因素是是否有其他癌症治疗方案（得分23.5），其次是了解停止治疗的风险（得分19.2），以及降低长期神经病变的风险（得分19.1）。在决定因CIPN而停止治疗时，最不重要的因素是：亲人的支持（得分5.2）和其他患者的支持（得分3.3）。结论：当面临因CIPN而停止治疗的决定时，mBC女性更重视生存和降低长期CIPN的风险。了解对患者最重要的是什么，可能有助于共同决策，以优化接受神经毒性化疗的患者的治疗结果。

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Factors influencing the decision to discontinue treatment due to chemotherapy-induced peripheral neuropathy among patients with metastatic breast cancer: a best-worst scaling.

Purpose: To measure the importance of factors that influence the decision to discontinue treatment due to chemotherapy-induced peripheral neuropathy (CIPN) among patients with metastatic breast cancer (mBC).

Methods: An online survey incorporating a best-worst scaling (BWS) was conducted among women in the USA with mBC and experiencing CIPN. In the BWS, women chose the most and least important factors influencing their decision to discontinue treatment due to CIPN. Seven factors were included: relieving current neuropathy symptoms, reducing risk of long-term neuropathy, having another cancer treatment option, understanding the risk of treatment discontinuation, and receiving support for treatment discontinuation from the oncologist, loved ones, or patients with similar experiences. To measure the importance of each factor, a conditional logit model estimated coefficients, which were subsequently rescaled to importance scores that summed to 100. The dependent variable was the choice of a factor as most or least important across seven choice tasks.

Results: The sample included 189 women with a mean age of 52.5 (SD = 12.65) years, 52.9% were White, 33.9% were Black, and 64.6% held a bachelor's degree or higher. When faced with the decision to discontinue treatment due to CIPN, the most important factors were having another cancer treatment option (score 23.5), followed by understanding the risk of treatment discontinuation (score 19.2), and reducing risk of long-term neuropathy (score 19.1). The least important factors in the decision to discontinue treatment due to CIPN were: support from loved ones (score 5.2) and support from other patients (score 3.3).

Conclusion: When faced with the decision to discontinue treatment due to CIPN, women with mBC attributed more importance to survival and reducing the risk of long-term CIPN. Knowledge of what matters most to patients may assist with shared decision-making to optimize therapeutic outcomes in patients receiving neurotoxic chemotherapy.

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来源期刊

Supportive Care in Cancer 医学-康复医学

CiteScore

5.70

自引率

9.70%

发文量

751

审稿时长

3 months

期刊介绍： Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.