皮肤肿瘤学家对II期黑色素瘤辅助治疗的偏好:一项全国性的离散选择实验。

IF 3.7 4区 医学 Q1 DERMATOLOGY
Amelie Kraaz, Wiebke K Peitsch, Laura Ratusznik, Katharina Diehl, Christian Kromer, Dilan Akbarzadeh, Marthe-Lisa Schaarschmidt, Juliane Weilandt
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引用次数: 0

摘要

IIB/C期黑色素瘤的辅助治疗决策需要仔细权衡获益和风险。我们的目的是调查德国的皮肤肿瘤学家如何在这些阶段优先考虑现代佐剂的疗效、毒性和应用模式。在一项全国性的离散选择实验中,医生评估了在复发风险、严重不良事件风险、不良事件类型和给药方式等方面不同的假设治疗方案。本文介绍了两名患者的资料,包括一名55岁的IIB期(P1)健康患者和一名83岁的IIC期合并合并症(P2)患者。在86.4%的P1患者和60.5%的P2患者中,医生(n = 112)更倾向于辅助治疗而不是退出治疗。严重不良事件的风险被认为对两名患者都是最重要的,并且与P2(相对重要性评分(RIS) 53.6比40.2,p
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Preferences of Dermato-oncologists for Adjuvant Therapy in Stage II Melanoma: A Nationwide Discrete Choice Experiment.

Adjuvant treatment decisions in stage IIB/C melanoma require careful weighing of benefits and risks. Our aim was to investigate how dermato-oncologists in Germany prioritize efficacy, toxicity, and application mode of modern adjuvants in these stages. In a nationwide discrete choice experiment physicians evaluated hypothetical treatment scenarios that varied in recurrence risk, risk of severe adverse events, type of adverse events, and mode of administration. Two patient profiles were presented, including a 55-year-old healthy patient in stage IIB (P1) and an 83-year-old patient in stage IIC with comorbidity (P2). Physicians (n = 112) preferred adjuvant therapy to the opt-out option in 86.4% of scenarios for P1 and in 60.5% for P2. The risk of severe adverse events was considered most important for both patients and significantly more relevant for P2 (relative importance score (RIS) 53.6 vs 40.2, p < 0.001), while recurrence risk was more relevant for P1 (RIS 36.3 vs 21.8, p < 0.001). Immune-related adverse events were less acceptable than gastrointestinal symptoms or pyrexia. Infusions at longer intervals were favoured compared with oral therapies. In conclusion, dermato-oncologists prioritized safety over efficacy, particularly in the older, comorbid patient. These preferences should be reconciled with patients' preferences and treatment goals during shared decision-making.

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来源期刊
Acta dermato-venereologica
Acta dermato-venereologica 医学-皮肤病学
CiteScore
4.90
自引率
2.80%
发文量
210
审稿时长
6-12 weeks
期刊介绍: Acta Dermato-Venereologica publishes high-quality manuscripts in English in the field of Dermatology and Venereology, dealing with new observations on basic dermatological and venereological research, as well as clinical investigations. Each volume also features a number of Review articles in special areas, as well as short Letters to the Editor to stimulate debate and to disseminate important clinical observations. Acta Dermato-Venereologica has rapid publication times and is amply illustrated with a large number of colour photographs.
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