The patient's perspective on radiation for rectal cancer: Initial expectations versus actual experience

IF 2.9 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2023-09-29 DOI:10.1002/cam4.6541

Basil H. Chaballout, Eric M. Chang, Narek Shaverdian, Percy P. Lee, Phillip J. Beron, Michael L. Steinberg, Ann C. Raldow

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Abstract

Background

The aim of this study was to compare patient perceptions of radiotherapy (RT) before and after treatment to better inform future patients and providers.

Methods

Seventy-eight consecutive patients with rectal adenocarcinoma treated with neo- or adjuvant chemoradiation, surgical resection, and adjuvant chemotherapy from 2009 to 2018 and who were without recurrence were included. Patients were surveyed ≥6 months after ileostomy reversal or ≥3 months after adjuvant chemotherapy. The survey assessed patients' baseline knowledge and fears of RT, how their short- and long-term side effects compared with initial expectations, and how their experiences compared for each modality (RT, surgery, and chemotherapy).

Results

Forty patient-responses were received. Before treatment, 70% of patients indicated little to no knowledge of RT, though 43% reported hearing frightening stories about RT. The most commonly top-ranked fears included organ damage (26%), skin burns (14%), and inability to carry out normal daily activities (10%). Eighty percent reported short-term effects of RT to be less than or as expected, with urinary changes (93%), abdominal discomfort (90%), and anxiety (88%) most commonly rated as less than or as expected. 85% reported long-term effects to be less than or as expected, with pain (95%), changes to the appearance of the treated area (85%), and dissatisfaction with body image (80%) most commonly rated as less than or as expected. Surgery was most commonly rated as the most difficult treatment (50%) and most responsible for long-term effects (55%). RT was least commonly rated as the most difficult treatment (13%), and chemotherapy was least commonly rated as most responsible for long-term effects (13%).

Conclusions

The majority of patients indicated short- and long-term side effects of RT for rectal cancer to be better than initial expectations. In the context of trimodality therapy, patients reported RT to be the least difficult of the treatments.

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患者对癌症放射治疗的看法：初步预期与实际经验。

背景：本研究的目的是比较患者在治疗前后对放疗的看法，以更好地为未来的患者和提供者提供信息。方法：纳入2009年至2018年连续78例接受新或辅助放化疗、手术切除和辅助化疗且无复发的直肠腺癌患者。调查的患者≥6人回肠造口术后数月或≥3 辅助化疗后数月。该调查评估了患者对RT的基线知识和恐惧，他们的短期和长期副作用与最初的预期相比如何，以及他们对每种方式（RT、手术和化疗）的体验如何比较。结果：收到了40名患者的回复。在治疗前，70%的患者表示对RT知之甚少或一无所知，尽管43%的患者表示听到了关于RT的可怕故事。最常见的恐惧包括器官损伤（26%）、皮肤烧伤（14%）和无法进行正常日常活动（10%）。80%的患者报告RT的短期影响小于或如预期，其中泌尿系统变化（93%）、腹部不适（90%）和焦虑（88%）最常见，低于或如预期。85%的患者报告长期效果低于或如预期，疼痛（95%）、治疗区域外观变化（85%）和对身体形象的不满意（80%）最常见的评分低于或如预计。手术通常被认为是最困难的治疗方法（50%），对长期影响最负责任（55%）。RT被最不常见地评为最困难的治疗（13%），化疗被最不常用地评为对长期效果最负责（13%）。结论：大多数患者表示RT对癌症的短期和长期副作用好于最初的预期。在三模态治疗的背景下，患者报告RT是治疗中难度最小的。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.