Trading treatment toxicity for survival in locally advanced non-small cell lung cancer

Title

Trading treatment toxicity for survival in locally advanced non-small cell lung cancer

Creator

Brundage MD; Davidson JR; Mackillop WJ

Publisher

Journal Of Clinical Oncology

Date

1997

Subject

Female; Humans; Male; Aged; Middle Aged; Patient Satisfaction; Non-U.S. Gov't; Research Support; Carcinoma; Radiotherapy/adverse effects; Antineoplastic Combined Chemotherapy Protocols/adverse effects; Combined Modality Therapy/psychology; Lung Neoplasms/mortality/pathology/psychology/therapy; Non-Small-Cell Lung/mortality/pathology/psychology/therapy; Prostatic Neoplasms/mortality/pathology/psychology/therapy; Radiotherapy Dosage

Description

PURPOSE: To determine how patients weigh potential survival benefits against the potential toxicity of different treatment strategies for locally advanced non-small cell lung cancer (NSCLC). Specifically, we were interested in what improvement in survival probability patients would want to have before accepting more toxic therapy. PATIENTS AND METHODS: Fifty-six outpatients who had experienced lung cancer (n = 22) or prostate cancer (n = 34), and 20 clinic nurses and radiation therapy technologists participated. A treatment trade-off interview was conducted with each participant that compared low-dose versus high-dose radiotherapy and high-dose radiotherapy versus combination chemo-radiotherapy. Preferences for treatments were assessed by systematically increasing the hypothetical survival advantage of the more toxic treatment until the person reached his or her threshold for choosing the more toxic treatment. RESULTS: A wide range of thresholds was observed for both groups. The distributions of survival advantage thresholds for lung cancer and prostate cancer patients were not significantly different but were generally lower thresholds than those declared by staff. If the 3-year survival advantage was 10%, 60% of patients and 15% of staff would consider combination therapy over high-dose radiotherapy. Within patients, apparent willingness to consider more toxic treatments was not significantly related to age, sex, education, or preferred role in decision making. The treatment trade-off method had good test-retest reliability. CONCLUSION: There is great interindividual variability in willingness to accept aggressive treatments for locally advanced NSCLC. When choosing NSCLC treatment, each patient should be provided with comprehensive information about the options so that he or she may express his or her preferences should he or she wish to participate in the decision.
1997

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

330-340

Issue

1

Volume

15

Citation

Brundage MD; Davidson JR; Mackillop WJ, “Trading treatment toxicity for survival in locally advanced non-small cell lung cancer,” Pediatric Palliative Care Library, accessed September 23, 2021, https://pedpalascnetlibrary.omeka.net/items/show/11811.

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