Abstract：
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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.
RESULTS: 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.
OBJECTIVE: Two systematic literature reviews were conducted to explore the factors associated with TDM and DR.
METHODS: 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.
RESULTS: 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.
RESULTS: 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.
摘要：
背景：局部（LPC）或局部晚期（LAPC）前列腺癌患者的治疗决策（TDM）很复杂，治疗后决策后悔（DR）很常见。驱动TDM或预测DR的因素仍未得到充分研究。
目的：进行两篇系统文献综述，探讨TDM和DR的相关因素。
方法：三个在线数据库，选择国会程序，和灰色文献进行了搜索（2022年9月）。LPC/LAPC中有关TDM和DR的出版物按以下优先顺序进行：2012年起，≥100名患者，期刊文章,和定量数据。遵循首选报告项目评论和荟萃分析指南。影响因素为p<0.05；对于TDM，被描述为“决策驱动因素”的因素，\"关联\",\"有影响力\",或“重要”也包括在内。关键因素由研究数量决定，证据的一致性,和学习质量。
结果：75篇出版物（68项研究）报道了TDM。34种出版物报道了患者参与TDM；总体而言，患者更喜欢积极/共享的角色。在39个影响TDM的因素中，年龄,种族,外部因素(医生推荐最常见)，治疗特征/毒性是关键。49种出版物报道了DR。经历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%（雄激素剥夺治疗），和21-47%（联合治疗）。在42个显著的DR因子中，治疗毒性（性/尿/肠功能障碍），患者在TDM中的作用，治疗类型是关键。
结论：影响TDM的关键因素是医生推荐，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。为了帮助患者导航影响TDM的因素并限制DR，一个共享的，患者之间的自愿TDM方法，看护者,需要医生。
结果：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,患者年龄/种族，和治疗副作用。一个共享的，发现患者和医生之间的自愿TDM方法限制了DR。
目的：进行两篇系统文献综述，探讨TDM和DR的相关因素。
方法：三个在线数据库，选择国会程序，和灰色文献进行了搜索（2022年9月）。LPC/LAPC中有关TDM和DR的出版物按以下优先顺序进行：2012年起，≥100名患者，期刊文章,和定量数据。遵循首选报告项目评论和荟萃分析指南。影响因素为p<0.05；对于TDM，被描述为“决策驱动因素”的因素，\"关联\",\"有影响力\",或“重要”也包括在内。关键因素由研究数量决定，证据的一致性,和学习质量。
结果：75篇出版物（68项研究）报道了TDM。34种出版物报道了患者参与TDM；总体而言，患者更喜欢积极/共享的角色。在39个影响TDM的因素中，年龄,种族,外部因素(医生推荐最常见)，治疗特征/毒性是关键。49种出版物报道了DR。经历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%（雄激素剥夺治疗），和21-47%（联合治疗）。在42个显著的DR因子中，治疗毒性（性/尿/肠功能障碍），患者在TDM中的作用，治疗类型是关键。
结论：影响TDM的关键因素是医生推荐，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。为了帮助患者导航影响TDM的因素并限制DR，一个共享的，患者之间的自愿TDM方法，看护者,需要医生。
结果：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,患者年龄/种族，和治疗副作用。一个共享的，发现患者和医生之间的自愿TDM方法限制了DR。
