癌症患者在治疗方面面临艰难的决定,以及用生命质量(QoL)换取生命长度(LoL)的可能性。关于患者对癌症治疗的偏好和态度以及他们准备交换以延长寿命的个人成本的信息很少。这篇综述的目的是确定复杂的权衡和基础因素,使癌症患者选择质量而不是生命数量。
使用MeSH术语:癌症,长寿或LoL,QoL,决策,权衡,和健康效用。检索到的文章发表于1942年至2018年10月之间。
在4393篇文章中,这次审查包括30名。年纪大了,这可能与身体状况下降有关,与QoL优先于LoL相关。年轻患者更有可能接受积极治疗以增加生存年限。对QoL和LoL的偏好不受性别影响,教育,宗教,有孩子,婚姻状况,或癌症类型。健康状况较好的患者重视LoL,而身体状况较差的患者则倾向于QoL。
基线QoL和未来生活期望似乎是癌症患者对QoL和LoL偏好的关键决定因素。需要深入研究来了解这些权衡,以及患者愿意就QoL或LoL做出的妥协,特别是在预期寿命自然有限的老年患者中。
Patients with cancer face difficult decisions regarding treatment and the possibility of trading quality of life (QoL) for length of life (LoL). Little information is available regarding patients\' preferences and attitudes toward their cancer treatment and the personal costs they are prepared to exchange to extend their life. The aim of this
review is to determine the complex trade-offs and underpinning factors that make patients with cancer choose quality over quantity of life.
A systematic
review of the literature was conducted using MeSH terms: cancer, longevity or LoL, QoL, decision making, trade-off, and health utility. Articles retrieved were published between 1942 and October 2018.
Out of 4393 articles, 30 were included in this
review. Older age, which may be linked to declining physical status, was associated with a preference for QoL over LoL. Younger patients were more likely to undergo aggressive treatment to increase survival years. Preference for QoL and LoL was not influenced by gender, education, religion, having children, marital status, or type of cancer. Patients with better health valued LoL and inversely those with poorer physical status preferred QoL.
Baseline QoL and future expectations of life seem to be key determinants of preference for QoL versus LoL in cancer patients. In-depth studies are required to understand these trade-offs and the compromises patients are willing to make regarding QoL or LoL, especially in older patients with naturally limited life expectancy.