背景:了解肝细胞癌(HCC)的患者旅程可能会为未来的临床决策提供信息并增强患者体验。这项研究的目的是探讨肝癌患者的经验与治疗方案的关系,在整个疾病旅程中的治疗决策和治疗目标。这项研究还旨在确定早期HCC的症状和影响,中晚期肝癌。
方法:对n=50的HCC患者和n=12的具有治疗HCC患者经验的医疗保健专业人员(HCPs)进行了60分钟的半结构化访谈。使用定向内容分析技术和混合归纳和演绎方法对访谈数据进行了分析。对患者的症状体验进行概念饱和评估。
结果:患者将治疗决定描述为主要由HCP主导。在这项研究中,手术/切除是HCC旅程中最常见的治疗选择,大多数患者对提供给他们的治疗方案感到满意。总的来说,患者将延长总生存期(OS)和维持生活质量(QoL)作为最重要的治疗目标,诊断为晚期/不可切除的HCC患者优先考虑QoL。尽管据报道,随着HCC的进展,QoL变得更加重要,但HCP也优先考虑OS和无进展生存期(PFS)。患者在HCC旅程中经历了各种症状,包括疲劳,恶心,食欲减退,腹泻和疼痛。
结论:总体而言,HCP和患者在整个治疗过程中就治疗决策和共同的治疗目标进行合作。OS对患者和HCP至关重要,尽管治疗目标可能会根据各种临床因素而改变。
肝癌是全球癌症死亡的第三大原因。很少有研究直接探索患者如何经历肝癌及其治疗。进行这项研究是为了了解肝癌患者的经历,包括治疗决定和目标,患者和治疗医生之间的沟通动态,提供给患者的治疗类型和患者在患有肝癌时经历的症状。采访了患者和医生,以了解他们与肝癌一起生活和治疗肝癌的经验。总的来说,病人和医生一起决定治疗。在为他们选择最佳治疗时,患者通常信任医生的知识和专业知识。治疗决定主要基于癌症进展的程度。患者将寿命延长和保持良好的生活质量描述为他们最重要的治疗目标。以及避免肝癌复发或恶化。医生发现病人寿命更长,时间不恶化的肝癌和管理副作用作为重要的治疗目标。
BACKGROUND: Understanding the patient journey of hepatocellular carcinoma (HCC) may inform future clinical decision-making and enhance the patient experience. The objectives of this
study were to explore the patient experience of HCC in relation to treatment options, treatment decision-making and treatment goals throughout the disease journey. This
study also aimed to determine the symptoms and impacts of HCC across early, intermediate and advanced HCC.
METHODS: Semi-structured 60-min interviews were conducted with n = 50 patients with HCC and n = 12 healthcare professionals (HCPs) with experience of treating patients with HCC. Interview data were analyzed using directed content analysis techniques with a hybrid inductive and deductive approach. An assessment of conceptual saturation was conducted for patients\' symptom experience.
RESULTS: Patients described treatment decisions as mostly HCP-led. In this
study, surgery/resection was the most frequently offered treatment option across the HCC journey, and most patients were satisfied with the treatment options presented to them. Overall, patients described extending their overall survival (OS) and preserving quality of life (QoL) as their most important treatment goals, with patients diagnosed with advanced/unresectable HCC prioritizing QoL. HCPs also prioritized OS and progression-free survival (PFS) though reported that QoL became more important as HCC progressed. Patients experienced various symptoms across the HCC journey including fatigue, nausea, appetite loss, diarrhea and pain.
CONCLUSIONS: Overall, HCPs and patients collaborate throughout the treatment journey regarding treatment decisions and shared treatment goals. OS is critically important to patients and HCPs, though treatment goals may change depending on various clinical factors.
Liver cancer is the third leading cause of cancer death worldwide. Very few studies have directly explored how patients experience liver cancer and its treatment. This research was performed to understand the patient experience of liver cancer including treatment decisions and goals, communication dynamics between patients and their treating doctors, the types of treatment offered to patients and symptoms that patients experience while living with liver cancer. Patients and doctors were interviewed to understand their experience of living with and treating liver cancer. Overall, patients and doctors work together to decide on treatment. Patients generally trusted their doctor’s knowledge and expertise when selecting the best treatment(s) for them. Treatment decisions are mostly based on how far along the cancer has progressed. Patients described living longer and maintaining a good quality of life as their most important treatment goals, as well as avoiding liver cancer returning or worsening. Doctors identified that patients living longer, time without worsening of liver cancer and managing side effects as important treatment goals.