“Even if I Don’t Remember, I Feel Better”. A Qualitative Study of Patients with Early-Stage Non–Small Cell Lung Cancer Undergoing Stereotactic Body Radiotherapy or Surgery

Golden, Sara E.; Thomas, Charles R.; Deffebach, Mark; Sukumar, Mithran S.; Schipper, Paul H.; Tieu, Brandon H.; Kee, Andrew Y.; Tsen, Andrew C.; Slatore, Christopher G.

doi:10.1513/annalsats.201602-130oc

Cited by 13 publications

(8 citation statements)

References 41 publications

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“…While there is no prospective trial data comparing metastatectomy vs SBRT for sarcoma lung metastases, small retrospective series show high local control rates, comparable with that of surgery, suggesting that SBRT can have an important role in the treatment of this disease. SBRT is particularly appealing for patients who are not fit for surgery, decline surgery, or who are not good candidates for the longer interruption in systemic therapy usually required following a major surgery 24 . SBRT is also suited to treat central nodules that would require larger anatomic resections (lobectomy or pneumonectomy) or to manage recurrences after prior resection.…”

Section: Discussionmentioning

confidence: 99%

Multi‐institutional analysis of stereotactic body radiotherapy for sarcoma pulmonary metastases: High rates of local control with favorable toxicity

Baumann

Bernstein

DeLaney

et al. 2020

Journal of Surgical Oncology

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Background/Objectives Oligometastatic sarcoma pulmonary metastases (PM's) are traditionally treated with resection and/or chemotherapy. We hypothesize that stereotactic body radiotherapy (SBRT) is an effective, safe alternative to surgery that can achieve excellent local control (LC) with a favorable toxicity profile. Methods Patients treated with SBRT for sarcoma PM's from 2011 to 2016 at Massachusetts General Hospital and the University of Pennsylvania were included. Median dose was 50 Gy. Patients underwent computed tomography (CT) or positron emission tomography/CT Q3 months post‐SBRT. Results 44 patients with 56 separate PM's were treated with SBRT. Median age was 59 (range 19‐82). 82% received prior chemotherapy, 66% had prior pulmonary resections (range, 1‐5 resections), and 32% received prior thoracic radiotherapy. Median lesion size was 2.0 cm (range, 0.5‐8.1 cm). Median follow‐up was 16 months and 25 months for patients alive at last follow‐up. Overall survival at 12 and 24 months was 74% (95% confidence interval [CI], 67%‐81%) and 46% (95% CI, 38%‐55%). LC at 12 and 24 months was 96% (95% CI, 93%‐98%) and 90% (95% CI, 84%‐96%). LC and overall survival did not differ based on age, gender, histology, fractionation, lesion location, or size (P > .05). Three developed Common Terminology Criteria for Adverse Events version 4 grade‐2 chest‐wall toxicities; one had grade‐2 pneumonitis. Conclusions In the first multi‐institutional series on SBRT for sarcoma PM's, SBRT has excellent LC and is well‐tolerated. SBRT should be considered as an alternative/complement to resection.

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Section: Discussionmentioning

confidence: 99%

Multi‐institutional analysis of stereotactic body radiotherapy for sarcoma pulmonary metastases: High rates of local control with favorable toxicity

Baumann

Bernstein

DeLaney

et al. 2020

Journal of Surgical Oncology

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“…Studies have suggested that current guidelines for patient-clinician discussions (i.e., conversations about results) are inadequate to change smoking behaviours [ 20 , 40 ]. However, when coupled with specialist interventions (e.g., telephone counselling) or intensive and personalised cessation advice, they were more likely to quit [ 12 , 20 , 40 ]. This suggests that delivering effective discussions can instigate behaviour change.…”

Section: Discussionmentioning

confidence: 99%

Patients’ Views on Medical Events in Lung Cancer Screening as Teachable Moments for Smoking Behaviour Change: A Systematic Review and Metasynthesis

Vikram,

Muller,

Hulme

et al. 2023

J. Smok Cessat

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Although medical events in lung cancer screening (LCS) such as receiving scan results or interactions with clinicians are recognised as teachable moments (TMs), the views of patients about why this is the case for smoking behaviour change remain uncertain. This systematic review and metasynthesis study is aimed at identifying the reasons why patients believed that medical events during LCS act as TMs for smoking behaviour change. A search strategy was developed for use with MEDLINE, PsycINFO, EMBASE, CINAHL-P, Web of Science databases, and Google Scholar. This helped identify qualitative and mixed-method research which mentioned patients’ views of how these TMs result in smoking behaviour change. After screening, final articles were critically appraised; general characteristics and data relevant to the aims were extracted to conduct a line-of-argument metasynthesis. After screening 695 papers, 11 were included. Undergoing LCS scans was seen to act on their intrinsic motivation to reduce smoking as it served as a “wake-up call” and increased awareness of the health consequences of smoking. Receiving positive or negative LCS results resulted in cessation as it was a “health scare” and challenged smoking habits. Interactions with clinicians addressed misconceptions and signposted them to specialist cessation services. Attendees believed that the following encouraged them to change their smoking behaviour: having an intrinsic motivation to quit, their beliefs on smoking and health reframed, their negative emotions appraised, and using LCS to access specialist support. In line with the TM heuristic, these experiences provided the necessary skills, confidence, and motivation to quit. Future research should explore whether the views of the clinicians match those of the attendees to address misconceptions and further develop clinical guidelines.

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“…The first publication from this effort was a qualitative content analysis of interviews with 13 patients with earlystage NSCLC focused on their feelings of distress, satisfaction with provider communication, and their understanding of their diagnoses and treatment recommendations. 12 Although patients were generally pleased with their role in the decision-making process, they did not recall seeing both surgeons and radiation oncologists before their treatment and were rarely told about all of their treatment options. Furthermore, patients were frequently unable to remember specifics about their recommended treatment course and often felt that clinicians did not specifically address their concerns.…”

Section: Patientephysician Treatment Discussionmentioning

confidence: 99%

Informed Consent in Radiation Oncology

Gutiontov

Golden

McCloskey

et al. 2021

International Journal of Radiation Oncology*Biology*Physics

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“Even if I Don’t Remember, I Feel Better”. A Qualitative Study of Patients with Early-Stage Non–Small Cell Lung Cancer Undergoing Stereotactic Body Radiotherapy or Surgery

Cited by 13 publications

References 41 publications

Multi‐institutional analysis of stereotactic body radiotherapy for sarcoma pulmonary metastases: High rates of local control with favorable toxicity

Multi‐institutional analysis of stereotactic body radiotherapy for sarcoma pulmonary metastases: High rates of local control with favorable toxicity

Patients’ Views on Medical Events in Lung Cancer Screening as Teachable Moments for Smoking Behaviour Change: A Systematic Review and Metasynthesis

Informed Consent in Radiation Oncology

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