Patient attitudes towards chemotherapy as assessed by patient versus physician: A prospective observational study in advanced non-small cell lung cancer

Chu, Da Tong; Kim, Sang We; Kuo, Han Pin; Özacar, Rıfat; Salajka, František; Krishnamurthy, Sairam; Damyanov, Danail; Altuǧ, Sedat; Reece, William H. H.; Wang, Li

doi:10.1016/j.lungcan.2007.01.028

Cited by 27 publications

(20 citation statements)

References 21 publications

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“…The trade-offs that patients with lung cancer are willing to accept for treatments such as chemotherapy vary widely. [147][148][149] Physician presumptions about which trade-offs patients with NSCLC are willing to accept may not always be accurate or may not align with patientreported attitudes. 147 Patients with lung cancer may overestimate the survival benefits of potentially toxic treatment.…”

Section: 144mentioning

confidence: 99%

American Society of Clinical Oncology Clinical Practice Guideline Update on Chemotherapy for Stage IV Non–Small-Cell Lung Cancer

Azzoli

Baker²,

Temin³

et al. 2009

JCO

701

336

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The purpose of this article is to provide updated recommendations for the treatment of patients with stage IV non–small-cell lung cancer. A literature search identified relevant randomized trials published since 2002. The scope of the guideline was narrowed to chemotherapy and biologic therapy. An Update Committee reviewed the literature and made updated recommendations. One hundred sixty-two publications met the inclusion criteria. Recommendations were based on treatment strategies that improve overall survival. Treatments that improve only progression-free survival prompted scrutiny of toxicity and quality of life. For first-line therapy in patients with performance status of 0 or 1, a platinum-based two-drug combination of cytotoxic drugs is recommended. Nonplatinum cytotoxic doublets are acceptable for patients with contraindications to platinum therapy. For patients with performance status of 2, a single cytotoxic drug is sufficient. Stop first-line cytotoxic chemotherapy at disease progression or after four cycles in patients who are not responding to treatment. Stop two-drug cytotoxic chemotherapy at six cycles even in patients who are responding to therapy. The first-line use of gefitinib may be recommended for patients with known epidermal growth factor receptor (EGFR) mutation; for negative or unknown EGFR mutation status, cytotoxic chemotherapy is preferred. Bevacizumab is recommended with carboplatin-paclitaxel, except for patients with certain clinical characteristics. Cetuximab is recommended with cisplatin-vinorelbine for patients with EGFR-positive tumors by immunohistochemistry. Docetaxel, erlotinib, gefitinib, or pemetrexed is recommended as second-line therapy. Erlotinib is recommended as third-line therapy for patients who have not received prior erlotinib or gefitinib. Data are insufficient to recommend the routine third-line use of cytotoxic drugs. Data are insufficient to recommend routine use of molecular markers to select chemotherapy.

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Section: 144mentioning

confidence: 99%

American Society of Clinical Oncology Clinical Practice Guideline Update on Chemotherapy for Stage IV Non–Small-Cell Lung Cancer

Azzoli

Baker²,

Temin³

et al. 2009

JCO

701

336

View full text Add to dashboard Cite

show abstract

“…A systematic review of four studies quantifying the survival benefits judged sufficient to make chemotherapy worthwhile found that smaller benefits were judged sufficient for NSCLC that was metastatic rather than locally advanced, broadly implying that smaller benefits may be sufficient when the baseline prognosis is worse [2] which may further widen the disparity between physician and patient perceptions of the value of chemotherapy. A large international study comparing patients' and physicians' assessments of the patients' attitudes towards treatment found that patients were much more likely to classify themselves as desiring a maximum extension of survival with high acceptance of toxicity than were physicians (60% vs 29%), while physicians were more likely to categories patients as prioritizing primary symptom relief than the patients themselves (29% vs 14%) [3].…”

Section: Perceptions Of Lung Cancer Patients: Balancing Risks and Benmentioning

confidence: 99%

“…Previous experience of chemotherapy also seems to influence treatment choice. Chu et al [3] described that differences in outlook towards lung cancer are influenced by experience with chemotherapy such that chemonaive patients underestimate the extent of toxicity associated with chemotherapy whilst physicians experienced in the area were more focused on avoidance of this toxicity and as such underestimated patients' ability to cope.…”

Section: Perceptions Of Lung Cancer Patients: Balancing Risks and Benmentioning

confidence: 99%

“…Lung cancer has a poor prognosis predominately due to advanced stage of disease at presentation and associated co-morbidities [3,4]. Current evidence and clinical guidelines recommend chemotherapy for all stages of lung cancer, however in practice, the prescription of chemotherapy for lung cancer patients remains inconsistent and varies significantly both nationally and internationally [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Decisions for lung cancer chemotherapy: the influence of physician and patient factors

Davidson

Jiwa

Goldsmith

et al. 2011

Support Care Cancer

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Results: Wide variability in perceptions of the value of chemotherapy in lung cancer is present among both physicians and patients. There is a mismatch in the degree patients and physicians weigh survival, such that patients value survival benefits highly whilst physicians strongly emphasize toxicity and associated symptoms. This lack of congruence between patients and clinicians is influenced by a range of factors and has implications for treatment decisions, long-term survival and quality of life in people affected by lung cancer. Conclusion:The divergence of treatment priorities indicates a need for improved communication strategies addressing the needs and concerns of both patients and clinicians. Patients should understand the benefits and risks of treatment options while clinicians can gain a greater awareness of factors influencing patients' decisions on treatments. Reflecting these perspectives and patient preferences for lung cancer treatment in clinical guidelines may improve clinician awareness.

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“…Survival in our observational study was also compared to three recent randomized clinical trials (RCTs) [11][12][13]. The results of the study's secondary objective, which focused on the extent of differences between patient-assessed and physician-assessed attitudes to chemotherapy, have been recently published [14].…”

Section: Introductionmentioning

confidence: 99%

Patient attitudes towards chemotherapy and survival: A prospective observational study in advanced non-small cell lung cancer

et al. 2009

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Patient attitudes towards chemotherapy as assessed by patient versus physician: A prospective observational study in advanced non-small cell lung cancer

Cited by 27 publications

References 21 publications

American Society of Clinical Oncology Clinical Practice Guideline Update on Chemotherapy for Stage IV Non–Small-Cell Lung Cancer

American Society of Clinical Oncology Clinical Practice Guideline Update on Chemotherapy for Stage IV Non–Small-Cell Lung Cancer

Decisions for lung cancer chemotherapy: the influence of physician and patient factors

Patient attitudes towards chemotherapy and survival: A prospective observational study in advanced non-small cell lung cancer

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