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Title: Decision Regret in Men Undergoing Dose-Escalated Radiation Therapy for Prostate Cancer

Abstract

Purpose: Decision regret (DR) is a negative emotion associated with medical treatment decisions, and it is an important patient-centered outcome after therapy for localized prostate cancer. DR has been found to occur in up to 53% of patients treated for localized prostate cancer, and it may vary depending on treatment modality. DR after modern dose-escalated radiation therapy (DE-RT) has not been investigated previously, to our knowledge. Our primary aim was to evaluate DR in a cohort of patients treated with DE-RT. Methods and Materials: We surveyed 257 consecutive patients with localized prostate cancer who had previously received DE-RT, by means of a validated questionnaire. Results: There were 220 responses (85.6% response rate). Image-guided intensity modulated radiation therapy was given in 85.0% of patients and 3-dimensional conformal radiation therapy in 15.0%. Doses received included 73.8 Gy (34.5% patients), 74 Gy (53.6%), and 76 Gy (10.9%). Neoadjuvant androgen deprivation (AD) was given in 51.8% of patients and both neoadjuvant and adjuvant AD in 34.5%. The median follow-up time was 23 months (range, 12-67 months). In all, 3.8% of patients expressed DR for their choice of treatment. When asked whether they would choose DE-RT or AD again, only 0.5% probably or definitely wouldmore » not choose DE-RT again, compared with 8.4% for AD (P<.01). Conclusion: Few patients treated with modern DE-RT express DR, with regret appearing to be lower than in previously published reports of patients treated with radical prostatectomy or older radiation therapy techniques. Patients experienced more regret with the AD component of treatment than with the radiation therapy component, with implications for informed consent. Further research should investigate regret associated with individual components of modern therapy, including AD, radiation therapy and surgery.« less

Authors:
 [1]; ; ; ;  [1];  [1]
  1. Department of Radiation Oncology, North Coast Cancer Institute, Coffs Harbour (Australia)
Publication Date:
OSTI Identifier:
22224532
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 86; Journal Issue: 4; Other Information: Copyright (c) 2013 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANDROGENS; IMAGES; NEOPLASMS; PATIENTS; PROSTATE; RADIATION DOSES; RADIOTHERAPY; SURGERY

Citation Formats

Steer, Anna N., Aherne, Noel J., E-mail: noel.aherne@ncahs.health.nsw.gov.au, Rural Clinical School Faculty of Medicine, University of New South Wales, Coffs Harbour, Gorzynska, Karen, Hoffman, Matthew, Last, Andrew, Hill, Jacques, Shakespeare, Thomas P., and Rural Clinical School Faculty of Medicine, University of New South Wales, Coffs Harbour. Decision Regret in Men Undergoing Dose-Escalated Radiation Therapy for Prostate Cancer. United States: N. p., 2013. Web. doi:10.1016/J.IJROBP.2013.03.006.
Steer, Anna N., Aherne, Noel J., E-mail: noel.aherne@ncahs.health.nsw.gov.au, Rural Clinical School Faculty of Medicine, University of New South Wales, Coffs Harbour, Gorzynska, Karen, Hoffman, Matthew, Last, Andrew, Hill, Jacques, Shakespeare, Thomas P., & Rural Clinical School Faculty of Medicine, University of New South Wales, Coffs Harbour. Decision Regret in Men Undergoing Dose-Escalated Radiation Therapy for Prostate Cancer. United States. https://doi.org/10.1016/J.IJROBP.2013.03.006
Steer, Anna N., Aherne, Noel J., E-mail: noel.aherne@ncahs.health.nsw.gov.au, Rural Clinical School Faculty of Medicine, University of New South Wales, Coffs Harbour, Gorzynska, Karen, Hoffman, Matthew, Last, Andrew, Hill, Jacques, Shakespeare, Thomas P., and Rural Clinical School Faculty of Medicine, University of New South Wales, Coffs Harbour. Mon . "Decision Regret in Men Undergoing Dose-Escalated Radiation Therapy for Prostate Cancer". United States. https://doi.org/10.1016/J.IJROBP.2013.03.006.
@article{osti_22224532,
title = {Decision Regret in Men Undergoing Dose-Escalated Radiation Therapy for Prostate Cancer},
author = {Steer, Anna N. and Aherne, Noel J., E-mail: noel.aherne@ncahs.health.nsw.gov.au and Rural Clinical School Faculty of Medicine, University of New South Wales, Coffs Harbour and Gorzynska, Karen and Hoffman, Matthew and Last, Andrew and Hill, Jacques and Shakespeare, Thomas P. and Rural Clinical School Faculty of Medicine, University of New South Wales, Coffs Harbour},
abstractNote = {Purpose: Decision regret (DR) is a negative emotion associated with medical treatment decisions, and it is an important patient-centered outcome after therapy for localized prostate cancer. DR has been found to occur in up to 53% of patients treated for localized prostate cancer, and it may vary depending on treatment modality. DR after modern dose-escalated radiation therapy (DE-RT) has not been investigated previously, to our knowledge. Our primary aim was to evaluate DR in a cohort of patients treated with DE-RT. Methods and Materials: We surveyed 257 consecutive patients with localized prostate cancer who had previously received DE-RT, by means of a validated questionnaire. Results: There were 220 responses (85.6% response rate). Image-guided intensity modulated radiation therapy was given in 85.0% of patients and 3-dimensional conformal radiation therapy in 15.0%. Doses received included 73.8 Gy (34.5% patients), 74 Gy (53.6%), and 76 Gy (10.9%). Neoadjuvant androgen deprivation (AD) was given in 51.8% of patients and both neoadjuvant and adjuvant AD in 34.5%. The median follow-up time was 23 months (range, 12-67 months). In all, 3.8% of patients expressed DR for their choice of treatment. When asked whether they would choose DE-RT or AD again, only 0.5% probably or definitely would not choose DE-RT again, compared with 8.4% for AD (P<.01). Conclusion: Few patients treated with modern DE-RT express DR, with regret appearing to be lower than in previously published reports of patients treated with radical prostatectomy or older radiation therapy techniques. Patients experienced more regret with the AD component of treatment than with the radiation therapy component, with implications for informed consent. Further research should investigate regret associated with individual components of modern therapy, including AD, radiation therapy and surgery.},
doi = {10.1016/J.IJROBP.2013.03.006},
url = {https://www.osti.gov/biblio/22224532}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 86,
place = {United States},
year = {2013},
month = {7}
}