Therapiepräferenzen und Behandlungswünsche von Patient*innen mit Ösophaguskarzinom – ausgewählte Ergebnisse einer quantitativen Pilotstudie

The standard treatment for most patients with nonmetastatic esophageal cancer (EC) after neoadjuvant chemotherapy (nCT) or radiochemotherapy (nCRT) is surgery. For patients with clinically complete response to neoadjuvant therapy, active surveillance with surgery as needed may be an equivalent option in terms of survival.

In order to be able to offer patients comprehensive patient-centered information in a planned randomized controlled trial (RCT), the motives and fears/hopes of esophageal cancer (EC) patients regarding the choice of the two treatment options are investigated and factors influencing the acceptance of randomization are identified.

The pilot study was conducted in the form of a multicenter quantitative questionnaire survey administering the Preference and Decision Aid Questionnaire (PDAQ) to patients with EC. In addition, sociodemographic and psychosocial factors were evaluated in the PDAQ using standardized instruments to record anxiety (GAD7), depressive symptoms (PHQ 9), fear of progression (PA-F-KF), quality of life (EORTC QLQ-C15-PAL), and esophageal cancer-specific symptoms of the patients (EORTC QLQ-OES18). A total of 73 patients were recruited at five study centers.

Avoiding surgery and maintaining quality of life are the most important reasons for surgery if needed. The impairment of quality of life is also seen as one of the main reasons against immediate surgery. The key argument for immediate surgery is the feeling of mental relief and a subjective reassurance provided by surgical removal of the tumor.

The results provide indications of patients’ preferences and fears regarding the two treatment options and contribute to the development of recommendations for patient-centered information material, which are helpful to improve patient-centered education in the main study and therefore reduce dropout rates in the following RCT.