Development of an online, patient-centred decision aid for patients with oropharyngeal cancer in the transoral robotic surgery era

J.S. Lam, G.M. Scott, D.A. Palma, K. Fung, A.V. Louie

Abstract


Background  

Radiotherapy (rt) has been the standard treatment for early oropharyngeal cancer, achieving excellent outcomes, but with significant toxicities. Transoral robotic surgery (tors) has emerged as a promising alternative. A decision aid (da) can help to establish patient treatment preferences.

Methods

A da was developed and piloted in 40 healthy adult volunteers. Assuming equal oncologic outcomes of the treatments, participants indicated their preference. The treatment trade-off point was then established, and participant perceptions were elicited.

Results

More than 80% of participants initially selected tors for treatment, regardless of facilitator background. For all participants, the treatment trade-off point changed after an average 15% cure benefit. Treatment toxicities, duration, novelty, and perceptions all influenced treatment selection. All subjects valued the da.

Conclusions

A da developed for early oropharyngeal cancer treatment holds promise in the era of shared decision making. Assuming equal cure rates, tors was preferred over rt by healthy volunteers.

Keywords


Oropharyngeal cancer; decision aids; shared decision-making; transoral robotic surgery; radiation therapy

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DOI: http://dx.doi.org/10.3747/co.24.3669






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ISSN: 1198-0052 (Print) ISSN: 1718-7729 (Online)