Systemische behandeling bij gemetastaseerde longkanker

Objective

Lung cancer has a high impact on both patients and relatives due to the high disease burden and short life expectancy. We studied the perspectives of relatives in hindsight on the achievement of treatment goals and the choice to start systemic treatment for metastatic lung cancer of their loved one.

Design

Structured telephone interview study.

Method

Between February 2017 and November 2019 we interviewed 118 relatives of deceased patients diagnosed with metastatic lung cancer from 1 academic and 5 non-academic hospitals. Patients were treated with systemic medication and completed a questionnaire on their treatment goals before the start of treatment and when treatment was finished. We asked the relatives about the achievement of patients’ treatment goals and relatives’ satisfaction with the choice to start treatment.

Results

Relatives reported the goals ‘quality of life’, ‘decrease tumour size’ and ‘life prolongation’ as achieved in 21%, 37% and 41% respectively. The majority of the relatives (78%) were satisfied with the choice to start a treatment and even when none of the goals were achieved, 70% of the relatives were satisfied. About 50% of relatives who were satisfied with the patients’ choice mentioned negative aspects of the treatment choice.

Conclusion

The majority of relatives reported patients’ treatment goals as not achieved. However, relatives were predominantly satisfied about the treatment choice. Satisfaction does not provide a full picture of the experience with the treatment decision considering that the majority of relatives mentioned (also) negative aspects of this decision. At the time of making the treatment decision it is important to manage expectations about the chance of success and the possible side effects of the treatment.

Conflict of interest and financial support: none declared.