Patient's preferences for adjuvant postoperative chemoradiation therapy in rectal cancer.

Abstract

This study was designed to elicit patient's preferences with regard to adjuvant postoperative chemoradiation therapy in rectal cancer. Forty-seven previously treated colorectal cancer patients underwent a structured interview and were presented with two scenarios involving surgery for rectal cancer: surgery alone, or surgery followed by postoperative chemoradiation therapy. Acute and long-term health states for each options were described. Their willingness to trade-off side-effects for treatment efficacy was evaluated by using the probability trade-off method. The age and gender distribution of the cohort were comparable with the general colon cancer population. Rectal cancer had been diagnosed in 20 individuals. The majority of patients valued their disease-free status in light of the anticipated long-term effects on their quality of life. The median point at which patients switched their preference was 5 percent, a value reflecting the critical local recurrence rate acceptable. The important items that influenced decisions were the effects on bowel function and fear of recurrence. This small study demonstrates a substantial variation in patient's preferences with regard to postoperative chemoradiation for rectal cancer. Further studies in the preoperative setting are warranted.