Palliative radiotherapy (PRT) is central to symptom control in advanced cancer, yet referrals are often late, and patients and clinicians frequently hold misconceptions about intent, benefits, and logistics. Patient education may address these gaps, but the PRT-specific evidence base has not been consolidated. We conducted a narrative review following SANRA guidance. We searched PubMed, Scopus, and the Cochrane Library for English-language studies from 1 January 2000 to 18 July 2025. Eligible articles evaluated structured patient-education interventions or characterized education or communication content, information needs, or decision processes among adults referred to or receiving PRT. Two reviewers independently screened and extracted data. Owing to heterogeneity of designs and endpoints, we performed a narrative synthesis without meta-analysis. Six studies met criteria: two randomized controlled trials, two prospective pre–post studies, one qualitative interview study, and one observational communication study, conducted in the Netherlands, the United States, Canada, and Hong Kong. Education at referral or consultation improved knowledge, reduced decisional uncertainty, and increased readiness to proceed with PRT. Education integrated with treatment improved symptom outcomes, including higher rates of pain control at 12 weeks and faster time to pain control when a nurse-led pain-education program accompanied PRT for painful bone metastases, and improvements in dyspnea, fatigue, anxiety, and function in advanced lung cancer. Observational and qualitative work showed low patient question-asking and persistent curative expectations; overall quality of life generally did not change. Although the evidence is limited and heterogeneous, targeted, standardized education appears to improve decision quality and selected symptoms in PRT pathways. Pragmatic multi-site trials and implementation studies are needed to define content, timing, personnel, and delivery models that are scalable in routine care.
姑息性放疗（PRT）是晚期癌症症状控制的核心手段，但转诊常被延迟，且患者与临床医生对其治疗目的、获益及实施流程普遍存在误解。患者教育或可弥补这些认知差距，但针对PRT的专项证据尚未系统整合。本研究依据SANRA指南进行了叙述性综述，检索了PubMed、Scopus及Cochrane图书馆中2000年1月1日至2025年7月18日发表的英文文献。纳入标准为评估结构化患者教育干预措施，或描述PRT转诊/接受阶段成人患者的教育/沟通内容、信息需求及决策过程的文章。由两名评审员独立完成文献筛选与数据提取。鉴于研究设计与终点的异质性，采用叙述性综合法进行分析，未进行荟萃分析。 共纳入六项研究：两项随机对照试验、两项前瞻性前后对照研究、一项定性访谈研究及一项观察性沟通研究，分别来自荷兰、美国、加拿大和香港地区。结果显示：在转诊或咨询阶段开展教育能提升患者知识水平、降低决策不确定性并增强接受PRT的意愿；结合治疗实施的教育可改善症状结局——针对疼痛性骨转移患者，护士主导的疼痛教育项目联合PRT能提高12周疼痛控制率并加速疼痛缓解；在晚期肺癌患者中，教育干预可改善呼吸困难、疲劳、焦虑及功能状态。观察性与定性研究显示患者提问积极性较低，且常持续抱有治愈性期望；总体生活质量通常未见显著变化。 尽管现有证据有限且存在异质性，针对性、标准化的教育似乎能提升PRT路径中的决策质量并改善特定症状。未来需开展多中心实效性试验与实施性研究，以明确适用于常规临床场景的可推广教育内容、时机、人员配置及实施模式。
Patient Education and Communication in Palliative Radiotherapy: A Narrative Review
肿瘤(癌症)患者之家