Möller Torgil R, Brorsson Bengt, Ceberg Jeanette, Frödin Jan-Erik, Lindholm Christer, Nylén Urban, Perfekt Roland
Oncological Centre, Lund University Hospital, Lund, Sweden.
Acta Oncol. 2003;42(5-6):387-410. doi: 10.1080/02841860310011131.
A prospective survey of radiotherapy practice in Sweden was conducted during 12 weeks in the autumn of 2001. All hospitals that provided radiotherapy participated, and all patients who started radiotherapy during the study period were included. The final patient sample comprised 5,105 treatments given to 4,171 patients. The results were compared with those of a similar survey conducted in 1992, and the following conclusions were drawn: A substantial increase in the use of radiotherapy was noted; The estimated proportion of cancer cases receiving radiotherapy (compared to the incident number of cases) had increased from 32% in 1992 to 47%; The proportion of cancer patients receiving radiotherapy was estimated at between 37 and 46%; 54% of treatments were given with curative intent, a small increase since 1992; The difference between regional and county departments for proportion of treatments with curative intent had diminished; Treatments with curative intent used a higher proportion of resources measured in terms of fractions; The proportion of palliative treatment was slightly lower than in 1992, but the absolute number of treatments had increased by more than 20%; No improvement in participation in clinical trials was noted; Treatments given with curative intent were more complex with more fields; Hyperfractionation was used, mainly in treatments of cancers of the head and neck, lung, and bladder; The use of brachytherapy for non-gynaecological malignancies had increased dramatically; Treatment of bone metastases with a single or few fractions was used much more frequently; Dose planning and patient set-up showed a high standard but quality control of dosimetry of given treatment did not fully comply with Swedish and European recommendations; The treatment devices seem to be used more efficiently.
2001年秋季,瑞典开展了一项为期12周的放射治疗实践前瞻性调查。所有提供放射治疗的医院均参与其中,研究期间开始接受放射治疗的所有患者均被纳入。最终的患者样本包括对4171名患者进行的5105次治疗。将结果与1992年进行的类似调查结果进行了比较,得出以下结论:放射治疗的使用显著增加;接受放射治疗的癌症病例估计比例(与病例发生数相比)从1992年的32%增至47%;接受放射治疗的癌症患者比例估计在37%至46%之间;54%的治疗具有治愈目的,自1992年以来略有增加;区域部门和县级部门在具有治愈目的治疗比例上的差异有所减小;具有治愈目的的治疗在分次治疗方面使用了更高比例的资源;姑息治疗的比例略低于1992年,但治疗的绝对数量增加了20%以上;参与临床试验的情况没有改善;具有治愈目的的治疗更复杂,照射野更多;采用了超分割治疗,主要用于头颈部、肺部和膀胱癌症的治疗;近距离放射治疗在非妇科恶性肿瘤中的使用显著增加;单次或少数几次分割治疗骨转移的情况更为频繁;剂量规划和患者摆位显示出较高水平,但给定治疗剂量测定的质量控制未完全符合瑞典和欧洲的建议;治疗设备的使用似乎更有效率。