CancerCare Manitoba, Winnipeg, MB.
Curr Oncol. 2009 Sep;16(5):58-64. doi: 10.3747/co.v16i5.298.
Our study examined the wait time from ready-to-treat to radiation therapy for cohorts of breast cancer patients requiring adjuvant radiation therapy in 2001 and in 2005 after the implementation of strategies to reduce wait times for radiation treatment. We also examined the overall time from diagnosis to radiation treatment and whether distance from the cancer treatment centre or month of referral had an effect on wait times.
This population-based retrospective study looked at representative samples of women newly diagnosed with breast cancer in 2001 and 2005. Patients who required radiation treatment to the breast or chest wall were followed from first contact to the start of radiation treatment.
Time from ready-to-treat to first radiation treatment was significantly reduced for patients in 2005 as compared with 2001, regardless of whether chemotherapy was administered before radiation treatment. Time from diagnosis to radiation treatment was not different by year for those who received radiation only. Time from diagnosis to chemotherapy was significantly longer in 2005. No effect of month of diagnosis on wait times was observed.
A significant improvement in the median wait time from ready-to-treat to first radiation treatment was noted from 2001 to 2005. This improvement may be attributable to measures taken to reduce such waits. However, we observed an increase in the median time from diagnosis to referral and from referral to consultation with medical or radiation oncology (or both), so that the overall time from diagnosis to radiation treatment was not different. Although specific intervals related to radiation treatment delivery were improved, the entire trajectory of breast cancer care experienced by patients needs to be considered.
本研究通过考察 2001 年和 2005 年在实施减少放疗等待时间策略后需要辅助放疗的乳腺癌患者队列的从准备治疗到放疗的等待时间,来评估该策略的效果。我们还研究了从诊断到放疗的总体时间,以及距癌症治疗中心的距离或转诊月份是否会影响等待时间。
本基于人群的回顾性研究观察了 2001 年和 2005 年新诊断为乳腺癌的代表性女性样本。需要对乳房或胸壁进行放疗的患者从首次接触到开始放疗进行随访。
与 2001 年相比,2005 年接受放疗的患者从准备治疗到首次放疗的时间明显缩短,无论在放疗前是否接受化疗。仅接受放疗的患者从诊断到放疗的时间在不同年份之间没有差异。在 2005 年,从诊断到化疗的时间明显延长。未观察到诊断月份对等待时间的影响。
从 2001 年到 2005 年,从准备治疗到首次放疗的中位等待时间显著缩短。这种改善可能归因于为减少这种等待而采取的措施。然而,我们观察到从诊断到转诊以及从转诊到与医学或放射肿瘤学(或两者)咨询的中位时间增加,因此从诊断到放疗的总体时间没有差异。虽然与放疗实施相关的特定间隔得到了改善,但需要考虑患者经历的整个乳腺癌治疗轨迹。