Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool Hospital and Faculty of Medicine, University of New South Wales, Sydney, Australia.
Clin Oncol (R Coll Radiol). 2010 Feb;22(1):56-64. doi: 10.1016/j.clon.2009.11.003. Epub 2009 Dec 6.
An optimal utilisation rate for palliative radiotherapy in newly diagnosed cancers will be useful in the planning and delivery of cancer services and has not been reported to date. The aim of this study was to estimate the proportion of new cases of cancer that should receive palliative radiotherapy as their first course of radiotherapy at some time during the course of their illness.
A previously developed model depicting indications for radiotherapy was merged with Australian cancer epidemiological data and re-analysed to identify palliative or radical treatment end points. Palliative radiotherapy end points were further divided by treatment site. The optimal palliative radiotherapy utilisation rates were compared with actual radiotherapy utilisation data for newly diagnosed cancers.
Fourteen per cent of all new cancer cases should optimally receive palliative radiotherapy as their first course of radiotherapy treatment. Comparisons with actual radiotherapy utilisation rates from New South Wales, Australia, show that for some common cancers, more newly diagnosed patients receive palliative radiotherapy as their first radiotherapy treatment than would be optimally recommended in this model. This suggests that many patients in New South Wales are not currently being referred for curative treatment.
Palliative radiotherapy is optimally recommended as the first course of radiotherapy in 14% of all newly diagnosed cancers.
优化新诊断癌症患者的姑息性放疗使用率,对癌症服务的规划和实施具有重要意义,但目前尚未有相关报道。本研究旨在评估新诊断癌症患者中,在病程中某个时间点应接受姑息性放疗作为其首次放疗的比例。
我们将之前开发的描述放疗适应证的模型与澳大利亚癌症流行病学数据合并,并重新进行分析,以确定姑息性或根治性治疗终点。姑息性放疗终点进一步按治疗部位进行细分。将最佳姑息性放疗使用率与新诊断癌症的实际放疗使用率进行比较。
14%的所有新发癌症病例应作为首次放疗治疗接受最佳姑息性放疗。与来自澳大利亚新南威尔士州的实际放疗使用率进行比较后发现,对于某些常见癌症,接受姑息性放疗作为首次放疗治疗的新诊断患者比例高于本模型中最佳推荐的比例。这表明新南威尔士州的许多患者目前未被转诊接受根治性治疗。
14%的新发癌症患者应接受姑息性放疗作为首次放疗治疗,这是最佳推荐方案。