Division of Palliative Care, Bruyère Continuing Care, Elisabeth Bruyère Hospital, Ottawa, ON.
Curr Oncol. 2010 Feb;17(1):48-55. doi: 10.3747/co.v17i1.460.
Palliative radiotherapy (PRT) is a routine part of oncology care in adult patients, but it is used much less frequently among children with incurable cancer. We surveyed Canadian pediatric oncologists to learn about their knowledge and use of PRT and to identify potential barriers to referral.
A 13-item questionnaire assessing PRT knowledge and utilization was sent to 80 Canadian pediatric oncologists.
The survey completion rate was 80%, with most respondents being providers of palliative care for children and making referrals for PRT. Although 62% had received training in radiation oncology, only 28% had received formal palliative care training. Respondents with palliative care training were found to be significantly more knowledgeable about PRT and were more likely to refer children for PRT (p < 0.01). Only 59% of respondents thought that they had adequate knowledge about the indications for PRT. A positive correlation was found between knowledge about the indications for PRT and referral for treatment (p < 0.01). Among survey respondents, 51% believed that PRT was underutilized, and the perceived barriers to PRT referral included patient or family reluctance, distance to the cancer centre, belief that PRT has little impact on quality of life, and concerns about toxicity.
Palliative radiotherapy is considered to be underutilized among children. This situation appears to be related, in part, to inadequate knowledge and training among pediatric oncologists, suggesting that more emphasis needs to be placed on pediatric palliative care education.
姑息性放疗（PRT）是成人肿瘤患者常规治疗的一部分，但在患有绝症的儿童中使用得较少。我们对加拿大儿科肿瘤学家进行了调查，以了解他们对 PRT 的了解和使用情况，并确定转诊的潜在障碍。
我们向 80 名加拿大儿科肿瘤学家发送了一份包含 13 个问题的调查问卷，以评估他们对 PRT 的了解和使用情况。
调查的完成率为 80%，大多数受访者为儿童提供姑息治疗，并进行 PRT 转诊。尽管 62%的受访者接受过放射肿瘤学培训，但只有 28%的受访者接受过正规的姑息治疗培训。接受过姑息治疗培训的受访者对 PRT 的了解明显更为深入，并且更有可能将儿童转诊进行 PRT（p<0.01）。只有 59%的受访者认为自己对 PRT 的适应证有足够的了解。对 PRT 适应证的了解与转诊治疗呈正相关（p<0.01）。在调查受访者中，51%的人认为 PRT 的使用不足，对 PRT 转诊的障碍包括患者或家属的不情愿、距离肿瘤中心的距离、认为 PRT 对生活质量影响不大，以及对毒性的担忧。
姑息性放疗在儿童中被认为使用不足。这种情况部分与儿科肿瘤学家的知识和培训不足有关，这表明需要更加重视儿科姑息治疗教育。
