Department of Radiation Oncology, University of Western Ontario, London Ontario, Canada.
Clin Lung Cancer. 2012 May;13(3):225-35. doi: 10.1016/j.cllc.2011.11.002. Epub 2011 Dec 13.
The purpose of this work was to disseminate international practice survey results created in conjunction with the Third International Lung Cancer Consensus Workshop.
In conjunction with the American Society for Radiation Oncology (ASTRO) Guideline for Palliative Lung Cancer Care and International Workshop Consensus statements, an online international practice survey was conducted during the summer of 2010. The survey included demographic, educational, and clinical questions as well as 5 cases exploring the role of external beam radiotherapy, endobronchial brachytherapy, and concurrent chemoradiation.
A total of 279 individuals responded to the survey over a 3-month period. Most respondents were hospital-based, academic, or government-funded radiation oncologists. Factors that consistently related to use and choice of external beam dose fractionation included estimated treatment benefit to patient, performance status (PS), symptom severity, patient choice, estimated prognosis, and previous radiation to the same site. Factors consistently not related to use and dose fractionation included requirement for future radiation therapy, department policy, and waiting lists. A significant range of dose fractionation schedules existed for external beam (n = 35) and endobronchial brachytherapy treatment (n = 10). The integration of concurrent chemotherapy was recorded by a significant minority of respondents despite lack of level I evidence to support its use. Geographic differences in the use of external beam dose fractionation and of concurrent chemotherapy were seen.
Various patient, tumor, treatment, and logistic factors are associated with the variable use and external beam dose fractionation of palliative lung treatments. The copublication of the ASTRO Guideline for Palliative Lung Cancer Care and International Workshop Consensus statements should assist clinicians by providing evidence-based care.
本研究旨在传播与第三届国际肺癌共识研讨会共同制定的国际实践调查结果。
在美国放射肿瘤学会（ASTRO）姑息性肺癌护理指南和国际研讨会共识声明的配合下，于 2010 年夏季进行了一项在线国际实践调查。该调查包括人口统计学、教育和临床问题以及 5 个案例，探讨了外照射放疗、支气管内近距离放疗和同步放化疗的作用。
在 3 个月的时间里，共有 279 人对该调查做出了回应。大多数受访者是医院、学术或政府资助的放射肿瘤学家。与外照射剂量分割的使用和选择密切相关的因素包括对患者的治疗获益、表现状态（PS）、症状严重程度、患者选择、估计预后和同一部位的既往放疗。与使用和剂量分割无关的因素包括未来放疗的需求、科室政策和等候名单。外照射（n=35）和支气管内近距离放疗（n=10）的剂量分割方案存在显著差异。尽管缺乏支持其使用的 I 级证据，但相当一部分受访者记录了同步化疗的整合。在外照射剂量分割和同步化疗的使用方面存在明显的地域差异。
各种患者、肿瘤、治疗和后勤因素与姑息性肺癌治疗中使用和外照射剂量分割的变化相关。ASTRO 姑息性肺癌护理指南和国际研讨会共识声明的共同发表应通过提供循证护理来帮助临床医生。
