Radiation Oncology Department, Virgen de las Nieves University Hospital, Avd Fuerzas Armadas 4, Granada 18014, Spain.
Radiat Oncol. 2012 Aug 3;7:131. doi: 10.1186/1748-717X-7-131.
Metastases are detected in 20% of patients with solid tumours at diagnosis and a further 30% after diagnosis. Radiation therapy (RT) has proven effective in bone (BM) and brain (BrM) metastases. The objective of this study was to analyze the variability of RT utilization rates in clinical practice and the accessibility to medical technology in our region.
We reviewed the clinical records and RT treatment sheets of all patients undergoing RT for BM and/or BrM during 2007 in the 12 public hospitals in an autonomous region of Spain. Data were gathered on hospital type, patient type and RT treatment characteristics. Calculation of the rate of RT use was based on the cancer incidence and the number of RT treatments for BM, BrM and all cancer sites.
Out of the 9319 patients undergoing RT during 2007 for cancer at any site, 1242 (13.3%; inter-hospital range, 26.3%) received RT for BM (n = 744) or BrM (n = 498). These 1242 patients represented 79% of all RT treatments with palliative intent, and the most frequent primary tumours were in lung, breast, prostate or digestive system. No significant difference between BM and BrM groups were observed in: mean age (62 vs. 59 yrs, respectively); gender (approximately 64% male and 36% female in both); performance status (ECOG 0-1 in 70 vs. 71%); or mean distance from hospital (36 vs. 28.6 km) or time from consultation to RT treatment (13 vs. 14.3 days). RT regimens differed among hospitals and between patient groups: 10 × 300 cGy, 5 × 400 cGy and 1x800cGy were applied in 32, 27 and 25%, respectively, of BM patients, whereas 10 × 300cGy was used in 49% of BrM patients.
Palliative RT use in BM and BrM is high and close to the expected rate, unlike the global rate of RT application for all cancers in our setting. Differences in RT schedules among hospitals may reflect variability in clinical practice among the medical teams.
在确诊时，有 20%的实体瘤患者会检测到转移，另有 30%的患者在确诊后会出现转移。放射治疗（RT）已被证明对骨（BM）和脑（BrM）转移有效。本研究的目的是分析在我们的地区，放射治疗在临床实践中的应用率的变化以及医疗技术的可及性。
我们回顾了 2007 年在西班牙一个自治区的 12 家公立医院中接受 BM 和/或 BrM 放射治疗的所有患者的临床记录和放射治疗表。收集了医院类型、患者类型和放射治疗特征的数据。放射治疗的使用率是根据癌症发病率和 BM、BrM 和所有癌症部位的放射治疗次数计算的。
在 2007 年因任何部位癌症接受放射治疗的 9319 名患者中，有 1242 名（13.3%；医院间范围为 26.3%）接受了 BM（n=744）或 BrM（n=498）放射治疗。这 1242 名患者占所有姑息性放射治疗的 79%，最常见的原发肿瘤是肺癌、乳腺癌、前列腺癌或消化系统癌。BM 组和 BrM 组在以下方面无显著差异：平均年龄（分别为 62 岁和 59 岁）；性别（男女分别约为 64%和 36%）；体能状态（ECOG 0-1 分别为 70%和 71%）；或距医院的平均距离（分别为 36 公里和 28.6 公里）或从咨询到放射治疗的时间（分别为 13 天和 14.3 天）。放射治疗方案在医院之间和患者组之间存在差异：32%、27%和 25%的 BM 患者接受了 10×300cGy、5×400cGy 和 1x800cGy 治疗，而 49%的 BrM 患者接受了 10×300cGy 治疗。
BM 和 BrM 的姑息性放射治疗使用率高，接近预期率，而与我们的环境中所有癌症的全球放射治疗应用率不同。医院之间放射治疗方案的差异可能反映了医疗团队之间临床实践的差异。
