Thompson Stephen R, Delaney Geoff P, Gabriel Gabriel S, Izard Michael A, Hruby George, Jagavkar Raj, Bucci Joseph, Barton Michael B
Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool Hospital, Sydney ; Department of Radiation Oncology, Prince of Wales Hospital, Sydney ; University of New South Wales, Faculty of Medicine, Sydney.
Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool Hospital, Sydney ; University of New South Wales, Faculty of Medicine, Sydney ; University of Western Sydney, Faculty of Medicine, Sydney.
J Contemp Brachytherapy. 2015 Jan;6(4):344-9. doi: 10.5114/jcb.2014.46610. Epub 2014 Nov 12.
We performed the first comprehensive, population-based brachytherapy (BT) Patterns of Care Study in the Australian setting. Herein we report on prostate BT and assess the technical quality of BT practice, focusing on whether a caseload effect could be identified in New South Wales (NSW).
Site visits were made to all radiation oncology departments in NSW that delivered prostate BT, collecting relevant data on NSW residents treated with prostate BT in 2003. Overall quality of NSW prostate BT treatment was assessed using benchmarks including treatment of appropriate prostate cancer disease risk category, absence of (relative) physical contraindications, optimal planned and treated dosimetry, and pre-/post-implant planning/CT. Quality was compared between higher and lower caseload departments.
One hundred and fifty-seven (67%) patients underwent temporary BT and 79 (33%) permanent seed BT. Prostate BT was concentrated in five departments, with three of four departments with active programmes treating greater than the recommended 25 cases. Rates of concordance with quality benchmarks were high (85-99%) with no consistent caseload effect identified.
Prostate BT in NSW in 2003 was generally of high quality and a caseload effect on quality could not be identified. This may be because the number of departments was insufficient to determine a caseload effect, or because the prostate BT was largely concentrated in a small number of high caseload departments.
我们在澳大利亚开展了首次基于人群的综合性近距离放射治疗（BT）护理模式研究。在此，我们报告前列腺癌BT治疗情况，并评估BT治疗的技术质量，重点关注新南威尔士州（NSW）是否存在病例数量效应。
对新南威尔士州所有提供前列腺癌BT治疗的放射肿瘤学部门进行实地考察，收集2003年接受前列腺癌BT治疗的新南威尔士州居民的相关数据。使用包括对适当前列腺癌疾病风险类别进行治疗、不存在（相对）身体禁忌证、最佳计划和治疗剂量测定以及植入前/后计划/CT等基准来评估新南威尔士州前列腺癌BT治疗的总体质量。对病例数量较多和较少的部门之间的质量进行比较。
157例（67%）患者接受了临时性BT治疗，79例（33%）接受了永久性粒子植入BT治疗。前列腺癌BT治疗集中在五个部门，四个有活跃项目的部门中有三个治疗的病例数超过了推荐的25例。与质量基准的符合率较高（85 - 99%），未发现一致的病例数量效应。
2003年新南威尔士州的前列腺癌BT治疗总体质量较高，未发现病例数量对质量有影响。这可能是因为部门数量不足以确定病例数量效应，或者是因为前列腺癌BT治疗主要集中在少数病例数量较多的部门。
