Croke Jennifer, Fyles Anthony, Barbera Lisa, D'Souza David, Pearcey Robert, Stuckless Teri, Bass Brenda, Brundage Michael, Milosevic Michael
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Pract Radiat Oncol. 2016 Sep-Oct;6(5):315-323. doi: 10.1016/j.prro.2016.01.012. Epub 2016 Jan 28.
Radiation therapy plays an important curative role for patients with locally advanced cervical cancer (LACC). There are no standards to define best practice. The purpose of this study was to develop a suite of radiation therapy key quality-of-care indicators (KQIs) for the curative management of LACC based on expert consensus.
A modified Delphi method was used after identifying candidate KQIs. Round 1 involved surveying all Canadian gynecology radiation oncologists. The current and anticipated future (5 years) importance and current achievability of each KQI was ranked. Round 2 consisted of a facilitated face-to-face meeting with a smaller expert panel to discuss, revise, and develop consensus on the KQIs.
The literature review identified 83 candidate KQIs. Survey response was 71%. Round 2 yielded a final suite of 40 KQIs in the following categories: pretreatment assessment, external beam radiation therapy, brachytherapy, follow-up, and expertise/workload. A prominent theme was the importance of having KQIs to measure the current state, evolution, and future uptake of magnetic resonance-guided brachytherapy.
To our knowledge, this is the first study establishing radiation therapy KQIs in LACC based on expert consensus. These KQIs should be used to guide programmatic direction and resource allocation to assure consistent and optimal patient care.
放射治疗在局部晚期宫颈癌（LACC）患者的治疗中发挥着重要的治愈作用。目前尚无定义最佳实践的标准。本研究的目的是基于专家共识，制定一套用于LACC治愈性治疗的放射治疗关键护理质量指标（KQI）。
在确定候选KQI后，采用改良的德尔菲法。第一轮调查了所有加拿大妇科放射肿瘤学家。对每个KQI当前和预期未来（5年）的重要性以及当前的可实现性进行了排名。第二轮包括与一个较小的专家小组进行一次促进性面对面会议，以讨论、修订并就KQI达成共识。
文献综述确定了83个候选KQI。调查回复率为71%。第二轮产生了一套最终的40个KQI，分为以下几类：预处理评估、外照射放疗、近距离放疗、随访以及专业知识/工作量。一个突出的主题是拥有KQI以衡量磁共振引导近距离放疗的当前状态、发展情况和未来应用的重要性。
据我们所知，这是第一项基于专家共识在LACC中建立放射治疗KQI的研究。这些KQI应用于指导项目方向和资源分配，以确保为患者提供一致且最佳的护理。
