Shaverdian Narek, Yoo Sun Mi, Cook Ryan, Chang Eric M, Jiang Naomi, Yuan Ye, Sandler Kiri, Steinberg Michael, Lee Percy
Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
Int J Radiat Oncol Biol Phys. 2017 Aug 1;98(5):1153-1161. doi: 10.1016/j.ijrobp.2017.03.028. Epub 2017 Mar 29.
Internists and primary care providers play a growing role in cancer care. We therefore evaluated the awareness of radiation therapy in general and specifically the clinical utility of stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer (NSCLC) among current US internal medicine residents.
A web-based institutional review board-approved multi-institutional survey was distributed to US internal medicine residency programs. The survey evaluated trainee demographic characteristics, baseline radiation oncology awareness, knowledge of the role of SBRT for early-stage NSCLC, and whether the survey successfully improved awareness.
Thirty US internal medicine programs participated, with an overall participant response rate of 46% (1177 of 2551). Of the trainees, 93% (n=1076) reported no radiation oncology education in their residency, 39% (n=452) reported confidence in knowing when to consult radiation oncology in an oncologic emergency, and 26% (n=293) reported confidence in knowing when to consult radiation oncology in the setting of a newly diagnosed cancer. Of the participants, 76% (n=850) correctly identified that surgical resection is the standard treatment in operable early-stage NSCLC, but only 50% (n=559) of participants would recommend SBRT to a medically inoperable patient, followed by 31% of participants (n=347) who were unsure of the most appropriate treatment, and 10% (n=117) who recommended waiting to offer palliative therapy. Ninety percent of participants (n=1029) agreed that they would benefit from further training on when to consult radiation oncology. Overall, 96% (n=1072) indicated that the survey increased their knowledge and awareness of the role of SBRT.
The majority of participating trainees received no education in radiation oncology in their residency, reported a lack of confidence regarding when to consult radiation oncology, and overwhelmingly agreed that they would benefit from further training. These findings should serve as a call to increase the educational collaboration between internal medicine and radiation oncology departments to ensure optimal cancer care.
内科医生和初级保健提供者在癌症治疗中发挥着越来越重要的作用。因此，我们评估了美国当前内科住院医师对放射治疗的总体认识，特别是立体定向体部放射治疗（SBRT）对早期非小细胞肺癌（NSCLC）的临床应用。
一项经机构审查委员会批准的基于网络的多机构调查已分发给美国内科住院医师培训项目。该调查评估了受训人员的人口统计学特征、基线放射肿瘤学知识、对SBRT在早期NSCLC中作用的了解，以及该调查是否成功提高了认识。
30个美国内科项目参与了调查，总体参与者回复率为46%（2551人中的1177人）。在受训人员中，93%（n = 1076）报告在住院期间未接受过放射肿瘤学教育，39%（n = 452）报告有信心在肿瘤急症时知道何时咨询放射肿瘤学，26%（n = 293）报告有信心在新诊断癌症时知道何时咨询放射肿瘤学。在参与者中，76%（n = 850）正确识别出手术切除是可手术早期NSCLC的标准治疗方法，但只有50%（n = 559）的参与者会向医学上无法手术的患者推荐SBRT，其次是31%（n = 347）不确定最合适治疗方法的参与者，以及10%（n = 117）建议等待提供姑息治疗的参与者。90%的参与者（n = 1029）同意他们将从关于何时咨询放射肿瘤学的进一步培训中受益。总体而言，96%（n = 1072）表示该调查增加了他们对SBRT作用的知识和认识。
大多数参与调查的受训人员在住院期间未接受过放射肿瘤学教育，报告在何时咨询放射肿瘤学方面缺乏信心，并且绝大多数人同意他们将从进一步培训中受益。这些发现应促使加强内科和放射肿瘤学部门之间的教育合作，以确保最佳的癌症治疗。
