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加拿大不列颠哥伦比亚省接受放疗的青少年和年轻成年中枢神经系统、软组织或骨肿瘤幸存者晚期效应风险和筛查建议的文档记录。

Documentation of Late-Effects Risks and Screening Recommendations for Adolescent and Young Adult Central Nervous System, Soft Tissue, or Bone Tumor Survivors Treated with Radiotherapy in British Columbia, Canada.

机构信息

1 Faculty of Applied Sciences, School of Nursing, University of British Columbia , Vancouver, Canada .

2 MD Undergraduate Program, University of British Columbia , Vancouver, Canada .

出版信息

J Adolesc Young Adult Oncol. 2019 Apr;8(2):142-148. doi: 10.1089/jayao.2018.0081. Epub 2018 Oct 9.

Abstract

PURPOSE

To assess the documentation of late-effects (LE) risks and screening recommendations in medical records of adolescent and young adult central nervous system (CNS), soft tissue, and bone tumor survivors.

METHODS

The medical records of all patients diagnosed with a CNS neoplasm, an arteriovenous malformation, a soft tissue, and bone tumor, at ages 15-39 years, treated between 1985 and 2010 with radiation therapy in the province of British Columbia, Canada, surviving >5 years, alive, and discharged to the community were assessed. The documentation of LE risks and screening recommendations were analyzed descriptively.

RESULTS

In the medical records of 132 CNS tumor survivors and 94 soft tissue or bone tumor survivors, 15% and 13% included no documentation of LE risks, 21% and 22% included only nonspecific documentation, and 64% and 65% minimal documentation, respectively. Documentation of at least one specific LE risk increased significantly among CNS tumor patient charts (from 29% in 1980-1989, to 67% in 1990-1999, to 88% in 2000-2010, χ [2, N = 132] = 32.257, p < 0.000) and soft tissue or bone tumor patient charts (from 47% [1980-1989] to 56% [1990-1999] to 78% [2000-2010], χ [2, N = 94] = 6.702, p = 0.035). There was no documentation of a screening recommendation in 75% of CNS tumor patient charts and 91% of soft tissue and bone tumor charts.

CONCLUSION

The documentation of LE risks and screening recommendations has been limited, highlighting the need to improve written communication with primary care providers.

摘要

目的

评估青少年和年轻成年中枢神经系统(CNS)、软组织和骨肿瘤幸存者病历中晚期效应(LE)风险和筛查建议的记录情况。

方法

评估了在加拿大不列颠哥伦比亚省接受放射治疗、5 年以上生存、存活并出院至社区的 1985 年至 2010 年间诊断为 CNS 肿瘤、动静脉畸形、软组织和骨肿瘤、年龄在 15-39 岁的所有患者的病历。对 LE 风险和筛查建议的记录进行了描述性分析。

结果

在 132 例 CNS 肿瘤幸存者和 94 例软组织或骨肿瘤幸存者的病历中,分别有 15%和 13%没有记录 LE 风险,21%和 22%仅记录了非特异性内容,64%和 65%记录的内容最少。CNS 肿瘤患者病历中至少记录一项特定 LE 风险的比例显著增加(从 1980-1989 年的 29%增加到 1990-1999 年的 67%,再增加到 2000-2010 年的 88%,χ²[2,N=132]=32.257,p<0.000),软组织或骨肿瘤患者病历中这一比例从 47%(1980-1989 年)增加到 56%(1990-1999 年),再增加到 78%(2000-2010 年),χ²[2,N=94]=6.702,p=0.035)。75%的 CNS 肿瘤患者病历和 91%的软组织和骨肿瘤患者病历中没有记录筛查建议。

结论

LE 风险和筛查建议的记录有限,这突显了需要改善与初级保健提供者的书面沟通。

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