Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
Competence Center for Palliative Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Radiat Oncol. 2021 Nov 24;16(1):227. doi: 10.1186/s13014-021-01949-5.
As cancer is developing into a chronic disease due to longer survival, continuity and coordination of oncological care are becoming more important for patients. As radiation oncology departments are an integral part of cancer care and as repeat irradiation becomes more commonplace, the relevance of continuity and coordination of care in operating procedures is increasing. This study aims to perform a single-institution analysis of cancer patients in which continuity and coordination of care matters most, namely the highly selected group with multiple repeat course radiotherapy throughout their chronic disease.
All patients who received at least five courses of radiotherapy at the Department of Radiation Oncology at the University Hospital Zurich from 2011 to 2019 and who were alive at the time of the initiation of this project were included into this study. Patient and treatment characteristics were extracted from the hospital information and treatment planning systems. All patients completed two questionnaires on continuity of care, one of which was designed in-house and one of which was taken from the literature.
Of the 33 patients identified at baseline, 20 (60.6%) participated in this study. A median of 6 years (range 3-13) elapsed between the first and the last visit at the cancer center. The median number of involved primary oncologists at the radiation oncology department was two (range 1-5). Fifty-seven percent of radiation therapy courses were preceded by a tumor board discussion. Both questionnaires showed high levels of experienced continuity of care. No statistically significant differences in experienced continuity of care between groups with more or less than two primary oncologists was found.
Patients treated with multiple repeat radiation therapy at our department over the past decade experienced high levels of continuity of care, yet further efforts should be undertaken to coordinate care among oncological disciplines in large cancer centers through better and increased use of interdisciplinary tumor boards.
由于癌症患者的生存时间延长，连续性和肿瘤治疗的协调性对于癌症患者变得越来越重要，癌症正逐渐成为一种慢性病。由于放射肿瘤科是癌症治疗的一个组成部分，并且重复放疗变得越来越普遍，因此在操作程序中连续性和协调性的重要性也在增加。本研究旨在对癌症患者进行单中心分析，这些患者的护理连续性和协调性最为重要，即那些在慢性疾病期间接受多次重复疗程放疗的高度选择组。
从 2011 年至 2019 年，所有在苏黎世大学医院放射肿瘤科接受至少五次放疗的患者，并且在本项目启动时仍存活的患者均被纳入本研究。从医院信息和治疗计划系统中提取患者和治疗特征。所有患者均完成了两份关于护理连续性的问卷，一份是内部设计的，一份是从文献中提取的。
在基线时确定的 33 名患者中，有 20 名（60.6%）参与了本研究。从第一次到癌症中心的最后一次就诊之间的中位时间为 6 年（范围 3-13 年）。在放射肿瘤科涉及的初级肿瘤医生中位数为 2 名（范围 1-5 名）。57%的放疗课程之前进行了肿瘤委员会讨论。两份问卷均显示出高度的护理连续性体验。在涉及更多或更少的初级肿瘤医生的组之间，护理连续性体验方面没有统计学上的显著差异。
在过去十年中，我们科室接受多次重复放疗的患者经历了高水平的护理连续性，但在大型癌症中心中，还应进一步努力通过更好地利用和增加多学科肿瘤委员会来协调肿瘤学科之间的护理。
