Department of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada.
Department of Experimental Oncology, Cross Cancer Institute, Edmonton, AB, Canada.
Support Care Cancer. 2022 Oct;30(10):8339-8347. doi: 10.1007/s00520-022-07246-5. Epub 2022 Jul 22.
Palliative radiotherapy (PRT) in advanced cancer improves symptom control and quality of life. PRT consultations take place in various clinical settings, including through dedicated rapid access clinics. We examined holistic assessment and PRT delivery by consultation setting.
We analyzed patients with breast cancer who died (01/04/2013-31/03/2014), after at least one lifetime PRT consultation. Data abstracted included Karnofsky Performance Status (KPS), Edmonton Symptom Assessment System Revised (ESAS-r) ratings, and PRT timelines. Descriptive statistics, t tests of proportions, independent t tests, and chi-square tests were calculated.
One hundred thirty patients were assessed for PRT over 224 consults, 28/224 (12.5%) in the rapid access clinic. In non-rapid access versus rapid access visits, KPS was documented in 30.1% versus 89.3%, and medication history in 53.6% versus 96.4%, respectively (both p < 0.0001). Baseline ESAS-r scores were available for 67.9% of rapid access visits, versus no non-rapid access visit. Rapid access consults had a higher proportion of subsequent supportive care referrals (46.4% versus 8.2%; p < 0.0001). Same day PRT start occurred in 37% of rapid access versus 23.4% of non-rapid access visits (p = 0.13).
Assessment for PRT by a dedicated multidisciplinary team provides a comprehensive picture of patient needs and streamlines PRT delivery, essential to personalizing supportive care.
晚期癌症的姑息性放疗（PRT）可改善症状控制和生活质量。PRT 咨询在各种临床环境中进行，包括专门的快速通道诊所。我们研究了咨询环境对整体评估和 PRT 实施的影响。
我们分析了在至少一次终生 PRT 咨询后死亡的乳腺癌患者（2013 年 4 月 1 日至 2014 年 3 月 31 日）。数据包括卡诺夫斯基表现状态（KPS）、埃德蒙顿症状评估系统修订版（ESAS-r）评分和 PRT 时间线。计算描述性统计、比例 t 检验、独立 t 检验和卡方检验。
在 224 次咨询中，有 130 名患者接受了 PRT 评估，其中 28/224（12.5%）在快速通道诊所。在非快速通道与快速通道就诊中，KPS 记录率分别为 30.1%和 89.3%（均 p<0.0001），药物治疗史记录率分别为 53.6%和 96.4%（均 p<0.0001）。快速通道就诊中有 67.9%的患者有基线 ESAS-r 评分，而非快速通道就诊中则无。快速通道就诊中有更高比例的后续支持性护理转诊（46.4%与 8.2%；p<0.0001）。在快速通道就诊中，当天开始 PRT 的比例为 37%，而非快速通道就诊中为 23.4%（p=0.13）。
由多学科团队专门进行 PRT 评估可全面了解患者需求并简化 PRT 实施，这对个性化支持性护理至关重要。
