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对患者报告的焦虑情绪以及在磁共振直线加速器上进行自适应放射治疗的体验进行前瞻性评估。

Prospective evaluation of patient-reported anxiety and experiences with adaptive radiation therapy on an MR-linac.

作者信息

Moreira Amanda, Li Winnie, Berlin Alejandro, Carpino-Rocca Cathy, Chung Peter, Conroy Leigh, Dang Jennifer, Dawson Laura A, Glicksman Rachel M, Hosni Ali, Keller Harald, Kong Vickie, Lindsay Patricia, Shessel Andrea, Stanescu Teo, Taylor Edward, Winter Jeff, Yan Michael, Letourneau Daniel, Milosevic Michael, Velec Michael

机构信息

Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.

Department of Radiation Oncology, University of Toronto, Toronto, Canada.

出版信息

Tech Innov Patient Support Radiat Oncol. 2024 Feb 27;29:100240. doi: 10.1016/j.tipsro.2024.100240. eCollection 2024 Mar.

Abstract

PURPOSE

An integrated magnetic resonance scanner and linear accelerator (MR-linac) was implemented with daily online adaptive radiation therapy (ART). This study evaluated patient-reported experiences with their overall hospital care as well as treatment in the MR-linac environment.

METHODS

Patients pre-screened for MR eligibility and claustrophobia were referred to simulation on a 1.5 T MR-linac. Patient-reported experience measures were captured using two validated surveys. The 15-item MR-anxiety questionnaire (MR-AQ) was administered immediately after the first treatment to rate MR-related anxiety and relaxation. The 40-item satisfaction with cancer care questionnaire rating doctors, radiation therapists, the services and care organization and their outpatient experience was administered immediately after the last treatment using five-point Likert responses. Results were analyzed using descriptive statistics.

RESULTS

205 patients were included in this analysis. Multiple sites were treated across the pelvis and abdomen with a median treatment time per fraction of 46 and 66 min respectively. Patients rated MR-related anxiety as "not at all" (87%), "somewhat" (11%), "moderately" (1%) and "very much so" (1%). Positive satisfaction responses ranged from 78 to 100% (median 93%) across all items. All radiation therapist-specific items were rated positively as 96-100%. The five lowest rated items (range 78-85%) were related to general provision of information, coordination, and communication. Overall hospital care was rated positively at 99%.

CONCLUSION

In this large, single-institution prospective cohort, all patients had low MR-related anxiety and completed treatment as planned despite lengthy ART treatments with the MR-linac. Patients overall were highly satisfied with their cancer care involving ART using an MR-linac.

摘要

目的

将集成磁共振扫描仪和直线加速器(MR-直线加速器)应用于每日在线自适应放射治疗(ART)。本研究评估了患者对其整体医院护理以及在MR-直线加速器环境中治疗的报告体验。

方法

对经磁共振成像(MR)资格和幽闭恐惧症预筛查的患者,在1.5T MR-直线加速器上进行模拟。使用两项经过验证的调查收集患者报告的体验指标。15项MR焦虑问卷(MR-AQ)在首次治疗后立即进行,以评估与MR相关的焦虑和放松程度。40项癌症护理满意度问卷对医生、放射治疗师、服务和护理组织以及他们的门诊体验进行评分,并在最后一次治疗后立即使用五点李克特量表进行回答。结果采用描述性统计分析。

结果

本分析纳入了205名患者。骨盆和腹部的多个部位接受了治疗,每次分割的中位治疗时间分别为46分钟和66分钟。患者将与MR相关的焦虑评为“完全没有”(87%)、“有点”(11%)、“中度”(1%)和“非常严重”(1%)。所有项目的积极满意度回答范围为78%至100%(中位数为93%)。所有与放射治疗师相关的项目的好评率为96%至100%。评分最低的五个项目(范围为78%至85%)与信息的一般提供、协调和沟通有关。整体医院护理的好评率为99%。

结论

在这个大型单机构前瞻性队列中,所有患者与MR相关的焦虑较低,尽管使用MR-直线加速器进行了长时间的ART治疗,但仍按计划完成了治疗。总体而言,患者对使用MR-直线加速器的ART癌症护理非常满意。

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