专门的团队管理改善了接受姑息性放疗患者的以人为本的护理

IF 5.3 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology Pub Date : 2025-09-01 DOI:10.1016/S0167-8140(25)04697-3

Pamela Paterson , Samir Patel , Ben Burke , Melanie Clarkson , Alysa Fairchild

{"title":"专门的团队管理改善了接受姑息性放疗患者的以人为本的护理","authors":"Pamela Paterson , Samir Patel , Ben Burke , Melanie Clarkson , Alysa Fairchild","doi":"10.1016/S0167-8140(25)04697-3","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose:</h3><div>Palliative radiotherapy (PRT) integrated with supportive care provided by a multidisciplinary team (MDT) improves symptoms and quality of life. At our centre, PRT consultations occur in either the general outpatient department (OP) or with a dedicated specialist Palliative Radiation Oncology (PRO) clinic. We explored the differential impact of PRT consult pathway on clinical outcomes.</div></div><div><h3>Materials and Methods:</h3><div>Consecutive adults with four primary cancers prescribed ≤10 fractions of PRT (03-06/2023) with 4-week follow-up were retrospectively reviewed. Data abstracted included patient-reported symptom scores, urgent unplanned cancer centre encounters triggered by symptoms, hospital admissions, analgesic escalation, and MDT referrals. Descriptive and summary statistics were calculated.</div></div><div><h3>Results:</h3><div>Of 110 patients (78 assessed in PRO and 32 in OP), 33.6% had breast, 28.2% GU, 20.9% lung, and 17.3% GI cancers. Overall, 93.6% completed PRT as prescribed. At four weeks post-PRT, in PRO patients, pain improved in 32/78 (41.0%), was stable in 45/78 (57.7%), and worse in 1/78 (1.3%). For OP patients (one pain score missing), pain improved in 2/31 (6.5%), was stable in 20/31 (64.5%) and worse in 9/31 (29.0%). Just over half required >1 urgent unplanned outpatient encounter (55.1% of PRO versus 56.3% of OP patients). 13/78 (16.7%) PRO versus 6/32 (18.8%) OP patients required hospital admission. Analgesic adjustment was required by 43.6% (34/78) of PRO and 50% (16/32) of OP patients. Most MDT referrals were made through the PRO Clinic. Median survival was 42.4 wks (95% CI 25.3- 53.1wks) for PRO patients versus 29.6 wks (95%CI 10.1-52.1 wks) for OP patients.</div></div><div><h3>Conclusions:</h3><div>Patients managed through the dedicated PRO program were more likely to report improved pain and be referred for multidisciplinary supportive care, while analgesic escalation and acute care admission occurred more often in OP patients. Integrating PRT delivery with holistic symptom management delivered by a specialized MDT optimizes personalized care.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"210 ","pages":"Page S18"},"PeriodicalIF":5.3000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"SPECIALIZED TEAM MANAGEMENT IMPROVES PERSON-CENTRED CARE FOR PATIENTS UNDERGOING PALLIATIVE RADIOTHERAPY\",\"authors\":\"Pamela Paterson , Samir Patel , Ben Burke , Melanie Clarkson , Alysa Fairchild\",\"doi\":\"10.1016/S0167-8140(25)04697-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose:</h3><div>Palliative radiotherapy (PRT) integrated with supportive care provided by a multidisciplinary team (MDT) improves symptoms and quality of life. At our centre, PRT consultations occur in either the general outpatient department (OP) or with a dedicated specialist Palliative Radiation Oncology (PRO) clinic. We explored the differential impact of PRT consult pathway on clinical outcomes.</div></div><div><h3>Materials and Methods:</h3><div>Consecutive adults with four primary cancers prescribed ≤10 fractions of PRT (03-06/2023) with 4-week follow-up were retrospectively reviewed. Data abstracted included patient-reported symptom scores, urgent unplanned cancer centre encounters triggered by symptoms, hospital admissions, analgesic escalation, and MDT referrals. Descriptive and summary statistics were calculated.</div></div><div><h3>Results:</h3><div>Of 110 patients (78 assessed in PRO and 32 in OP), 33.6% had breast, 28.2% GU, 20.9% lung, and 17.3% GI cancers. Overall, 93.6% completed PRT as prescribed. At four weeks post-PRT, in PRO patients, pain improved in 32/78 (41.0%), was stable in 45/78 (57.7%), and worse in 1/78 (1.3%). For OP patients (one pain score missing), pain improved in 2/31 (6.5%), was stable in 20/31 (64.5%) and worse in 9/31 (29.0%). Just over half required >1 urgent unplanned outpatient encounter (55.1% of PRO versus 56.3% of OP patients). 13/78 (16.7%) PRO versus 6/32 (18.8%) OP patients required hospital admission. Analgesic adjustment was required by 43.6% (34/78) of PRO and 50% (16/32) of OP patients. Most MDT referrals were made through the PRO Clinic. Median survival was 42.4 wks (95% CI 25.3- 53.1wks) for PRO patients versus 29.6 wks (95%CI 10.1-52.1 wks) for OP patients.</div></div><div><h3>Conclusions:</h3><div>Patients managed through the dedicated PRO program were more likely to report improved pain and be referred for multidisciplinary supportive care, while analgesic escalation and acute care admission occurred more often in OP patients. Integrating PRT delivery with holistic symptom management delivered by a specialized MDT optimizes personalized care.</div></div>\",\"PeriodicalId\":21041,\"journal\":{\"name\":\"Radiotherapy and Oncology\",\"volume\":\"210 \",\"pages\":\"Page S18\"},\"PeriodicalIF\":5.3000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiotherapy and Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0167814025046973\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiotherapy and Oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0167814025046973","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的：姑息放疗（PRT）结合多学科团队（MDT）提供的支持性护理可改善症状和生活质量。在我们的中心，PRT会诊在普通门诊部（OP）或专门的专家姑息放射肿瘤学（PRO）诊所进行。我们探讨了PRT咨询途径对临床结果的不同影响。材料与方法：回顾性分析连续4周随访的4例原发性癌症患者，处方≤10份PRT（03-06/2023）。提取的数据包括患者报告的症状评分、由症状引发的紧急计划外癌症中心就诊、住院情况、镇痛药升级和MDT转诊。计算描述性统计和汇总统计。结果：在110例患者中（78例PRO评估，32例OP评估），33.6%为乳腺癌，28.2%为GU， 20.9%为肺癌，17.3%为GI癌。总体而言，93.6%的人按照规定完成了PRT。在prt后4周，PRO患者的疼痛在32/78（41.0%）中改善，在45/78（57.7%）中稳定，在1/78中恶化（1.3%）。对于OP患者（1个疼痛评分缺失），2/31疼痛改善（6.5%），20/31疼痛稳定（64.5%），9/31疼痛加重（29.0%）。超过一半的患者需要1次紧急计划外门诊就诊（PRO患者占55.1%，OP患者占56.3%）。13/78 (16.7%) PRO和6/32 (18.8%)OP患者需要住院。43.6%（34/78）的PRO和50%（16/32）的OP患者需要镇痛调节。大多数MDT转诊是通过PRO诊所进行的。PRO患者的中位生存期为42.4周（95%CI 25.3- 53.1周），OP患者的中位生存期为29.6周（95%CI 10.1-52.1周）。结论：通过专门的PRO项目管理的患者更有可能报告疼痛改善，并被转介到多学科支持治疗，而镇痛升级和急性护理住院更常发生在OP患者中。将PRT交付与专业MDT提供的整体症状管理相结合，可优化个性化护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

SPECIALIZED TEAM MANAGEMENT IMPROVES PERSON-CENTRED CARE FOR PATIENTS UNDERGOING PALLIATIVE RADIOTHERAPY

Purpose:

Palliative radiotherapy (PRT) integrated with supportive care provided by a multidisciplinary team (MDT) improves symptoms and quality of life. At our centre, PRT consultations occur in either the general outpatient department (OP) or with a dedicated specialist Palliative Radiation Oncology (PRO) clinic. We explored the differential impact of PRT consult pathway on clinical outcomes.

Materials and Methods:

Consecutive adults with four primary cancers prescribed ≤10 fractions of PRT (03-06/2023) with 4-week follow-up were retrospectively reviewed. Data abstracted included patient-reported symptom scores, urgent unplanned cancer centre encounters triggered by symptoms, hospital admissions, analgesic escalation, and MDT referrals. Descriptive and summary statistics were calculated.

Results:

Of 110 patients (78 assessed in PRO and 32 in OP), 33.6% had breast, 28.2% GU, 20.9% lung, and 17.3% GI cancers. Overall, 93.6% completed PRT as prescribed. At four weeks post-PRT, in PRO patients, pain improved in 32/78 (41.0%), was stable in 45/78 (57.7%), and worse in 1/78 (1.3%). For OP patients (one pain score missing), pain improved in 2/31 (6.5%), was stable in 20/31 (64.5%) and worse in 9/31 (29.0%). Just over half required >1 urgent unplanned outpatient encounter (55.1% of PRO versus 56.3% of OP patients). 13/78 (16.7%) PRO versus 6/32 (18.8%) OP patients required hospital admission. Analgesic adjustment was required by 43.6% (34/78) of PRO and 50% (16/32) of OP patients. Most MDT referrals were made through the PRO Clinic. Median survival was 42.4 wks (95% CI 25.3- 53.1wks) for PRO patients versus 29.6 wks (95%CI 10.1-52.1 wks) for OP patients.

Conclusions:

Patients managed through the dedicated PRO program were more likely to report improved pain and be referred for multidisciplinary supportive care, while analgesic escalation and acute care admission occurred more often in OP patients. Integrating PRT delivery with holistic symptom management delivered by a specialized MDT optimizes personalized care.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Radiotherapy and Oncology 医学-核医学

CiteScore

10.30

自引率

10.50%

发文量

2445

审稿时长

45 days

期刊介绍： Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.