General Approach to Palliative Care and Palliative Radiation Oncology

2017 ◽  
pp. 3-21
Author(s):  
C.C. Johnstone ◽  
S. Lutz
Keyword(s):  
Palliative Care ◽  
Radiation Oncology ◽  
Palliative Radiation

A palliative radiation oncology consult service’s impact on care of advanced cancer patients with symptomatic bone metastases.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 110-110
Author(s):  
Sanders Chang ◽  
Cardinale B. Smith ◽  
R. Sean Morrison ◽  
Kenneth Rosenzweig ◽  
Kavita Vyas Dharmarajan
Keyword(s):  
Palliative Care ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Radiation Oncology ◽  
Cancer Type ◽  
Advanced Cancer Patients ◽  
Palliative Radiation ◽  
The Impact ◽  
Pain Improvement

110 Background: Single-fraction and ≤ 5 fraction radiation treatment (SF-RT and Hypo-RT, respectively) is underutilized despite strong evidence regarding its efficacy in symptom management. Established in 2013, the Palliative Radiation Oncology Consult Service (PROC) is a specialty service designed to provide individualized, efficient treatment for advanced cancer patients by a radiation oncology team with a dedicated palliative care focus. We assessed the impact of this new model of care on use of SF-RT, hypo-RT, pain improvement, palliative care utilization, and hospitalization among patients treated with palliative radiation (PRT) for painful bone metastases. Methods: We searched electronic charts of advanced cancer patients who had PRT for symptomatic bone mets from Dec 2010 to April 2015, extracting PRT details, demographics, cancer type, pain pre- and 1 month post-PRT, comorbidities (summarized using Charlson comorbidity index [CCI]), palliative care consults, and hospitalization. Comparisons were made before and after PROC using chi-square or t-tests. Multivariable logistic regression estimated the likelihood of SF-RT or hypo-RT, controlling for age, gender, cancer type, treatment site, and CCI. Results: We identified 334 patients, described in the table below. Patients were more likely to have SF-RT (OR 2.2, 95% CI [1.2-3.8], p = 0.007), or hypo-RT (OR 3.0, 95% CI [1.8-4.7], p < 0.001) after establishment of PROC. Conclusions: Establishment of a PROC service nearly doubled utilization of SF-RT and hypo-RT while maintaining pain improvement, and was associated with an increased use of palliative care consult services, decreased inpatient PRT use, and decreased length of stay. A dedicated service combining palliative care principles and radiation oncology improved quality of palliative cancer care. [Table: see text]

scholarly journals 83 Palliative Care Outreach: Improving Palliative Radiation Therapy Utilization in the Community

2019 ◽  
Vol 139 ◽  
pp. S37-S38
Author(s):  
James Loudon ◽  
Natalie Rozanec ◽  
Ashley Clement ◽  
Rachel Woo ◽  
Anne Grant ◽  
...  
Keyword(s):  
Palliative Care ◽  
Radiation Therapy ◽  
Palliative Radiation ◽  
Palliative Radiation Therapy

Impact of the distance from a radiation oncology treatment facilty on initiation of therapy and its influence on survival in patients with stage III and IV NSCLC.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17594-e17594
Author(s):  
Danielle M. File ◽  
Carlos Eduardo Arce-Lara ◽  
Jeffrey C. Whittle ◽  
Elizabeth Gore ◽  
Rafael Santana-Davila
Keyword(s):  
Radiation Therapy ◽  
Metastatic Disease ◽  
Radiation Oncology ◽  
Stage Iv ◽  
The State ◽  
Stage Iii ◽  
Palliative Radiation ◽  
Stage Iv Disease ◽  
Oncology Treatment ◽  
Time To First Treatment

e17594 Background: Patients with stage III and IV lung cancer require multidisciplinary care. The Milwaukee VA is the only center within the Veterans Health Administration in the state that has a radiation oncology facility. Patients frequently travel from across the state to receive treatment here. We conducted a retrospective review of cases seen in our institution to determine if the distance from the patients’ home to our center influenced their outcome. Methods: Patients with NSCLC treated between 2000 and 2012 were identified from our internal registry. Type of treatment was identified from the registry and confirmed in a chart review.. SAS 9.2 was used for statistical analysis and to measure distance between the patients’ home address and our center. Results: We included 230 patients with stage III disease treated with radiation therapy and 139 patients with stage IV treated with chemotherapy. Of those with Stage III (53% with IIIA and 47% IIIB) 41.3% (n=95) received concurrent radiation therapy and chemotherapy, 14% received sequential therapy, 40% received radiation therapy alone and 5% were treated with chemotherapy followed by palliative radiation. In those with metastatic disease 61% received palliative radiation at some point during their treatment. Median distance between the patients’ home and the Milwaukee VA was 57miles (IQR 10-109) in patients with stage III disease and 22 (IQR 5-84) in those with metastatic disease. There was no correlation between the distance travelled and the time to first treatment in either stage (r=0.008 in stage III and r=0.05 in stage IV). In a univariate analysis living further than 50 miles did not appear to influence survival in stage III (median OS 14.6 vs. 16.4 months p=0.25) nor stage IV disease(9.7 vs 8 p=0.55). In a multivariate analysis when controlling for age, time to first treatment and distance as a continuous variable was not associated with survival in patients with stage III(HR 1.01, 95% CI 0.99-1.02 p=0.15) or stage IV disease (HR 1.01, 95%CI 0.98-1.04 p=0.35). Conclusions: Distance traveled to a radiation oncology treatment facility in this cohort did not influence survival in patients with stage III and IV NSCLC.

Choosing oncology as specialization: Medical students' perception after clinical rotation in cancer center.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 10528-10528
Author(s):  
Omar Orlando Castillo Fernandez ◽  
Maria Lim ◽  
Lilian Hayde Montano ◽  
Gaspar Perez-Jimenez ◽  
Jhonattan Camaño ◽  
...  
Keyword(s):  
Palliative Care ◽  
Medical Students ◽  
Radiation Oncology ◽  
Cancer Care ◽  
Medical Oncology ◽  
Surgical Oncology ◽  
Cancer Center ◽  
Clinical Rotation ◽  
Chi Square ◽  
Field Methods

10528 Background: Cancer is a leading cause of death worldwide and the demand for oncologist and palliative care specialists is increasing dramatically. Two years ago, The Universidad de Panama incorporated Oncology in the curriculum in order to face the shortage of professionals involved in cancer care. Little information is available concerning young medical students desire to pursue a career in oncology.The aim of this study is to evalute medical students perception about Oncology as a specialization field. Methods: An electronic survey was sent to medical students from Universidad de Panama after finishing Oncology rotation the last 2 years. Chi square and Mann Whitney U tests were used to compare variables. Results: 145 questionnaries were responded (40%). 60% female and 40% male. Median age was 25 years old. Clinical rotation during Oncology practices were: 37% in Medical Oncology, 24% in Surgical Oncology, 21% in Radiation Oncology and 18% in Palliative Care. 20% (29) of students are highly motivated to pursue a career in Oncology. 8 in Radiation Oncology. 8 in Surgical Oncology, 8 in Medical Oncology and 5 in Palliative Care. Variable associated with a oncology preference were: male gender (p=0.007), lack of human resources (p=0.009), contact with patients and family (p=0.005), good experience with mentor (p=0.002), nature and complexity of disease (p<0.001). Potential emotional burden was negatively asssociated (p=0.004) with oncology preference. 66% of students acknowledged that clinical rotation changed positively their perception about cancer patient care and a third of students haved not rule out the possibility to choose Oncology in the near future. Conclusions: Early exposition to medical student to cancer care might help to reduce the global shortage of oncologist and palliative specialists.

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