Journal Article

Quality of palliative radiotherapy assessed using quality indicators: a multicenter survey

Shikama, Naoto, Yasuda, Shigeo, Miwa, Misako, Kiyohara, Hiroki, Takahashi, Takeo, Kawamoto, Terufumi, Nozaki, Miwako, Heianna, Joichi, Mori, Takashi, Ohkubo, Yu, Nishimura, Takeshi, Kosugi, Takashi, Ebara, Takeshi, Onishi, Hiroshi, Sekii, Shuhei, Higuchi, Keiko, Wada, Yuki, Uchida, Nobue, Yorozu, Atsunori, Imano, Nobuki, Yamada, Kazunari, Harada, Hideyuki, Watanabe, Miho, Miyazawa, Kazunari, Ejima, Yasuo, Saito, Tetsuo, Koizumi, Masahiko, Nakajima, Kaori, Araki, Norio, Nakamura, Naoki

2024

Overview

We sought to identify potential evidence-practice gaps in palliative radiotherapy using quality indicators (QIs), previously developed using a modified Delphi method. Seven QIs were used to assess the quality of radiotherapy for bone metastases (BoM) and brain metastases (BrM). Compliance rate was calculated as the percentage of patients for whom recommended medical care was conducted. Random effects models were used to estimate the pooled compliance rates. Of the 39 invited radiation oncologists, 29 (74%) from 29 centers participated in the survey; 13 (45%) were academic and 16 (55%) were non-academic hospitals. For the QIs, except for BoM-4, the pooled compliance rates were higher than 80%; however, for at least some of the centers, the compliance rate was lower than these pooled rates. For BoM-4 regarding steroid use concurrent with radiotherapy for malignant spinal cord compression, the pooled compliance rate was as low as 32%. For BoM-1 regarding the choice of radiation schedule, the compliance rate was higher in academic hospitals than in non-academic hospitals (P = 0.021). For BrM-3 regarding the initiation of radiotherapy without delay, the compliance rate was lower in academic hospitals than in non-academic hospitals (P = 0.016). In conclusion, overall, compliance rates were high; however, for many QIs, practice remains to be improved in at least some centers. Steroids are infrequently used concurrently with radiotherapy for malignant spinal cord compression.

• Publisher: Oxford University Press (OUP),Oxford University Press
• Subject: Bone Neoplasms - radiotherapy / Bone Neoplasms - secondary / Brain cancer / Brain Neoplasms - radiotherapy / Brain tumors / Compliance / Delphi method / Evidence-based medicine / Guideline Adherence / Hospitals / Humans / Indicators / Japan / Medical colleges / Metastasis / Oncology/Medicine / Palliative Care / Quality control / Quality Indicators, Health Care / Radiation / Radiation therapy / Radiotherapy / Spinal cord / Steroids / Surveys / Surveys and Questionnaires