Involvement of family physicians in the care of cancer patients seen in the palliative Rapid Response Radiotherapy Program.
(57/250)
PURPOSE: It is important for cancer patients to maintain continuity of care with their family physician (FP) while being followed at the cancer center. The primary objective of this study was to determine the perception of patients seen in the palliative Rapid Response Radiotherapy Program (RRRP) on FP involvement in their cancer care. Secondary objectives were to identify factors predicting for perceived FP involvement in patient cancer care. PATIENTS AND METHODS: Consecutive patients were approached for study enrollment at the time of RRRP visit and asked to complete a 15-item survey. RESULTS: Three hundred sixty-five patients were accrued over 15 months. Ninety-eight percent had an FP, and 43% felt their FP was involved in their cancer care. Eighty percent of patients were satisfied with the overall medical care provided by their FP, and 71% had been with their FP for > or = 5 years. The most common reason patients gave for perceiving limited FP involvement was the medical oncologist looking after all of their cancer needs. Multivariate analysis found that satisfaction with overall medical care provided by the FP, shorter time since last FP visit, seeing the FP since cancer diagnosis, and FP providing on-call service for after-hour emergencies all significantly predicted for patients perceiving FP involvement in their cancer care. CONCLUSION: Less than half of patients surveyed perceived their FP as involved in their cancer care. Encouraging continuity of care between patients and FPs may allow for easier transition of care back to the FP once palliative treatment at the cancer center has finished and help facilitate end-of-life planning. (+info)
Randomized controlled trials in health technology assessment: overkill or overdue?
(58/250)
From policy to practice: assessing the impact of staging policies for recording cancer stage across Canada.
(61/250)
In 1998, a survey of all hospitals in Canada by the National Cancer Institute (NCI) of Canada found that only 17% reported that stage was routinely recorded. Closely following the methodology of the 1998 study, an online questionnaire was sent to the chief executive officer of 201 institutions in Canada. Since the study in 1998, it was found that the staging rate in Canada has significantly increased from 17 to 36%. The implementation of a staging policy has had a significant impact on the practices of recording stage, but further policy initiatives, education and communication are required to improve institutional staging practices. (+info)
Development of a novel post-processing treatment planning platform for 4D radiotherapy.
(62/250)
The aim of this study is to develop an Automatic Post-processing Tool for four-dimensional (4D) treatment planning (APT4D) that enables the user to perform some necessary procedures related to 4D treatment planning, such as automated image registration, automatic propagation of regions of interest, and dose distribution transformation. Demons-based deformable registrations were performed to map the moving phase images (such as the end-inhalation phase or 0% phase) to the reference phase (typically the end-exhalation fixed phase or 50% phase). Contours were automatically propagated into the moving phase using the image registration results. The dose distribution of each moving phase was transformed to the fixed phase and subsequently was summed as an average with equal weighting factor. To validate the application of APT4D utility, the 4D computed tomography (CT) images of a lung cancer patient and an abdominal cancer patient were acquired and resorted into ten respiratory phases. 4D plans based on the 4D CT images were developed. The correlation coefficient ranged from 0.992 to 0.999 for the re-sampled deformed moving phase image against the fixed phase image for the lung patient plan and from 0.977 to 0.999 for the abdominal patient plan. For all the organs, the match indices between the manual contours and automatic contour propagation results were around 0.92 to 0.95. The 4D composite dose-volume histogram showed dosimetric reductions for liver and kidneys in the high dose region. The APT4D adds automation, efficiency, and functionality, while integrating the whole process of 4D treatment planning. (+info)
Assessment of "best practice" treatment patterns for a "radiation oncology community outreach group" engaged in cancer disparities outcomes.
(63/250)