Jordan Hill1, Mohannad Alhumaid1, Sunita Ghosh2, Alexander Le3, Sharon M Watanabe3,4, Alysa Fairchild5,6. 1. Department of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada. 2. Department of Experimental Oncology, Cross Cancer Institute, Edmonton, AB, Canada. 3. Faculty of Medicine, University of Alberta, Edmonton, AB, Canada. 4. Department of Symptom Control and Palliative Care, Cross Cancer Institute, Edmonton, AB, Canada. 5. Department of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada. alysa.fairchild@albertathealthservices.ca. 6. Faculty of Medicine, University of Alberta, Edmonton, AB, Canada. alysa.fairchild@albertathealthservices.ca.
Abstract
PURPOSE: Palliative radiotherapy (PRT) in advanced cancer improves symptom control and quality of life. PRT consultations take place in various clinical settings, including through dedicated rapid access clinics. We examined holistic assessment and PRT delivery by consultation setting. METHODS: We analyzed patients with breast cancer who died (01/04/2013-31/03/2014), after at least one lifetime PRT consultation. Data abstracted included Karnofsky Performance Status (KPS), Edmonton Symptom Assessment System Revised (ESAS-r) ratings, and PRT timelines. Descriptive statistics, t tests of proportions, independent t tests, and chi-square tests were calculated. RESULTS: One hundred thirty patients were assessed for PRT over 224 consults, 28/224 (12.5%) in the rapid access clinic. In non-rapid access versus rapid access visits, KPS was documented in 30.1% versus 89.3%, and medication history in 53.6% versus 96.4%, respectively (both p < 0.0001). Baseline ESAS-r scores were available for 67.9% of rapid access visits, versus no non-rapid access visit. Rapid access consults had a higher proportion of subsequent supportive care referrals (46.4% versus 8.2%; p < 0.0001). Same day PRT start occurred in 37% of rapid access versus 23.4% of non-rapid access visits (p = 0.13). CONCLUSIONS: Assessment for PRT by a dedicated multidisciplinary team provides a comprehensive picture of patient needs and streamlines PRT delivery, essential to personalizing supportive care.
PURPOSE: Palliative radiotherapy (PRT) in advanced cancer improves symptom control and quality of life. PRT consultations take place in various clinical settings, including through dedicated rapid access clinics. We examined holistic assessment and PRT delivery by consultation setting. METHODS: We analyzed patients with breast cancer who died (01/04/2013-31/03/2014), after at least one lifetime PRT consultation. Data abstracted included Karnofsky Performance Status (KPS), Edmonton Symptom Assessment System Revised (ESAS-r) ratings, and PRT timelines. Descriptive statistics, t tests of proportions, independent t tests, and chi-square tests were calculated. RESULTS: One hundred thirty patients were assessed for PRT over 224 consults, 28/224 (12.5%) in the rapid access clinic. In non-rapid access versus rapid access visits, KPS was documented in 30.1% versus 89.3%, and medication history in 53.6% versus 96.4%, respectively (both p < 0.0001). Baseline ESAS-r scores were available for 67.9% of rapid access visits, versus no non-rapid access visit. Rapid access consults had a higher proportion of subsequent supportive care referrals (46.4% versus 8.2%; p < 0.0001). Same day PRT start occurred in 37% of rapid access versus 23.4% of non-rapid access visits (p = 0.13). CONCLUSIONS: Assessment for PRT by a dedicated multidisciplinary team provides a comprehensive picture of patient needs and streamlines PRT delivery, essential to personalizing supportive care.
Authors: Ethan Basch; Allison M Deal; Amylou C Dueck; Howard I Scher; Mark G Kris; Clifford Hudis; Deborah Schrag Journal: JAMA Date: 2017-07-11 Impact factor: 56.272
Authors: Sharon M Watanabe; Viane Faily; Asifa Mawani; Ann Huot; Yoko Tarumi; Alexei Potapov; Konrad Fassbender; Alysa Fairchild; Anil A Joy; Karen M King; Wilson Roa; Christopher P Venner; Vickie E Baracos Journal: Oncologist Date: 2020-06-09
Authors: Betty R Ferrell; Jennifer S Temel; Sarah Temin; Erin R Alesi; Tracy A Balboni; Ethan M Basch; Janice I Firn; Judith A Paice; Jeffrey M Peppercorn; Tanyanika Phillips; Ellen L Stovall; Camilla Zimmermann; Thomas J Smith Journal: J Clin Oncol Date: 2016-10-28 Impact factor: 44.544
Authors: Ethan Basch; Allison M Deal; Mark G Kris; Howard I Scher; Clifford A Hudis; Paul Sabbatini; Lauren Rogak; Antonia V Bennett; Amylou C Dueck; Thomas M Atkinson; Joanne F Chou; Dorothy Dulko; Laura Sit; Allison Barz; Paul Novotny; Michael Fruscione; Jeff A Sloan; Deborah Schrag Journal: J Clin Oncol Date: 2015-12-07 Impact factor: 44.544