RESUMO
OBJECTIVE: The aim of this follow-up pattern of care study was to evaluate current clinical practices, staffing and equipment, and to compare these results to a study performed 5 years previously. MATERIALS AND METHODS: This descriptive, pattern of care study was carried out via an online questionnaire. The survey was sent to a total of 95 cancer care centres in Spain. RESULTS: Seventy-three centres (76.8%) responded to the survey. More than half (57.5%) of responding centres offered brachytherapy (BT). A mean of 120 patients/centre were treated by BT in 2007. The most common localisations were the endometrium (29.6% of cases), prostate (29.6%), cervix uteri (14.6%), breast (12.6%), head and neck (3.6%) and vagina (2.5%). Other sites accounted for less than 2% of cases each. Most centres that offered BT (33/40 = 82.5%) were equipped with a dedicated BT operating room. The most commonly reported dosimetric method was CT dosimetry (31 of 40 centres = 77.5%), followed by plain film (30/40 = 75%), ultrasound (26/40 = 65%), MRI (8/40 = 20%), in vivo (7/40 = 17.5%) and PET-CT (5/40 = 12.5%) dosimetry. CONCLUSION: The three most common treatment sites (gynaecological, breast and prostate) remain unchanged from 2002, with prostate treatments showing large increase. Advanced dosimetric techniques (MRI, PET-CT and CT-dosimetry) continue to gain adherents. Some centres treat small numbers of patients, a finding that deserves more attention in terms of cost and quality of care. Although BT remains strong in Spain, it could be further strengthened by making modern dosimetric techniques and treatments more widely available.
Assuntos
Braquiterapia/instrumentação , Braquiterapia/estatística & dados numéricos , Neoplasias/radioterapia , Admissão e Escalonamento de Pessoal , Padrões de Prática Médica , Qualidade da Assistência à Saúde , Seguimentos , Pesquisas sobre Atenção à Saúde , Humanos , Neoplasias/diagnóstico por imagem , Neoplasias/patologia , Prognóstico , Radiografia , Inquéritos e QuestionáriosRESUMO
PURPOSE: The aim of this pattern of care survey was to provide an overview of brachytherapy resources and practices in the United Kingdom (UK) and Spain and to identify differences that may be relevant to health-care delivery and planning. METHODS AND MATERIALS: Both countries formed part of a larger survey of European radiation oncology centres carried out in 2002. The present study includes only data from centres that perform brachytherapy and completed the questionnaire. RESULTS: Between 1997 and 2002, the number of hospitals offering brachytherapy increased by 10.2% in the UK and 21.4% in Spain. The mean number of radiotherapy patients per centre was significantly higher in the UK (2811 patients) than in Spain (1203). Gynaecological tumours accounted for most procedures (59.7% in Spain and 60.8% in the UK), followed by prostate cancer in the UK (16.7%) and breast cancer in Spain (15.5%). Significantly more procedures for breast cancer were performed in Spain (19.7 patients/centre) than in the UK (0.4 patients/centre). A significantly higher percentage of radiation oncologists in Spain performed brachytherapy, dedicating more time to brachytherapy-related work (22.2 h/week) than their colleagues in the UK (6.7 h/week). CONCLUSIONS: Brachytherapy resources and patterns of care are similar in both countries, although several notable differences exist. Radiation oncologists in Spain dedicate significantly more time to brachytherapy. Compared to the UK, brachytherapy is used more frequently in Spain as a boost in breast cancer treatments. Both countries perform more brachytherapy procedures for prostate cancer than the European average.