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O26 - Support and Palliation II (ID 140)
- Event: WCLC 2013
- Type: Oral Abstract Session
- Track: Nurses
- Presentations: 1
O26.05 - Patterns of care in palliative radiotherapy delivery in advanced lung cancer: How has this influenced the development of a Palliative Radiotherapy Rapid Assessment Clinic (PRRAC)? (ID 3060)
16:15 - 17:45 | Author(s): C. Fitzpatrick
Radiotherapy (RT) is a clinically and cost effective modality of treatment for symptom palliation. It plays a significant role in advanced lung cancer, by providing relief from symptoms such as haemoptysis and bone pain, as well as preserving neurological function in patients with brain metastases or spinal cord compression. The standard clinical approach for RT may require multiple attendances for consultation and planning, followed by a waiting period for treatment. However, patients with advanced lung cancer presenting for palliative radiotherapy are often of poor performance status with limited life expectancy. Prompt and streamlined RT is required to improve the experience of care for these patients. The Palliative Radiotherapy Rapid Assessment Clinic (PRRAC) was developed as an innovative and sustainable clinic to align consultation, planning and treatment within a single visit to facilitate efficient access to palliative radiotherapy for patients with advanced lung cancer. The PRRAC aims to i) increase accessibility of palliative RT for symptomatic patients with lung cancer, ii) reduce waiting times and iii) improve patient and referrer satisfaction.
A retrospective audit of symptomatic patients with lung cancer who received low dose palliative RT from June – November 2012 at Peter Mac, East Melbourne was performed. Patient demographics, dates of initial clinic, planning and RT commencement, and RT dose fractionation schedules were collected. A service model (PRRAC) was developed based on the adaptation of similar clinics in operation in Canada and Brisbane, Australia. The proposed PRRAC will be piloted for 6 months. Eligibility criteria include those patients with symptomatic locally advanced or metastatic lung cancer who require low dose simple RT techniques. Service utilisation and average waiting times will be compared to previous patterns of care. Patient outcomes and surveys of referring physicians will be evaluated prospectively. Overall utilisation of the service will help assess clinical need & sustainability.
The retrospective audit has demonstrated 79 patients with lung cancer who were prescribed low dose palliative RT. The mean age was 70 years and 17% of patients were ECOG status >3. The mean waiting time from initial clinic assessment to planning was 3.6 days (SD 3.7), and from planning to RT commencement was 5.4 days (SD 5.1). 48% of patients were prescribed a single dose of RT. The early results and challenges in developing the prospective PRRAC as a new model of care for patients with lung cancer will be presented.
The PRRAC is expected to improve access of patients to palliative radiotherapy, and shorten waiting time from clinic to RT commencement date with less visits and potentially shorter dose fractionation schedules. It is anticipated that PRRAC will also improve patient and referrer satisfaction. Following successful completion of the project, the PRRAC will be embedded into clinical practice, and extended to other tumour streams.
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