Abstract：
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.
摘要：
我们试图使用质量指标(QIs)来确定姑息性放疗的潜在证据-实践差距。以前使用改进的Delphi方法开发。七个QI用于评估骨转移（BoM）和脑转移（BrM）的放疗质量。依从率计算为推荐医疗护理的患者百分比。随机效应模型用于估计合并的依从率。在邀请的39名放射肿瘤学家中，来自29个中心的29个（74％）参加了调查；13个（45％）是学术医院，16个（55％）是非学术医院。对于QIs，除BoM-4外，汇总合规率高于80%；然而，至少对于一些中心来说，依从率低于这些汇总率.对于BoM-4，关于在恶性脊髓压迫的放疗中同时使用类固醇，合并依从率低至32%.对于BoM-1关于辐射时间表的选择，学术医院的依从率高于非学术医院(P=0.021).对于BrM-3关于立即开始放疗，学术医院的依从率低于非学术医院(P=0.016).总之,总的来说,合规率很高；然而，对于许多QIs来说，至少在一些中心，实践还有待改进。类固醇很少与放射治疗恶性脊髓压迫同时使用。
