Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice guidelines and Quality Certification Do Not Avert Variability in Clinical Practice

Background: The therapeutic approach to cancer is complex and multidisciplinary. Radiotherapy is among the essential treatments, whether used alone or in conjunction with other therapies. This study reports a clinical audit of the radiotherapy process to assess the process of care, evaluate adherenc...

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Autores: Torras, M. G., Canals, E., Jurado Bruggeman, D., Marín Borràs, S., Macià, M., Jové, J., Boladeras, A. M., Muñoz Montplet, C., Molero, J., Picón, C., Puigdemont, M., Aliste, Luisa, Torrents, A., Guedea Edo, Ferran, Borràs Andrés, Josep Maria
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Recursos:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/172493
Acesso em linha:https://hdl.handle.net/2445/172493
Access Level:acceso abierto
Palavra-chave:Càncer
Radioteràpia
Cancer
Radiotherapy
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spelling Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice guidelines and Quality Certification Do Not Avert Variability in Clinical PracticeTorras, M. G.Canals, E.Jurado Bruggeman, D.Marín Borràs, S.Macià, M.Jové, J.Boladeras, A. M.Muñoz Montplet, C.Molero, J.Picón, C.Puigdemont, M.Aliste, LuisaTorrents, A.Guedea Edo, FerranBorràs Andrés, Josep MariaCàncerRadioteràpiaCancerRadiotherapyBackground: The therapeutic approach to cancer is complex and multidisciplinary. Radiotherapy is among the essential treatments, whether used alone or in conjunction with other therapies. This study reports a clinical audit of the radiotherapy process to assess the process of care, evaluate adherence to agreed protocols and measure the variability to improve therapeutic quality for rectal cancer. Methods: Multicentre retrospective cohort study in a representative sample of patients diagnosed with rectal cancer in the Institut Català d'Oncologia, a comprehensive cancer centre with three different settings. We developed a set of indicators to assess the key areas of the radiotherapy process. The clinical audit consisted of a review of a random sample of 40 clinical histories for each centre. Results: The demographic profile, histology and staging of patients were similar between centres. The MRI reports did not include the distance from tumour to mesorectal fascia (rCRM) in 38.3% of the cases. 96.7% of patients received the planned dose, and 57.4% received it at the planned time. Surgery followed neoadjuvant treatment in 96.7% of the patients. Among this group, postoperative CRM was recorded in 65.5% of the cases and was negative in 93.4% of these. With regard to the 34.5% (n = 40) of cases where no CRM value was stated, there were differences between the centres. Mean follow-up was 3.4 (SD 0.6) years, and overall survival at four years was 81.7%. Conclusions: The audit revealed a suboptimal degree of adherence to clinical practice guidelines. Significant variability between centres exists from a clinical perspective but especially with regard to organization and process.Elsevier2020202020182020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion6 p.application/pdfhttps://hdl.handle.net/2445/172493Articles publicats en revistes (Ciències Clíniques)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1016/j.tranon.2018.03.015Translational Oncology, 2018, vol. 11, num. 3, p. 794-799https://doi.org/10.1016/j.tranon.2018.03.015cc-by-nc-nd (c) Torras, M. G. et al., 2018http://creativecommons.org/licenses/by-nc-nd/3.0/esinfo:eu-repo/semantics/openAccessoai:recercat.cat:2445/1724932026-05-29T05:05:01Z
dc.title.none.fl_str_mv Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice guidelines and Quality Certification Do Not Avert Variability in Clinical Practice
title Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice guidelines and Quality Certification Do Not Avert Variability in Clinical Practice
spellingShingle Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice guidelines and Quality Certification Do Not Avert Variability in Clinical Practice
Torras, M. G.
Càncer
Radioteràpia
Cancer
Radiotherapy
title_short Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice guidelines and Quality Certification Do Not Avert Variability in Clinical Practice
title_full Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice guidelines and Quality Certification Do Not Avert Variability in Clinical Practice
title_fullStr Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice guidelines and Quality Certification Do Not Avert Variability in Clinical Practice
title_full_unstemmed Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice guidelines and Quality Certification Do Not Avert Variability in Clinical Practice
title_sort Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice guidelines and Quality Certification Do Not Avert Variability in Clinical Practice
dc.creator.none.fl_str_mv Torras, M. G.
Canals, E.
Jurado Bruggeman, D.
Marín Borràs, S.
Macià, M.
Jové, J.
Boladeras, A. M.
Muñoz Montplet, C.
Molero, J.
Picón, C.
Puigdemont, M.
Aliste, Luisa
Torrents, A.
Guedea Edo, Ferran
Borràs Andrés, Josep Maria
author Torras, M. G.
author_facet Torras, M. G.
Canals, E.
Jurado Bruggeman, D.
Marín Borràs, S.
Macià, M.
Jové, J.
Boladeras, A. M.
Muñoz Montplet, C.
Molero, J.
Picón, C.
Puigdemont, M.
Aliste, Luisa
Torrents, A.
Guedea Edo, Ferran
Borràs Andrés, Josep Maria
author_role author
author2 Canals, E.
Jurado Bruggeman, D.
Marín Borràs, S.
Macià, M.
Jové, J.
Boladeras, A. M.
Muñoz Montplet, C.
Molero, J.
Picón, C.
Puigdemont, M.
Aliste, Luisa
Torrents, A.
Guedea Edo, Ferran
Borràs Andrés, Josep Maria
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Càncer
Radioteràpia
Cancer
Radiotherapy
topic Càncer
Radioteràpia
Cancer
Radiotherapy
description Background: The therapeutic approach to cancer is complex and multidisciplinary. Radiotherapy is among the essential treatments, whether used alone or in conjunction with other therapies. This study reports a clinical audit of the radiotherapy process to assess the process of care, evaluate adherence to agreed protocols and measure the variability to improve therapeutic quality for rectal cancer. Methods: Multicentre retrospective cohort study in a representative sample of patients diagnosed with rectal cancer in the Institut Català d'Oncologia, a comprehensive cancer centre with three different settings. We developed a set of indicators to assess the key areas of the radiotherapy process. The clinical audit consisted of a review of a random sample of 40 clinical histories for each centre. Results: The demographic profile, histology and staging of patients were similar between centres. The MRI reports did not include the distance from tumour to mesorectal fascia (rCRM) in 38.3% of the cases. 96.7% of patients received the planned dose, and 57.4% received it at the planned time. Surgery followed neoadjuvant treatment in 96.7% of the patients. Among this group, postoperative CRM was recorded in 65.5% of the cases and was negative in 93.4% of these. With regard to the 34.5% (n = 40) of cases where no CRM value was stated, there were differences between the centres. Mean follow-up was 3.4 (SD 0.6) years, and overall survival at four years was 81.7%. Conclusions: The audit revealed a suboptimal degree of adherence to clinical practice guidelines. Significant variability between centres exists from a clinical perspective but especially with regard to organization and process.
publishDate 2018
dc.date.none.fl_str_mv 2018
2020
2020
2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/172493
url https://hdl.handle.net/2445/172493
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1016/j.tranon.2018.03.015
Translational Oncology, 2018, vol. 11, num. 3, p. 794-799
https://doi.org/10.1016/j.tranon.2018.03.015
dc.rights.none.fl_str_mv cc-by-nc-nd (c) Torras, M. G. et al., 2018
http://creativecommons.org/licenses/by-nc-nd/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc-nd (c) Torras, M. G. et al., 2018
http://creativecommons.org/licenses/by-nc-nd/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 6 p.
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv Articles publicats en revistes (Ciències Clíniques)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.811543

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