Document Detail


Estimating risks of radiotherapy complications as part of informed consent: the high degree of variability between radiation oncologists may be related to experience.
MedLine Citation:
PMID:  12377314     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Estimating the risks of radiotherapy (RT) toxicity is important for informed consent; however, the consistency in estimates has not been studied. This study aimed to explore the variability and factors affecting risk estimates (REs). METHODS AND MATERIALS: A survey was mailed to Australian radiation oncologists, who were asked to estimate risks of RT complications given 49 clinical scenarios. The REs were assessed for association with oncologist experience, subspecialization, and private practice. RESULTS: The REs were extremely variable, with a 50-fold median variability. The least variability (sevenfold) was for estimates of late, small intestinal perforation/obstruction after a one-third volume received 50 Gy with concurrent 5-fluorouracil (RE range 5-35%). The variation between the smallest and largest REs in 17 scenarios was >or=100-fold. The years of experience was significantly associated with REs of soft/connective-tissue toxicity (p = 0.01) but inversely associated with estimates of neurologic/central nervous system toxicity (p = 0.08). Ninety-six percent of respondents believed REs were important to RT practice; only 24% rated evidence to support their estimates as good. Sixty-seven percent believed national/international groups should pursue the issue further. CONCLUSION: Enormous variability exists in REs for normal tissue complications due to RT that is influenced by the years of experience. Risk estimation is perceived as an important issue without a good evidence base. Additional studies are strongly recommended.
Authors:
Thomas Philip Shakespeare; Mary Dwyer; Rahul Mukherjee; Roland Yeghiaian-Alvandi; Val Gebski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  54     ISSN:  0360-3016     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-10-14     Completed Date:  2002-11-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  647-53     Citation Subset:  IM    
Affiliation:
National University Hospital, Singapore, Singapore. ThomasS@nuh.com.sg
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MeSH Terms
Descriptor/Qualifier:
Antimetabolites, Antineoplastic / administration & dosage
Australia
Dose-Response Relationship, Radiation
Fluorouracil / administration & dosage
Health Care Surveys
Humans
Informed Consent*
Organ Specificity
Radiation Injuries / etiology*
Radiation Oncology / standards*
Radiotherapy / adverse effects*
Risk Assessment
Chemical
Reg. No./Substance:
0/Antimetabolites, Antineoplastic; 51-21-8/Fluorouracil
Comments/Corrections
Comment In:
Int J Radiat Oncol Biol Phys. 2002 Nov 1;54(3):642-6   [PMID:  12377313 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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