title: Influence of the treatment schedule on the physicians' decisions to refer bone metastases patients for palliative radiotherapy: a questionnaire survey of physicians in various specialties.
abstract: We investigated whether the treatment schedule influences physicians' decisions to refer their patients for radiotherapy. We presented a questionnaire to 104 physicians in various specialties at three hospitals. It included three hypothetical patients with uncomplicated painful bone metastasis: patients with an expected life span of one year (case 1), 6 months (case 2), and 2 months (case 3). The physicians were asked whether they would refer their patients for radiotherapy when a radiation oncologist presented three different treatment schedules: a short (8 Gy/1 fraction/1 day)-, a medium (20 Gy/5 fractions/1 week)-, and a long (30 Gy/10 fractions/2 weeks) schedule. We used Cochran's Q-test to compare the percentage of physicians across the three schedules and a mixed-effect logistic model to identify predictors of the selection of only the one-day schedule. Of the 104 physicians, 68 (65%) responded. Of these, 37 (54%), 27 (40%), and 26 (38%) chose to refer patients for radiotherapy when the short-, medium-, and long schedules, respectively, were proposed in case 1 (p = 0.14). These numbers were 44 (65%), 29 (43%), and 15 (22%) for case 2 (p < 0.001), and 59 (87%), 12 (18%), and 1 (1%) for case 3 (p < 0.001). Hypothetical patient and the physicians' years of practice and perspective regarding side effects were independently predictive of the selection of only the one-day schedule. In conclusion, the treatment schedule influenced the physicians' decisions to refer patients for radiotherapy.
authors: Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto, Japan; Department of Radiation Oncology, Hitoyoshi Medical Center, Hitoyoshi, Japan.
authors: Tetsuo
authors: T
authors: Saito
authors: Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto, Japan.
authors: Ryo
authors: R
authors: Toya
authors: Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto, Japan.
authors: Akiko
authors: A
authors: Semba
authors: Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto, Japan.
authors: Tomohiko
authors: T
authors: Matsuyama
authors: Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto, Japan.
authors: Natsuo
authors: N
authors: Oya
mesh_terms: D001859:Bone Neoplasms / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008297:Male; D010166:Palliative Care; D011879:Radiotherapy Dosage; D011795:Surveys and Questionnaires
keywords: bone metastasis; pain; palliative care; questionnaire; radiotherapy