Base de dados : IBECS
Pesquisa : H02.403.429.515.500 [Categoria DeCs]
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Texto completo SciELO Espanha
Id: 189480
Autor: Padilla Garrido, Nuria; Aguado Correa, Francisco; Bayo Lozano, Eloísa; Bayo Calero, Juan; Ortega Moreno, Mónica.
Título: Conocimiento y evaluación de la toma de decisiones compartidas en la práctica oncológica desde el punto de vista médico / Physicians' awareness and assessment of shared decision making in oncology practice
Fonte: Rev. esp. salud pública;93:0-0, 2019. tab.
Idioma: es.
Resumo: OBJETIVO: La implementación de la Toma de Decisiones Compartidas (TDC) en oncología es escasa. El objetivo del estudio fue determinar el conocimiento de la TDC que tienen los médicos que tratan a pacientes con cáncer, la utilidad que le conceden, el rol que desempeñan, la evaluación que hacen, y las barreras y facilitadores que encuentran para su uso. MÉTODOS: Se realizó una encuesta a oncólogos médicos, oncólogos radioterápicos y cirujanos generales que ejercían en Andalucía (España). Se recogieron variables sociodemográficas, clínico-asistenciales y de aspectos de la TDC. La TDC se evaluó mediante el cuestionario SDM-Q-Doc. Se emplearon contrastes no paramétricos para determinar las posibles diferencias entre especialidades médicas. RESULTADOS: El cuestionario se envió a 351 médicos y la tasa de respuesta fue del 37,04%. Respondieron 63 mujeres y 67 hombres, con un promedio de 45,6 años de edad y 18,04 años de experiencia. El 33,08% eran oncólogos médicos, el 34,61% oncólogos radioterápicos y el 29,23% cirujanos generales. El 82,3% no tenía formación en TDC y el 33,8% reconocía saber bastante y utilizarla en su práctica habitual. El 80% consideró que era muy útil. El 60% respondió que la decisión sobre el tratamiento la tomaban mayormente ellos. Al evaluar la TDC con la escala SDM-Q-Doc, todas las especialidades obtuvieron más de 80 puntos sobre 100. Las principales barreras para aplicar la TDC fueron la dificultad del paciente para entender lo que necesitaba saber, la falta de instrumentos de apoyo, así como la falta de tiempo. CONCLUSIONES: Un 82% de los médicos no tiene formación en TDC y un 66% no la utiliza en su práctica habitual, tomando la decisión sobre el tratamiento mayoritariamente ellos. Es importante adoptar estrategias para aumentar la formación en TDC e implementarla en la práctica clínica diaria

OBJECTIVE: Implementation of Shared Decision Making (SDM) in oncology is limited. The objective of the study was to determine the extent of physicians' awareness of Shared Decision Making (SDM) in their treatment of cancer patients, the usefulness that they assign to SDM, the role they play, their assessment of SDM, and perceptions of the main barriers and facilitators to its use. METHODS: A questionnaire was completed by medical oncologists, radiation oncologists and general surgeons working in Andalusia (Spain). Sociodemographic, clinical-care and aspects of SDM variables were collected. SDM was evaluated using the SDM-Q-Doc questionnaire. Non-parametric contrasts were used to determine the possible differences between medical specialties. RESULTS: The questionnaire was sent to 351 physicians. The response rate was 37.04%, 63 women and 67 men, with an average age of 45.6 years and 18.04 years' experience. Of these, 33.08% were medical oncologists, 34.61% radiation oncologists and 29.23% general surgeons. A total of 82.3% stated they had received no training in SDM, whereas 33.8% said they knew a lot about SDM and applied it in practice; 80% considered it to be very useful. In addition, 60% of respondents said they were mainly the ones who made the decisions on treatment. An evaluation of SDM on the SDM-Q-Doc scale showed that all the specialities scored more than 80/100. The main barriers to applying SDM were the difficulty patients experienced in understanding what they needed to know, the lack of decision aids and time. CONCLUSIONS: Some 82% of physicians have no training in SDM and 66% don't use it in practice, with decisions on treatment taken mainly by the physicians themselves. Strategies to increase training in SDM and to implement it into clinical practice are important
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Id: 185071
Autor: Helmberge, T.
Título: Oncología intervencionista: ¿cuál es la situación actual y qué estrategia debemos seguir en el futuro? / Interventional Oncology - where are we now? - And where we should head for
Fonte: Radiología (Madr., Ed. impr.);61(1):1-3, ene.-feb. 2019.
Idioma: es.
Resumo: No disponible
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Id: 176650
Autor: Rahy-Martín, Aida Cristina; Cruz-Benavides, Francisco; Sánchez-Lauro, Mar; Rodríguez-Méndez, Álvaro; San Miguel, Íñigo; Lara, Pedro; Marchena-Gómez, Joaquín.
Título: Radioterapia intraoperatoria con Intrabeam(R) para el tratamiento del adenocarcinoma de páncreas resecable / Intraoperative radiotherapy with the Intrabeam(R) device for the treatment of resectable pancreatic adenocarcinoma
Fonte: Cir. Esp. (Ed. impr.);96(8):482-487, oct. 2018. ilus, tab.
Idioma: es.
Resumo: INTRODUCCIÓN: La aplicación de radioterapia intraoperatoria en el lecho tumoral tras la resección de un cáncer de páncreas ha demostrado ser beneficiosa en el control local de la enfermedad. El objetivo de este estudio fue valorar los resultados iniciales obtenidos tras la aplicación de una nueva modalidad de radioterapia intraoperatoria (Intrabeam(R)) en términos de viabilidad, seguridad y resultados a corto plazo. MÉTODOS: Se estudiaron 5 pacientes sometidos a duodenopancreatectomía cefálica por cáncer de páncreas resecable, en los que se aplicó intraoperatoriamente un boost de radioterapia (5Gy) en el lecho tumoral mediante la utilización del dispositivo portátil Intrabeam(R), fuente puntual de rayos X de baja energía. Se analizaron las complicaciones, estancia y mortalidad postoperatorias, recidivas y superviviencia a corto plazo. RESULTADOS: La edad media fue de 68 años. Todos los pacientes presentaban un estadio tumoral T3 y uno de ellos N1. En 3 pacientes se realizó una resección R0 y en 2 casos resultó ser una resección R1. La mortalidad peroperatoria fue del 0%. Solo se presentaron como complicaciones un retraso en el vaciamiento gástrico y una hemorragia postoperatoria. No hubo fístulas pancreáticas. Durante el seguimiento (media: 11,2 meses) se constató una recidiva en el paciente en el que se había practicado una resección R1. CONCLUSIONES: La aplicación de radioterapia con el dispositivo Intrabeam(R) en pacientes seleccionados no ha supuesto un aumento de la morbimortalidad peroperatoria, mostrándose como un procedimiento seguro en el tratamiento del cáncer resecable

INTRODUCTION: The application of intraoperative radiation therapy to the tumor bed after resection of pancreatic cancer has been shown to be beneficial in the local control of the disease. The objective of this study was to evaluate the preliminary outcomes after the application of a single intraoperative dose to the tumor bed with a new intraoperative radiotherapy device (Intrabeam(R)) in terms of viability, safety and short-term results. METHODS: We studied 5 patients who underwent pancreaticoduodenectomy for resectable pancreatic cancer in which a radiotherapy boost (5Gy) was intraoperatively applied to the tumoral bed using the portable Intrabeam(R) device, a low-energy point-source X-ray. Postoperative complications, hospital stay and mortality, recurrences and short-term survival were analyzed. RESULTS: Mean patient age was 68 years. All patients had a T3-stage tumor and one of them N1. In 3 patients, R0 resection was performed, while R1 resection was conducted in 2. Perioperative mortality was 0%. The only complications included delayed gastric emptying and postoperative hemorrhage. There were no pancreatic fistulas. During follow-up (mean: 11.2 months), there was a relapse in the patient who had undergone R1 resection. CONCLUSIONS: The application of radiotherapy with the Intrabeam (R) device in selected patients has not resulted in increased perioperative morbidity or mortality; therefore, this is a safe procedure for the treatment of resectable cancer
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Id: 173764
Autor: Sabater, S; Montero, A; López Fernández, T; González Ferrer, JJ; Arenas, M.
Título: Management of patients with implanted cardiac devices during radiotherapy: results of a Spanish survey in radiation oncology departments
Fonte: Clin. transl. oncol. (Print);20(12):1577-1581, dic. 2018. tab.
Idioma: en.
Resumo: Background: There is an increasing number of patients with cardiac implantable electronic devices (CIED), either pacemakers or defibrillators, who are receiving a course of radiotherapy. Several guidelines have been published by national societies, but no Spanish national guidelines for management of these patients have been published. More importantly, national clinical practice regarding these patients is not standardised. Materials and methods: Members of the Spanish Breast Cancer Radiation Oncology Group (GEORM in Spanish) were surveyed through an online questionnaire on behalf of the Spanish radiation oncology departments. Results: Only 39.3% of the Spanish radiation oncology departments have policies aimed at CIED carrier patients. Regardless of that, 96.4% of those who responded to the survey refer these patients to their Cardiology department before the start of the course of radiotherapy, and 17.8% of respondents said to manipulate the CIED without any cardiology department direction. A wide range of responses was obtained related to concepts such as "distance from the irradiation field to the CIED" or "safe accumulated doses". Conclusions: Our results demonstrate the need for national guidelines for CIED patients and the need to promote educational activities addressed to standardise clinical management of these patients in the radiation oncology departments

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Id: 171636
Autor: Garrido, P; Aldaz, A; Vera, R; Calleja, MA; Álava, E de; Martín, M; Matías-Guiu, X; Palacios, J.
Título: Proposal for the creation of a national strategy for precision medicine in cancer: a position statement of SEOM, SEAP, and SEFH
Fonte: Clin. transl. oncol. (Print);20(4):443-447, abr. 2018.
Idioma: en.
Resumo: Precision medicine is an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person. Precision medicine is transforming clinical and biomedical research, as well as health care itself from a conceptual, as well as a methodological viewpoint, providing extraordinary opportunities to improve public health and lower the costs of the healthcare system. However, the implementation of precision medicine poses ethical-legal, regulatory, organizational, and knowledge-related challenges. Without a national strategy, precision medicine, which will be implemented one way or another, could take place without the appropriate planning that can guarantee technical quality, equal access of all citizens to the best practices, violating the rights of patients and professionals, and jeopardizing the solvency of the healthcare system. With this paper from the Spanish Societies of Medical Oncology, Pathology, and Hospital Pharmacy, we highlight the need to institute a consensual national strategy for the development of precision medicine in our country, review the national and international context, comment on the opportunities and challenges for implementing precision medicine, and outline the objectives of a national strategy on precision medicine in cancer (AU)

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Id: 167118
Autor: Lupiañez-Perez, Y; Gomez-Millan, J; Lobato, M; Pedrosa, P; Lupiañez-Perez, I; Medina, JA.
Título: Improving efficacy and efficiency through the implementation of a new organisational model in a Radiation Oncology Department
Fonte: Clin. transl. oncol. (Print);19(11):1375-1381, nov. 2017. tab.
Idioma: en.
Resumo: Background. To evaluate a new organisational model, "process management" (PM), implemented in the Hospital Universitario Virgen de la Victoria (HUVV) compared with traditional models used in other Radiation Oncology Departments (RODs), in terms of efficacy and efficiency. Methods. The study period ranged from September 2011 to August 2012. Efficacy was assessed, comparing the number of patients attended in first consultation and treated per month, average waiting time from referral to first visit and average waiting time from first visit to treatment. Data were collected from two public hospitals in Andalusia: the HUVV and another Public Hospital in Andalusia (PHA1). Efficiency was assessed comparing the costs per patient attended in first visit and treated at HUVV in 2012 compared with those of a second Public Hospital in Andalusia (PHA2) for 2008. The number of sessions saved using hypofractionation versus classical schemes during the year 2012 in HUVV was estimated, and the money saved was calculated. Results. In the efficacy analysis, we found significant differences in the average waiting time for first visit, start of treatment, and the number of patients seen and treated annually. After calculating the total cost generated in the ROD, the efficiency analysis showed a lower cost per patient attended in first visit (EUR 599.17) and per patient treated (EUR 783.50), with a saving of 6035 sessions using hypofractionated schemes. Conclusions. Process management in an ROD reduces time, both to first medical visit and to treatment initiation, allowing an optimisation of linear accelerator (LINAC) capacity (AU)

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Id: 160897
Autor: Luo, Y; Qin, Y; Lang, J.
Título: Effect of adaptive replanning in patients with locally advanced nasopharyngeal carcinoma treated by intensity-modulated radiotherapy: a propensity score matched analysis
Fonte: Clin. transl. oncol. (Print);19(4):470-476, abr. 2017. tab, graf.
Idioma: en.
Resumo: Purpose. Limited data have been published regarding the effect of adaptive radiotherapy (ART) on clinical outcome in patients with nasopharyngeal carcinoma (NPC). We compared the long-term outcomes in patients with locally advanced NPC treated by adaptive intensity-modulated radiotherapy (IMRT) replanning versus IMRT. Methods. 200 NPC patients with stage T3/T4 were included between October 2004 and November 2010. Patients in both treatment groups were matched using propensity score matching method at the ratio of 1:1. Clinical outcomes were analyzed with Kaplan-Meier method, log-rank test and Cox regression. Results. After matching, 132 patients (66 patients in each group) were included for analysis. The median follow-up for the IMRT replanning group was 70 months, while the IMRT group was 69 months. The 5-year local-regional recurrence-free survival (LRFS) rate was higher in IMRT replanning group (96.7 vs. 88.1 %, P = 0.022). No significant differences in distant metastasis-free survival (DMFS), progression-free survival (PFS) and overall survival (OS) were observed between the two groups. 21.2 % patients in IMRT replanning group and 28.8 % patients in IMRT group had distant metastasis. In multivariable analysis, IMRT replanning was identified as an independent prognostic factor for LRFS (hazard ratio 0.229; 95 % CI 0.062-0.854; P = 0.028), but not for DMFS, PFS and OS. Conclusions. IMRT replanning provides an improved LRFS for stage T3/T4 NPC patients compared with IMRT. Distant metastasis remains the main pattern of treatment failure. No significant advantage was observed in DMFS, PFS and OS when adaptive replanning was used (AU)

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Id: 157948
Autor: Pardo Masferrer, J.
Título: Nutrición en el paciente con radioterapia / No disponible
Fonte: Nutr. clín. diet. hosp;22(6):186-188, 2002.
Idioma: es.
Resumo: No disponible
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Id: 153900
Autor: Gil Calzada, Luis; Carrasco Estévez, Ainhoa; Muñoz Garzón, Víctor Manuel.
Título: Evaluación de la calidad de un servicio de voluntariado en oncología: un Análisis Importancia-Valoración (IPA) / Quality assessment of a volunteer service in oncology: an importance performance analysis (IPA)
Fonte: Psicooncología (Pozuelo de Alarcón);13(1):71-83, ene.-jun. 2016. tab, graf.
Idioma: es.
Resumo: Objetivo: Usando el Análisis de Importancia-Valoración (IPA), este artículo examina la importancia y valoración percibidas por pacientes oncológicos y sus acompañantes de un programa de humanización realizado por voluntarios en un servicio de Radioterapia de un hospital general en España. Método: Los autores identifican una lista de siete ítems que surgen de la revisión de literatura en Marketing Sanitario; cada ítem fue puntuado con una escala Likert de 5 puntos. Resultados: Los resultados se obtuvieron de las respuestas a 148 entrevistas. El gráfico fue corregido con las recomendaciones sugeridas en la literatura y en el caso de los pacientes, muestra tres factores que caen en el cuadrante de "Mantener el buen trabajo", cuatro atributos caen dentro del cuadrante de "Baja Prioridad" y ningún atributo se observa en los cuadrantes de "Posible dilapidación de recursos" y "Concentrarse aquí". Se encuentran diferencias entre medias de la muestra de pacientes (n=68) y de familiares acompañantes (n=80) en los atributos de catering (t=-2,38; g.l.=146; p<0,05), y en el de información (t=2,16; g.l.=146; p<0,05). Conclusiones: Los resultados parecen útiles para identificar áreas de interés para los gestores de los servicios de salud para desarrollar programas de humanización de servicios basados en el trabajo de voluntarios y dirigidos a diferentes tipos de usuarios. Las implicaciones para los gerentes de programas de voluntariado e investigadores son discutidas

Objective: Using an Importance-Performance Analysis (IPA), this paper examined a Radiotherapy and Oncological Patient and Non-patient perceived importance and performance of ten Humanization Volunteer Program selection factors in the General Hospital in Spain. Methods: The authors identified a list of seven items from the Health-marketing literature reviews, and each item was rated using a 5-point Likert scale. Responses were obtained of 148 usable interviews. Results: The importance-performance patient grid was corrected with literature recommendations and, in the patient sample, shows three items fall in the "Keep up the good work" quadrant, four items fall into the "Low priority" quadrant, zero items fall into the "Possible overkill" quadrant, and no items fall in the "Concentrate here" quadrant. Nonpatient (n=80) factors means shows statistical differences with patient (n=68) means in catering (t=-2.38; df.=146; p<0.05), and information (t=2.16; df146; p<0.05). Conclusions: The results are useful in identifying areas for strategic focus to help Health Services managers develop humanization programs with volunteer workers and different program users. Implication to volunteer programs managers and researchers were discussed
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Texto completo SciELO Espanha
Id: 151215
Autor: Pedraza Muriel, V.
Título: Formación de especialistas en Oncología Radioterápica en España / No disponible
Fonte: Oncología (Barc.);27(7):34-39, jul. 2004.
Idioma: es.
Resumo: No disponible
Responsável: ES1.1
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