Abstract
Context
Palliative radiotherapy is effective in the management of symptoms resulting from
advanced cancer. However, it remains underutilized. In developed countries, many factors
have been linked to this phenomenon but data in developing and low-income countries,
particularly in Latin America, are lacking.
Objectives
To conduct a cross-sectional survey to explore palliative care physicians' knowledge
of palliative radiotherapy and to investigate possible factors that limit patient
referral.
Methods
This is a cross-sectional survey. An online questionnaire was sent to palliative care
physicians (n = 170) registered in the Chilean Medical Society of Palliative Care directory.
Results
The overall response rate was 58.8%. Nearly all respondents (98%) considered radiotherapy
to be a useful treatment. Less than half the respondents (43%) had good knowledge
of palliative radiotherapy. Knowledge was correlated with self-reported knowledge
(P = 0.015), discussing cases with radiation oncologist (P = 0.001), and having attended educational events on palliative radiotherapy (P = 0.001). Patient reluctance, poor performance status, and family reluctance were
identified as major barriers to the use of palliative radiotherapy. Physicians from
cities other than the capital were more likely to be concerned about barriers such
as distance to radiotherapy facilities (P = 0.01), the duration of the referral process (P = 0.01), and the lack of a radiation oncologist available for discussing cases (P = 0.01).
Conclusions
Several barriers affect referral to palliative radiotherapy. Some barriers seem to
be more significant for physicians practicing in cities far from cancer centers. Physicians'
knowledge is less than optimal and has been identified as a barrier to referral. Educational
interventions and broadening the availability of cancer treatment resources are needed
to improve the referral process.
Key Words
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Article info
Publication history
Published online: June 29, 2020
Accepted:
June 16,
2020
Identification
Copyright
© 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
