Clinical application of a clinical pathway for chemoradiation with esophaseal carcinoma

Abstract

Objective To evaluate the effects of the clinical pathway for esophageal carcinoma and provide evidences for further improving the pathway.Methods Prospective cohort study was applied to compare the status between the previous group and the clinical pathway group, for whom the clinical pathway was applied. Evaluation indicators including: (1) indication, (2) radiation mode, (3) radiation dose, (4) compliance, (5)response of radiotherapy and chemotherapy.Results The indications was more stricted and treatment was relatively standardized in the study group than those in the contrast group. The percent of normal radiation in the study group was 42%, normal radiation plus comformal radiation 17%, fully comformal radiation 47% .radiation dose was from 50 to 60 Gy, and the average dose was 52.3 Gy. The compliance was better in the study group than those in the contrast group. There were no significant difference of radiation response and esophagitis in two groups(X2=1.22, P>0.05; X2= 0.589, P>0.05).Shortness of breath on postradiation could be evidencely reduced in the study group, and there were statistical difference between two groups(X2=8.241, P<0.05). The percent of normal radiation in the contrast group was 85%, normal radiation plus comformal radiation 6%, fully comformal radiation 9% .radiation dose was from 46 to 70 Gy, and the average dose was 67.5Gy.Conclusion The application of clinical pathway on patients with esophageal carcinoma can improve the quality of medical care, and it deserves to be used more widely. Key words: Esophageal carcinoma; Clinical pathway; Outcome assessment (health care)