Abstract
14 Background: Palliative radiation therapy (PRT) is often administered to patients with advanced cancers. These patients may present to radiation oncology clinicians with other palliative care needs. To date, the types and frequencies of palliative care issues encountered in this setting have not been well characterized. Methods: This study assesses palliative care issues encountered by radiation oncology clinicians during PRT consults at 3 Boston-area, community and academic, hospital-based centers. For consecutive consults from 5/19/14 to 9/15/14, participating physicians and nurse practitioners complete a survey to identify and rank the relevance (5-point scale, 'not at all' to 'extremely') of palliative care issues. Eight domains adapted from national palliative care guidelines – physical symptoms, psychosocial issues, cultural considerations, spiritual needs, care coordination, advance care planning, goals of care, and ethical and legal issues – are evaluated. Preliminary descriptive statistics based on 51 completed surveys are reported (response rate = 94%; anticipated sample size = 198). Results: Most (82%) consults had 2 or more palliative care domains ranked as very or extremely relevant to patient care. The domains of physical symptoms (92%), care coordination (75%), and goals of care (57%) were very or extremely relevant in >50% of consults. Within these domains, the issues most often reported as relevant were interdisciplinary care coordination (92%), consideration of prognosis in treatment plan development (86%), pain management (71%), and discussion of patient values and priorities in treatment plan development (67%). Advanced care planning (24%), cultural considerations (10%), spiritual needs (10%), and ethical and legal issues (10%) were least commonly ranked as very or extremely relevant. Conclusions: Radiation oncology clinicians encounter multiple palliative care issues when consulting on patients for PRT. Clinicians identified physical symptoms, care coordination, and goals of care as the most relevant palliative care domains. These findings can help guide palliative care development within radiation oncology, including education and structures of care delivery.
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