又到周五：三级超区域医疗网络中急性放疗的时机与转诊模式
Friday again: Timing and referral patterns of acute radiotherapy in a tertiary supraregional care network.
摘要(中文译文)
急性放疗在肿瘤急症中至关重要，但在转诊至放射肿瘤科之前或之后可能出现延迟。本研究的主要目的是描述一个三级超区域诊疗网络中的时间间隔特征。这项回顾性单中心分析纳入了2009年至2024年间在我科因肿瘤相关急症症状接受急性放疗的患者。分析了从症状出现到就诊以及从就诊到放疗开始的时间间隔。转诊模式和工作日分布为次要组织学结局；症状缓解和生存情况进行了描述性评估。所有比较分析均为探索性且未经校正。共纳入314例患者，涉及349个治疗部位。最常见的适应证为转移性脊髓压迫相关症状（260/349；74.5%）。在所有治疗部位中，45.8%由外部机构转诊。从症状出现到就诊的中位时间为5天（IQR 2-16.25），而从就诊到放疗开始的中位时间为0天（IQR 0-1）。218个治疗部位（62.6%）在当天即开始治疗，305个（87.6%）在一天内开始治疗。275个治疗部位可评估症状缓解，其中168个（61.1%）显示至少部分改善。中位生存期为84天（95% CI：67-98）。就诊量在临近周末时累积，周五是最常见的就诊日。急性放疗在就诊后迅速启动，而就诊至放射肿瘤科之前的间隔则明显较长。改进应侧重于更早识别症状和建立结构化的区域急诊路径。
Abstract
Acute radiotherapy is essential in oncological emergencies, but delays may occur before or after referral to radiation oncology. The primary aim of this study was to characterize timing intervals in a tertiary supraregional care network. This retrospective single-centre analysis included patients treated with acute radiotherapy for urgent tumour-related symptoms at our department between 2009 and 2024. Timing intervals from symptom onset to presentation and from presentation to radiotherapy start were analyzed. Referral patterns and weekday distribution were secondary organisational outcomes; symptomatic response and survival were assessed descriptively. All comparative analyses were exploratory and unadjusted. Overall, 314 patients treated at 349 treatment sites were included. The most frequent indication was metastatic spinal cord compression-related symptoms (260/349; 74.5%). 45.8% of all treatment sites were referred from external institutions. Median time from symptom onset to presentation was 5 days (IQR 2-16.25), whereas median time from presentation to radiotherapy start was 0 days (IQR 0-1). Treatment was initiated on the same day in 218 treatment sites (62.6%) and within one day in 305 (87.6%). Symptomatic response was evaluable for 275 treatment sites, of which 168 (61.1%) showed at least partial improvement. Median survival was 84 days (95% CI: 67-98). Presentations accumulated towards the weekend, with Friday being the most common presentation day. Acute radiotherapy was initiated rapidly after presentation, whereas a substantially longer interval occurred before presentation to radiation oncology. Improvements should focus on earlier symptom recognition and structured regional emergency pathways.
如何引用
AMA
J Knoth, E Suvajac, G Altorjai, V Dick, D Kauer-Dorner, F Eckert, et al. Friday again: Timing and referral patterns of acute radiotherapy in a tertiary supraregional care network.. Clinical and translational radiation oncology. 2027; doi:10.1016/j.ctro.2026.101294.
APA
J Knoth, E Suvajac, G Altorjai, V Dick, D Kauer-Dorner, F Eckert, et al (2027). Friday again: Timing and referral patterns of acute radiotherapy in a tertiary supraregional care network.. Clinical and translational radiation oncology. https://doi.org/10.1016/j.ctro.2026.101294
GB/T 7714
J Knoth, E Suvajac, G Altorjai, V Dick, D Kauer-Dorner, F Eckert, et al. Friday again: Timing and referral patterns of acute radiotherapy in a tertiary supraregional care network.[J]. Clinical and translational radiation oncology, 2027 doi:10.1016/j.ctro.2026.101294.
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