• Int. J. Radiat. Oncol. Biol. Phys. · Feb 2021

    Comparative Study

    Do Coordinated Knowledge Translation Campaigns Persuade Radiation Oncologists to Use Single-Fraction Radiation Therapy Compared With Multiple-Fraction Radiation Therapy for Bone Metastases?

    • Shaheer Shahhat, Nikesh Hanumanthappa, Youn Tae Chung, James Beck, Rashmi Koul, Bashir BashirRadiation Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada., Andrew Cooke, Arbind Dubey, Jim Butler, Maged Nashed, William Hunter, Shrinivas Rathod, Aldrich Ong, Kim Tran, and Julian O Kim.
    • Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
    • Int. J. Radiat. Oncol. Biol. Phys. 2021 Feb 1; 109 (2): 365-373.

    PurposeAlthough level 1 evidence supports the use of single-fraction radiation therapy (SFRT) compared with multiple-fraction radiation therapy (MFRT) for the palliative management of bone metastases, SFRT is underused. In early 2017, the Canadian Partnership Against Cancer and CancerCare Manitoba undertook a comprehensive knowledge translation campaign in Manitoba, Canada featuring educational outreach visits, local consensus meetings, and audit and feedback interventions to encourage greater use of SFRT. This study assessed the impact of this campaign on SFRT use and identified variables associated with MFRT usage.Methods And MaterialsThis retrospective, population-based cohort study identified all patients treated with palliative radiation therapy for bone metastases in Manitoba, Canada, from January 1, 2017, to December 31, 2017, using the provincial radiation therapy database. Baseline characteristics were extracted and tabulated by fractionation schedule. The proportion of patients treated with SFRT in 2017 (postintervention) was compared with the 2016 (preintervention) levels. Univariable and multivariable logistic regression analyses were performed to identify risk factors associated with MFRT use.ResultsIn 2017, 927 patients received palliative radiation therapy for bone metastasis, of which 548 (59.1%) received SFRT, a 21.1% absolute increase in SFRT use compared with 2016 levels (38.0%). With use of multivariable analysis, variables associated with receipt of MFRT included: complicated bone metastasis, soft tissue extension, hematological primary malignancy, and treatment at a subsidiary center.ConclusionThe comprehensive knowledge translation campaign carried out in Manitoba resulted in a significant increase in SFRT use for bone metastases. Continued audit/feedback strategies are recommended to further reinforce knowledge translation efforts supporting SFRT use in the future.Copyright © 2020 Elsevier Inc. All rights reserved.

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