International radiation oncology trainee decision

Authors: Kristopher Dennis Liying Zhang Stephen Lutz Yvette van der Linden Angela van Baardwijk Tanya Holt JeanLeon Lagrange Palmira ForoArnalot LeaChoung Wong Ernesto Maranzano KamHung Wong Rico Liu Vassilios Vassiliou Benjamin W Corn Carlo De Angelis Lori Holden C Shun Wong Edward Chow

Publish Date: 2013/02/26

Volume: 21, Issue: 7, Pages: 2041-2048

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Abstract

Radiation oncology trainees who were members of the national radiation oncology associations of the USA Canada Netherlands Australia New Zealand France Spain and Singapore completed a Webbased survey Respondents estimated the risks of nausea and vomiting associated with six standardised radiotherapyonly clinical case vignettes modelled after international antiemetic guidelines and then committed to prophylactic rescue or no therapy as an initial management approach for each caseOne hundred and seventysix trainees from 11 countries responded Only 28  were aware of any antiemetic guideline In general risk estimates and management approaches for the highrisk and minimal risk cases varied less and were more in line with guideline standards than were estimates and approaches for the moderate and lowrisk cases Prophylactic therapy was the most common approach for the highrisk and a moderaterisk case 83 and 71  of respondents respectively while rescue therapy was the most common approach for a second moderaterisk case 69  two lowrisk cases 69 and 76  and a minimal risk case 68  A serotonin receptor antagonist was the most commonly recommended prophylactic agent On multivariate analysis a higher estimated risk of nausea predicted for recommending prophylactic therapy and a lower estimated risk of nausea predicted for recommending rescue therapyRadiation oncology trainee risk estimates and recommended management approaches for RINV clinical case vignettes varied and matched guideline standards more often for highrisk and minimal risk cases than for moderate and lowrisk cases Risk estimates of nausea specifically were strong predictors of management decisionsWe thank JeanJacques Body Amanda Caissie Monica Castro Hans Chung Mark Pasetka Peter Hoskin Dimitrios Kardamakis Peter Kirkbride Dirk Rades Paul Van Houtte David Warr and Rebecca Wong for their contributions to survey development We also thank all survey respondents Kristopher Dennis MD FRCPC is supported by a Canadian Institutes of Health Research CIHR Fellowship Award This study is supported in part by a research grant from the InvestigatorInitiated Program of Merck Canada Inc The opinions expressed in this paper are those of the authors and do not necessarily represent those of Merck Canada Inc or its affiliates and related companiesIndependent oncologist respondent data from this study were presented at the ‘Advances of Antiemetics Applications Formulation and Adherence’ satellite symposium to the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology MASCC/ISOO 2011 International Symposium Athens Greece June 24 2011 at the Canadian Association of Radiation Oncology CARO Annual Scientific Meeting Winnipeg Canada September 17 2011 and at the American Society for Therapeutic Radiology and Oncology ASTRO Annual Meeting Miami USA October 2–6 2011

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