This palliative radiation oncology-based clinical service employs the shortest evidence-based and guideline-directed radiation treatment courses for metastases without compromising efficacy; discusses cases in a multidisciplinary tumor board; and participates in goals-of-care conversations with patients, caregivers, palliative medicine specialists, and primary oncology providers. Outcomes include a 5-day reduction in length of stay and a $20,000 savings per hospitalized radiation patient; a 4-fold decrease in unnecessarily lengthy radiation courses; and a 15% increase in the proportion of patients who met with a palliative care provider within a month of completing radiation.
Palliative radiation therapy, or radiation therapy focused on ameliorating symptoms from metastatic disease, is a highly effective treatment modality when utilized appropriately. Palliative radiation can have lasting benefits for patients with advanced cancers with limited prognosis by reducing tumor-causing pain (and thereby significantly cutting opiate requirements, sometimes to zero), improving mobility, and consequently improving the overall quality of life.
Mount Sinai Hospital’s Department of Radiation Oncology and the Tisch Cancer Institute in New York, N.Y., saw these challenges as an opportunity to incorporate radiation oncology within a multidisciplinary workflow that included palliative care providers and other supportive oncology services in order to improve upon the national benchmarks.
