放射線治療癌患資料的處理

Radiotherapy Cancer Data Management

陳光耀(Kuang Y. Chen)

《中華放射線醫學雜誌》 7卷2期 (1982/06) Pp. 94-98

摘要

癌病治療中心癌患資料是治療前、治療中和治療後的醫學記錄，包括病人個人與家庭的一般資料、癌病的部位、病理種類、TNM或其他期別，亦即腫瘤侵犯的範圍、診斷的方法、放射線治療的條件，包括原發性腫瘤、淋巴結及轉移病灶治療的劑量、次數、天數、放射綜或治療機種類、以及非放射綜治療的種類及日期等等。治療以後還要繼續跟查，記錄病情及活力(Karnofsky performance status)直到病人死亡確定其生存期為止。能保存完整的資料，才能分析病情，檢討治療得失。為了便於保存及撮取資料，癌病資料有必要以電腦處理。榮民總醫院癌病治療中心自1961按癌病部位與年分次序以人工登錄法，建立癌病資料檔，未按時複診病人則以雙明信片催促回院複檢，並收集病人近況資料。自1977年起，首先將1970年以後癌患的登記和跟查資料納人電腦檔。跟查的方法增加電話訪問、戶政事務所及其他機構如退除役輔導會和公保處等對病人生死或遷居的協查，也不定期的安排家庭訪問。自1981年起，補建1961年以來放射治療癌患的登記、跟查和放射治療記錄的電腦資料檔，複診資料翌日即輸入電腦檔。使跟查資料充分掌握，並提高跟查率。所使用的電腦為Helwett-Packard 3000型。一般資料為英文，但病人和親友姓名及地址是中文。電腦檔資料，尚有下列用途：(1)按申報表要求每月自電腦印刷機逐案輸出資料送衛生署。(2)找尋未按時複診病人可作電話訪問的病例，並提供訪問員癌患背景資料。(3)找尋未按時複診而宜作郵寄慰問與收集資料函病人；地址與收信人由電腦印刷。(3)按家庭訪問員預定活動的地區，由電腦預存的郵區號碼，提供相應的訪問病案。(4)提供適合其他跟查方法的病案。(5)應院內研究員的要求提供相關資料。電腦檔案資料最大的用途是使大綜病患多參數分析較容易進行，所使用的電腦程式是BMDP。

並列摘要

Cancer data are medical records before, during and after treatment, these include personal and family information, site and pathology of cancer, T N M staging, method and date of diagnosis and treatment. Radiotherapy record includes treatment parameters to primary, regional and metastatic lesions, such as dosage, fractionation, time (days) and treatment technique etc. Repeated follow-up information including Karnofsky performance status are mandatory until the patient die. Computerized system is necessary for large scale data storage and analyses. The Cancer Therapy Center of the Veterans General Hospital managed the cancer data by manual since 1961, computerized filing system was adopted in 1977. The first goal was transforming the data of 1970 to 1977 from marginal-punched cards into a computer file (IBM 370) which transfer further into the Hewlett-Packard 3000 computer installed in 1980 in our hospital. Cancer data continued to enter for new patients. Since 1981, early data back to 1961 are beginning to enter, including patient's basic information, cancer registry, follow-up information and radiotherapy record, these will take some more time to finish. The computer system is capable to storage and output Chinese characters which are mainly used for Chinese names and addresses. Out-patient return visit information are usually stored in computer file on the next day. Multiple techniques are practiced to encourage return visit and collect follow-up information; these include telephone call (local or long distance), correspondings (with patient or relatives), home visit by medical students, governmental censorship organization assistance for providing date of death or changing address etc.
The computer system of cancer data serves many purposes: 1) Print out monthly report of cancer patients and send to the Cancer Data Central Office of the Health Administration. 2) Select cases periodically for telephone call or other follow-up procedures, background information is provided for individual cases for proper communication. 3) By zip code number and other items, select proper cases for home visit. 4) Provide information to investigators for research and statistics.
For large scale multifactorial analysis, a package of computer programs called BMDP is used.