PHSOR05 Presentation Time: 9:20 AM

IF 1.7 4区医学 Q4 ONCOLOGY

Brachytherapy Pub Date : 2024-10-25 DOI:10.1016/j.brachy.2024.08.079

Hayeon Kim PhD , Hania Al-Hallaq PhD , Juergen Meyer PhD , Angelia Landers PhD , Jessica Lowenstein MS , Jacqueline E. Zoberi PhD

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引用次数: 0

Abstract

Purpose

To assess practice patterns and physics staffing levels for a range of HDR brachytherapy (BT) procedures across different clinical settings within the US.

Materials and Methods

A survey was designed to assess practice patterns of the US physics brachytherapy workforce. The survey was distributed in October 2023 by IROC-Houston (U24CA180803) using RedCap in the form of an email with background, instructions, and a non-personalized link to the survey. The survey covered: i) demographics, employment, experience level, and equipment, ii) practice patterns, and case load, iii) time and intensity as a function of procedure complexity and challenges/satisfaction associated with HDR BT. We present survey responses from section (ii) and results from a sub-analysis performed to assess physics FTE allocation. Chi-squared tests were used for group comparisons with significance assessed at the p<0.05 level.

Results

Of 429 respondents, 365 respondents performed HDR BT and were included for analysis. The percentage of respondents reporting particular HDR BT practice patterns is noted in () below in 1)- 4) and a sub-analysis for assessing physics full time equivalent (FTE) allocation is in 5). 1) Gynecologic (GYN) treatments using single channel (96%), 2-3 channels (78%), 4-12 channels (44%), and GYN ≥13 channels (33%), in addition to skin (33%), prostate (32%), breast (22%), and sarcoma (10%). 2) MRI-based treatment planning performed frequently (14%), sometimes (19%), or never (67%). 3) Interstitial BT performed frequently (33%), sometimes (23%), or never (44%). 4) The average number of physicist FTE allocated to HDR BT <1.0 (53%), 1.0-1.9 (23%), ≥ 2.0 (10%). 5) The percentage of FTE ≥1.0 assigned to different practice settings is shown below in a)-d) and compared, indicating statistically significant differences (p<0.05) for: a) Planning with MRI vs. without MRI: 52% vs. 32%. b) Interstitial vs. no interstitial: 50% vs. 26%. c) Annual volume grouped by applicator type (<25 patients vs. ≥25 patients): GYN single; 27% vs. 52%. GYN 2-3 channels; 34% vs. 64%. GYN 4-12 channels; 48% vs. 74%. GYN 13+ channels; 55% vs. 88%. Prostate interstitial; 44% vs. 69%. d) Hospital setting (non-academic vs. academic); 31.2% vs. 56%. If MRI based planning or interstitial BT is performed, the likelihood of physics FTE ≥1.0 was higher than their counterpart groups. Regardless of complexity, respondents reported a higher physics FTE when treating a higher volume of patients per year (≥ 25 patients). Also, academic hospitals were associated with ≥1.0 physics FTE. Of note, the current overall MRI utilization rate for HDR BT (33%) did not change compared to the ABS practice patterns survey for MRI- based HDR BT for GYN cancer in 2014.

Conclusion

To our knowledge, this is the first survey of US medical physicists for HDR BT practice patterns and physics staffing. Our survey reflects that patient volume and HDR BT procedure complexity are influential factors for increased physics FTE. Proper physics staffing estimation and recommendations accounting for complexity and patient volume need further assessment by professional societies and leaders.

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PHSOR05 演讲时间：上午 9:20

目的评估美国不同临床环境中一系列 HDR 近距离放射治疗 (BT) 过程的实践模式和物理人员配备水平。调查于 2023 年 10 月由 IROC-Houston (U24CA180803) 使用 RedCap 以电子邮件的形式发布，其中包含背景、说明和非个性化的调查链接。调查内容包括：i) 人口统计学、就业、经验水平和设备；ii) 实践模式和病例量；iii) 作为手术复杂性函数的时间和强度以及与 HDR BT 相关的挑战/满意度。我们将介绍第(ii)部分的调查回复，以及为评估物理全职时间分配而进行的子分析的结果。结果在 429 位受访者中，有 365 位受访者进行了 HDR BT，并被纳入分析范围。报告特定 HDR BT 实践模式的受访者百分比见下文（）中的 1)- 4)，评估物理学全职当量（FTE）分配的子分析见 5)。1) 妇科（GYN）治疗使用单通道（96%）、2-3 通道（78%）、4-12 通道（44%）和 GYN ≥13 通道（33%），此外还有皮肤（33%）、前列腺（32%）、乳腺（22%）和肉瘤（10%）。2) 经常（14%）、有时（19%）或从不（67%）进行基于 MRI 的治疗规划。3) 经常（33%）、有时（23%）或从不（44%）进行间质 BT。4) 分配给 HDR BT 的物理学家 FTE 平均值<1.0（53%），1.0-1.9（23%），≥2.0（10%）。5）分配到不同实践环境的 FTE ≥1.0 的百分比如下 a)-d) 所示，并进行了比较，表明在以下方面存在显著统计学差异（p<0.05）：a) 有 MRI 与无 MRI 的规划：52% vs. 32%；b) 间质与无间质：50% vs. 26%；c) 按应用器类型分组的年量（<25 名患者 vs. ≥25 名患者）：GYN 单通道；27% 对 52%。GYN 2-3 通道；34% 对 64%。妇产科 4-12 个通道；48% 对 74%。GYN 13 个以上通道；55% 对 88%。前列腺间质；44% 对 69%。 d) 医院环境（非学术环境对学术环境）；31.2% 对 56%。如果进行基于 MRI 的规划或间质 BT，物理 FTE ≥1.0 的可能性高于对应组别。无论复杂程度如何，受访者称每年治疗的患者数量较多（≥ 25 名患者）时，物理 FTE 较高。此外，学术医院的物理 FTE 也≥1.0。值得注意的是，与 2014 年针对基于 MRI 的妇科癌症 HDR BT 的 ABS 实践模式调查相比，目前 HDR BT 的总体 MRI 使用率（33%）没有变化。我们的调查反映出，患者数量和 HDR BT 手术的复杂性是增加物理全职医生数量的影响因素。专业协会和领导者需要进一步评估根据复杂性和患者数量对物理人员配备的适当估算和建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brachytherapy 医学-核医学

CiteScore

3.40

自引率

21.10%

发文量

119

审稿时长

9.1 weeks

期刊介绍： Brachytherapy is an international and multidisciplinary journal that publishes original peer-reviewed articles and selected reviews on the techniques and clinical applications of interstitial and intracavitary radiation in the management of cancers. Laboratory and experimental research relevant to clinical practice is also included. Related disciplines include medical physics, medical oncology, and radiation oncology and radiology. Brachytherapy publishes technical advances, original articles, reviews, and point/counterpoint on controversial issues. Original articles that address any aspect of brachytherapy are invited. Letters to the Editor-in-Chief are encouraged.