Treatment time and learning curve analysis of 1.5 T MR-Linac workflows led by radiation oncologists or therapists

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology Pub Date : 2024-12-14 DOI:10.1016/j.ctro.2024.100901

J.M. Westerhoff , F.J. Raaijmakers , L.A. Daamen , E.N. de Groot-van Breugel , L.T.C. Meijers , J.R.N. van der Voort van Zyp , J.J.C. Verhoeff , S. Mook , H.M. Verkooijen , M.P.W. Intven

{"title":"Treatment time and learning curve analysis of 1.5 T MR-Linac workflows led by radiation oncologists or therapists","authors":"J.M. Westerhoff , F.J. Raaijmakers , L.A. Daamen , E.N. de Groot-van Breugel , L.T.C. Meijers , J.R.N. van der Voort van Zyp , J.J.C. Verhoeff , S. Mook , H.M. Verkooijen , M.P.W. Intven","doi":"10.1016/j.ctro.2024.100901","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and purpose</h3><div>This study assessed the treatment time of online adaptive (i.e. Adapt-to-Shape, ATS) and virtual couch shift (i.e. Adapt-to-Position, ATP) magnetic resonance guided radiotherapy (MRgRT) on a 1.5 Tesla MR-Linac. Additionally, the transition from a radiation oncologists (RO)-led to a radiation therapist (RTT)-led workflow, and the presence of a learning curve were assessed.</div></div><div><h3>Materials and methods</h3><div>This study was conducted utilizing the prospective Multi-OutcoMe EvaluatioN of radiation Therapy Using the MR-Linac study (MOMENTUM, <span><span>NCT04075305</span><svg><path></path></svg></span>). Mean (±standard deviation) online adaptation time and total treatment time were collected from MR-Linac log files. Learning and proficiency phases were defined using a cumulative sum (CUSUM) analysis. Independent T-tests were performed. A p-value < 0.01 was considered statistically significant.</div></div><div><h3>Results</h3><div>In total, 4942 fractions of 645 patients were included. Mean total treatment time was 39 (±7), 15 (±2), 34 (±8), 41 (±11), and 40 (±7) minutes for ATS-treated prostate cancer, ATP-treated prostate cancer, ATS-treated pelvic lymph node metstasis (LNM), ATS-treated abdominal LNM and ATS-treated rectal cancer, respectively. Mean online adaptation time of RO-led and RTT-led treatment was 28 (±6) and 25 (±6) minutes (p < 0.001) for ATS-treated prostate cancer. No significant differences in the remaining subgroups were found. In subgroups with a learning curve, mean online adaptation time of learning and proficiency phase were 30 (±6) and 26 (±5) minutes (p < 0.001) for ATS-treated prostate cancer, 27 (±8) and 19 (±7) minutes for pelvic LNM (p < 0.001), and 29 (±7) and 25 (±7) minutes (p < 0.001) for rectal cancer, respectively.</div></div><div><h3>Conclusion</h3><div>The transition from RO-led to RTT-led workflows did not significantly increase total treatment time. The online adaptation time reduced after a learning curve for ATS-treated prostate cancer, pelvic LNM and rectal cancer.</div><div><strong>Keywords</strong>; MRgRT, MR-Linac, time, prostate cancer, oligolymphnode metastasis, rectal cancer.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"51 ","pages":"Article 100901"},"PeriodicalIF":2.7000,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759539/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Translational Radiation Oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405630824001782","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background and purpose

This study assessed the treatment time of online adaptive (i.e. Adapt-to-Shape, ATS) and virtual couch shift (i.e. Adapt-to-Position, ATP) magnetic resonance guided radiotherapy (MRgRT) on a 1.5 Tesla MR-Linac. Additionally, the transition from a radiation oncologists (RO)-led to a radiation therapist (RTT)-led workflow, and the presence of a learning curve were assessed.

Materials and methods

This study was conducted utilizing the prospective Multi-OutcoMe EvaluatioN of radiation Therapy Using the MR-Linac study (MOMENTUM, NCT04075305). Mean (±standard deviation) online adaptation time and total treatment time were collected from MR-Linac log files. Learning and proficiency phases were defined using a cumulative sum (CUSUM) analysis. Independent T-tests were performed. A p-value < 0.01 was considered statistically significant.

Results

In total, 4942 fractions of 645 patients were included. Mean total treatment time was 39 (±7), 15 (±2), 34 (±8), 41 (±11), and 40 (±7) minutes for ATS-treated prostate cancer, ATP-treated prostate cancer, ATS-treated pelvic lymph node metstasis (LNM), ATS-treated abdominal LNM and ATS-treated rectal cancer, respectively. Mean online adaptation time of RO-led and RTT-led treatment was 28 (±6) and 25 (±6) minutes (p < 0.001) for ATS-treated prostate cancer. No significant differences in the remaining subgroups were found. In subgroups with a learning curve, mean online adaptation time of learning and proficiency phase were 30 (±6) and 26 (±5) minutes (p < 0.001) for ATS-treated prostate cancer, 27 (±8) and 19 (±7) minutes for pelvic LNM (p < 0.001), and 29 (±7) and 25 (±7) minutes (p < 0.001) for rectal cancer, respectively.

Conclusion

The transition from RO-led to RTT-led workflows did not significantly increase total treatment time. The online adaptation time reduced after a learning curve for ATS-treated prostate cancer, pelvic LNM and rectal cancer.

Keywords; MRgRT, MR-Linac, time, prostate cancer, oligolymphnode metastasis, rectal cancer.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊