膀胱癌在线自适应病灶放射治疗的临床实施

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology Pub Date : 2024-11-02 DOI:10.1016/j.ctro.2024.100884

K. Goudschaal , S. Azzarouali , J. Visser , M. Admiraal , J. Wiersma , N. van Wieringen , A. de la Fuente , M. Piet , L. Daniels , D. den Boer , M. Hulshof , A. Bel

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引用次数: 0

摘要

材料与方法膀胱癌患者在环形直列加速器（Ethos，瓦里安，西门子医疗集团旗下公司，美国）上接受治疗（20次）。从 2021 年 4 月开始，14 名患者在放射肿瘤专家（RO）和医学物理专家（MPE）的监督下，在多学科工作流程中接受 RTT 治疗。从 2022 年 3 月起，14 名患者完全由 RTT 治疗。RTT培训包括目标划分课程和在模拟环境中练习OART。我们分析了仅由RTT负责的工作流程在疗程时间、RTT的调整、RO和MPE在直列加速器上的出席率以及肿瘤总体积（GTV）划定的定性评估等方面的效率。结果通过培训计划，RTT、RO 和 MPE 组成了一支技术娴熟的团队。与多学科方法相比，纯 RTT 工作流程的疗程时间更短。在使用纯 RTT 工作流程治疗的 14 名患者中，RTT 调整了 99% 的膀胱容量和 44% 的 GTV。79%的治疗过程不需要MPE和RO。所有的 GTV 划分都得到了 RO 的认可，因此被认为是临床上可以接受的，87% 的 GTV 划分只需稍作调整或无需调整。在 21 个病例中，有 18 个病例的患者表示满意。结论膀胱癌只进行 RTT 的 oART 工作流程，辅以培训计划以及 RO 和 MPE 的随叫随到支持，取得了成功。患者体验良好。目前，该流程已成为我们诊所的标准流程。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Clinical implementation of RTT-only CBCT-guided online adaptive focal radiotherapy for bladder cancer

查看原文本刊更多论文

Clinical implementation of RTT-only CBCT-guided online adaptive focal radiotherapy for bladder cancer

Purpose

The study assesses the clinical implementation of radiation therapist (RTT)-only Conebeam CT (CBCT)-guided online adaptive focal radiotherapy (oART) for bladder cancer, by describing the training program, analyzing the workflow and monitoring patient experience.

Materials and methods

Bladder cancer patients underwent treatment (20 sessions) on a ring-based linac (Ethos, Varian, a Siemens Healthineers Company, USA). Commencing April 2021, 14 patients were treated by RTTs supervised by the Radiation Oncologist (RO) and Medical Physics Expert (MPE) in a multidisciplinary workflow. From March 2022, 14 patients were treated solely by RTTs. RTT training included target delineation lessons and practicing oART in a simulation environment. We analyzed the efficiency of the RTT-only workflow regarding session time, adjustments by RTTs, attendance of the RO and MPE at the linac, and qualitative assessment of gross tumor volume (GTV) delineation. Patient experience was monitored through questionnaires.

Results

A training program resulted in a skilled team of RTTs, ROs and MPEs.

The RTT-only workflow demonstrated shorter session times compared to the multidisciplinary approach. Among 14 patients treated using the RTT-only workflow, RTTs adjusted 99% of bladder volumes and 44% of GTV. 79% of the sessions proceeded without MPEs and ROs. All GTV delineations were RO-approved, thus considered clinically acceptable, and 87% required minor or no adjustments. Patient satisfaction was reported in 18 of 21 cases.

Conclusions

The RTT-only oART workflow for bladder cancer, complemented by a training program and on-call support from ROs and MPEs, demonstrated success. Patient experience is positive. It is currently introduced as standard in our clinic.

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来源期刊

Clinical and Translational Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.30

自引率

3.20%

发文量

114

审稿时长

40 days