由放射肿瘤学家或治疗师领导的1.5 T MR-Linac工作流程的治疗时间和学习曲线分析。

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":"由放射肿瘤学家或治疗师领导的1.5 T MR-Linac工作流程的治疗时间和学习曲线分析。","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":"{\"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}","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

摘要

背景与目的：本研究在1.5 Tesla MR-Linac上评估在线自适应（即ATS）和虚拟沙发移位（即ATP）磁共振引导放疗（MRgRT）的治疗时间。此外，评估了从放射肿瘤学家（RO）领导到放射治疗师（RTT）领导的工作流程的转变，以及学习曲线的存在。材料和方法：本研究采用MR-Linac研究（MOMENTUM, NCT04075305）对放射治疗进行前瞻性多结局评价。平均（±标准差）在线适应时间和总治疗时间从MR-Linac日志文件中收集。学习和熟练阶段使用累积和（CUSUM）分析来定义。进行独立t检验。A p值结果：共纳入645例患者的4942个部分。ats治疗前列腺癌、前列腺癌、盆腔淋巴结转移（LNM）、腹部淋巴结转移（LNM）和直肠癌的平均总治疗时间分别为39（±7）分钟、15（±2）分钟、34（±8）分钟、41（±11）分钟和40（±7）分钟。ro主导和rtt主导治疗的平均在线适应时间分别为28（±6）和25（±6）分钟(p)。结论：ro主导工作流程向rtt主导工作流程的过渡并未显著增加总治疗时间。ats治疗前列腺癌、盆腔淋巴结转移和直肠癌的在线适应时间缩短。MRgRT, MR-Linac，时间，前列腺癌，少淋巴结转移，直肠癌。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

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

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.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊