Evaluation of a prospective radiation oncology departmental team review process using standardized simulation directives.

Autor: Kutuk T; Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, United States., LeGrand LA; Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, United States., Valladares MA; Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, United States., Rubens M; Department of Clinical Informatics, Miami Cancer Institute, Baptist Health South Florida, United States., Chisem M; Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, United States., Quintana G; Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, United States., Appel H; Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, United States., Chuong MD; Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, United States; Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, United States., Hall MD; Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, United States; Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, United States., Contreras JA; Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, United States; Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, United States., Fagundes M; Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, United States; Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, United States., Gutierrez AN; Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, United States; Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, United States., Mehta MP; Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, United States; Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, United States., Kotecha R; Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, United States; Department of Radiation Oncology, Herbert Wertheim College of Medicine, Florida International University, Miami, United States; Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, United States. Electronic address: RupeshK@baptisthealth.net.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2022 May; Vol. 170, pp. 102-110. Date of Electronic Publication: 2021 Dec 28.
DOI: 10.1016/j.radonc.2021.12.028
Abstrakt: Introduction: The primary objective of this study is to evaluate the utility and value of an institutional, multi-disciplinary radiation oncology team review process prior to radiotherapy (RT) simulation.
Methods: Over a period of 3 months and through an iterative team-based process, a standardized simulation requisition directive (SSRD) was developed, piloted, modified, and subsequently implemented for all patients treated with external beam RT at a single tertiary care institution from January to December 2020. The SSRDs were reviewed at a daily multi-disciplinary radiation oncology team review conference; modifications consequential to the review were prospectively recorded in a quality database.
Results: 1500 consecutive SSRDs were prospectively reviewed for this study. 397 modifications on 290 (19.3%) SSRDs were recorded and parsed into 5 main categories and 18 subcategories. The most common modifications resulted from changes in immobilization device (n = 88, 22.2%), RT care path (n = 56, 14.1%), and arm positioning (n = 43, 10.8%). On univariate analysis, modifications were associated with RT intent, scan parameters, tumor site, and consultation type. An increased rate modifications was observed for patients had telemedicine consults (n = 101, 22.7%) compared to in-person consultations (n = 189, 17.9%) (p = 0.032). Using logistic regression analysis, there was also a statistically significant relationship between postoperative RT delivery and modification rates (OR: 2.913, 95% CI: 1.014-8.372) (p = 0.0126). Overall, only 14 patients (0.9%) needed re-simulation during the entire study period.
Conclusions: Prospective multi-disciplinary radiation oncology team review prior to simulation identifies actionable change in approximately 19% of procedures, and results in an extremely low rate (<1%) of re-simulation. As departmental processes transition to virtual platforms, thorough attention is needed to identify patients at higher risk of simulation modifications.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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