[Radiation therapists shortage in France: Organizational consequences and difficulties in deploying new missions and/or tasks delegation].

Autor: Bourgier C; Fédération universitaire d'oncologie radiothérapie de Méditerranée-Occitanie, institut du cancer de Montpellier (ICM), université de Montpellier, Inserm U1194 IRCM, Montpellier, France. Electronic address: celine.bourgier@icm.unicancer.fr., Boisbouvier S; Département de radiothérapie, centre Léon-Bérard, rue, Laënnec, 69008 Lyon, France., Bayart É; Société française de radiothérapie oncologique, centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France., Chamois J; Département de radiothérapie, centre hospitalier privé de Saint-Grégoire, Saint-Grégoire, France., Clavère P; Département de radiothérapie, centre hospitalier universitaire de Limoges, Limoges, France., Corbin S; Département de radiothérapie, institut Gustave-Roussy, Villejuif, France., De Oliveira A; Département de radiothérapie, institut Curie, Paris, France., Hannoun-Lévi JM; Département de radiothérapie, centre Antoine-Lacassagne, Nice, France., Hasbini A; Département de radiothérapie, clinique Pasteur, Brest, France., Geffroy-Hulot C; Département de radiothérapie, centre Eugène-Marquis, Rennes, France., Le Tallec P; Association française du personnel paramédical d'électroradiologie, Montrouge, France., Monpetit É; Département de radiothérapie, clinique Saint-Yves, Vannes, France., Santini JJ; Fédération universitaire d'oncologie radiothérapie de Méditerranée-Occitanie, institut du cancer de Montpellier (ICM), université de Montpellier, Inserm U1194 IRCM, Montpellier, France.
Jazyk: francouzština
Zdroj: Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique [Cancer Radiother] 2023 Sep; Vol. 27 (6-7), pp. 577-582. Date of Electronic Publication: 2023 Aug 16.
DOI: 10.1016/j.canrad.2023.07.007
Abstrakt: Purpose: Radiation therapists shortage has been evaluated at national level in France, specifically in oncology radiotherapy, in terms of: (i) organizational adaptations, (ii) impact on patients care, and (iii) difficulties in deploying new missions and/or tasks delegation.
Materials and Methods: French professional organisations representing radiation therapists - SFRO, SNRO and AFPPE - sent their members a national survey (ten questions on 32 items).
Results: From 18 November 2022 to 31 December 2022, 55 responses were received (response rate: 31%) from radiotherapy managers or department heads; 51% had a structure comprising three to five treatment rooms (receiving 500 to 1000 patients per year [36%], or 1500 to 2000 patients per year [33%]). Activities performed were intensity-modulated radiotherapy (100%), stereotaxic radiotherapy (85%), brachytherapy (40%), adaptive radiotherapy (34%). These structures described consequences in closing machine time for 25% of them (reduction of the hourly volume greater than 10% in 57%) with the following consequences in the last 6 months: (i) an extension of the period of medical care (78%), a closing of one or more accelerators (50%) and the development of moderate hypofractionation scheme or extreme hypofractionation (50%). In current functioning, linear accelerators can deliver treatments with a team of two radiation therapists per room for a short day (43%) or two to four radiation therapists per room teams for a long day (40%). During the last 6 months, there has been a 10% increase in linear accelerators operating with a single team. (ii) regarding treatment planning: 16.4% reported a decrease in the opening amplitude (less than 20% in 44% of cases, from 20 to 50% in 33 % of cases). The initial scheduling of appointments for radiotherapy sessions was carried out by radiation therapists in 84% of the departments in current functioning (0.1 to 1 FTE dedicated to this activity in 62% of the departments). Over the last 6 months, there has been a clear reduction in the number of dedicated FTEs: [FTE=0.1 to 1]=-8%; [FTE=0]=+7%. (ii) Regarding tasks delegation (excluding the decree on acts and activities carried out by the radiation therapist): organ at risk delineation is partially performed by radiation therapist in 26% of the centres; caregiver support time in 78% (56% totally or 22% partially). This activity has been reduced by 42%. Seventy-five percent of departments want to develop new techniques, patient-centered approaches (44%), implement task delegation (organ at risk delineation: 58%; weekly consultations: 67%; positioning imaging validation: 71%), and 78% of departments are interested in developing advanced radiotherapy practice. However, the number of radiation therapists is considered insufficient in their implementation in 76% of cases (one to two FTE missing for 72% of structures).
Conclusion: This survey shows a significant impact of radiation therapist shortage in radiotherapy oncology care (treatment delays, access to caregiver support time, workload on treatment teams), and represents a major obstacle to the development of radiotherapy structures.
(Copyright © 2023 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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