Autor: |
Dylan Callens, Rob De Haes, Jan Verstraete, Patrick Berkovic, An Nulens, Truus Reynders, Maarten Lambrecht, Wouter Crijns |
Jazyk: |
angličtina |
Rok vydání: |
2024 |
Předmět: |
|
Zdroj: |
Technical Innovations & Patient Support in Radiation Oncology, Vol 32, Iss , Pp 100286- (2024) |
Druh dokumentu: |
article |
ISSN: |
2405-6324 |
DOI: |
10.1016/j.tipsro.2024.100286 |
Popis: |
Introduction: Traffic-light protocols (TLPs) use color codes to standardize image registration and improve interdisciplinary communication in IGRT. Generally, green indicates no relevant anatomical changes, orange signals changes requiring follow-up but does not compromise the current fraction, and red flags unacceptable changes. This study examines the communication aspect, specifically the reporting accuracy for locally advanced non-small-cell lung cancer (LA-NSCLC), and identifies barriers to reporting. Materials & Methods: We conducted a retrospective study on 1997 CBCTs from 74 LA-NSCLC patients. Each scan was in retrospect assessed blinded using the tailored TLP by an IGRT-RTT and subsequently by a second RTT for a subset of fractions. The assessment included both CBCTs from current clinical practice (TLP2023) and from the TLP implementation period (TLP2019). Accuracy of image registration was not evaluated. Reporting barriers were identified through focus group discussions with RTTs. Results: During TLP2023, 22 of the 63 (35%) patients received at least one code orange during therapy, with 2 of them having a systematic code orange, totaling 43 (2%) fractions with at least one code orange. The IGRT-RTT assigned code orange or red in 59 (94%) patients, 38 (60%) of which had systematic codes orange. In total, the IGRT-RTT reported 684 (40%) fractions with code orange and 13 with code red. During TLP2019, similar numbers are observed. In the subset reviewed by two IGRT-RTTs, reports matched in 77% of cases. Various factors contribute to a low reporting rate, originating both during the decision-making process such as lack of online reporting tools and within offline processes such as divergent feedback expectations. Conclusion: While our TLP has successfully promoted the widespread adoption of CBCT-based RTT-led IGRT, it has not succeeded in establishing interdisciplinary communication. Our study reveals significant underreporting of flagged LA-NSCLC fractions in clinical practice using a TLP. This underreporting stems from multifactorial origins. |
Databáze: |
Directory of Open Access Journals |
Externí odkaz: |
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