Identifying the non-addressed issues in Radiation Oncology—a preliminary opinion collection of radiation oncology community (original) (raw)
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Radiation Oncology Workforce Planning: Final Report
2009
Glossary of terms ACPSEM Formula 2000: the formula developed by the ACPSEM to assess the radiation oncology medical physicist requirements for an individual department based on available technology and techniques. Formula 2000 calculates the requirements for all physics staff, including physics technicians. Adjuvant therapy: treatment given in addition to the primary treatment (e.g. surgery) to enhance the effectiveness of the primary treatment. Age standardisation: age standardisation is a statistical method that adjusts crude rates to account for age differences between study populations. Age standardisation enables better comparisons between different populations. Area of Need: the program that enables the recruitment of suitably qualified overseas-trained doctors into declared Area of Need positions on a temporary basis. ARECQA: Accreditation in Radiotherapy Equipment Commissioning and Quality Assurance; the accreditation program in radiation oncology medical physics offered by the ACPSEM prior to the development and implementation of the Training Education and Accreditation Program. AROMP: Accreditation in Radiation Oncology Medical Physics; the accreditation awarded by the ACPSEM after successful completion of the Training Education and Accreditation Program. Attendance: a single presentation by a patient for radiotherapy treatment; at each attendance a fraction of the prescribed treatment course is delivered. Brachytherapy: radiotherapy for cancers where the radiation source is placed directly in contact with the malignancy. Basic treatment equivalent: the BTE model was developed in 1996 in an attempt to improve the measurement of linear accelerator throughput in radiotherapy. The BTE is a productivity measure for radiation oncology linear accelerator treatment delivery that accounts for variations in complexity. It is derived by measuring the fraction durations and the treatment factors that affect fraction duration across a large number of radiation oncology departments. Chemotherapy: refers to the use of anti-cancer drugs to destroy cancer cells. In most treatments a number of drugs may be given at the same time. This process is referred to as combination chemotherapy. Clinical workload: comprises anything linked to patient care, including: new patient/follow up clinics, multidisciplinary clinics, planning/simulation, contouring organs/voluming, treatment review, multidisciplinary team meetings, remote case conferences, patient/clinician phone calls, and ward rounds.
Clinical practice workflow in Radiation Oncology should be highly standardized
Journal of Applied Clinical Medical Physics
Radiotherapy (RT) treatment is a complex process that requires the entire radiation oncology team working together to ensure a safe, expeditious, and effective treatment of patients in the clinic. Standardizing the RT workflow is considered essential to improve RT treatment quality and reduce miscommunication or human errors.
Radiotherapy and Oncology, 2017
PURPOSE To evaluate and report the frequency of changes in radiation therapy treatment plans after peer review in a simulation review meeting once a week. MATERIALS AND METHODS Between July 1 and August 31, 2016, the radiation plans of 116 patients were discussed in departmental simulation review meetings. All plans were finalized by the primary radiation oncologist before presenting them in the meeting. A team of radiation oncologists reviewed each plan, and their suggestions were documented as no change, major change, minor change, or missing contour. Changes were further classified as changes in clinical target volume, treatment field, or dose. All recommendations were stratified on the basis of treatment intent, site, and technique. Data were analyzed by Statistical Package for the Social Sciences and are presented descriptively. RESULTS Out of 116 plans, 26 (22.4%) were recommended for changes. Minor changes were suggested in 15 treatment plans (12.9%) and a major change in 10 (8.6%), and only one plan was suggested for missing contour. The frequency of change recommendations was greater in radical radiation plans than in palliative plans (92.3% v 7.7%). The head and neck was the most common treatment site recommended for any changes (42.3%). Most of the changes were recommended in the technique planned with three-dimensional conformal radiation therapy (50%). Clinical target volume (73.1%) was identified as the most frequent parameter suggested for any change, followed by treatment field (19.2%) and dose (0.08%). CONCLUSION Peer review is an important tool that can be used to overcome deficiencies in radiation treatment plans, with a goal of improved and individualized patient care. Our study reports changes in up to a quarter of radiotherapy plans.
Radiotherapy and Oncology, 2021
Purpose The EORTC Radiation Oncology Group uses a Facility Questionnaire (FQ) to collect information from its member radiation oncology departments. We analysed the FQ database for patientrelated workload, staffing levels and infrastructure to determine developments in radiation oncology departments in the clinical trials community. Materials Methods We exported the FQ database in August 2019. Departments were included if their FQ was created or updated within the two preceding years. Observations were compared with previous evaluations of the FQ database. Results In total, 161 departments from 24 mostly European countries were analysed. The average number of patients per department increased by 3.0% to 2,453 (2013: 2,381). The annual number of patients decreased by 7.4% to 225 per radiation oncologist (2013: 243) and by 7.9% to 326 per medical physicist (2013: 354). In contrast, the number of patients increased by 23.3% to 106 per radiation therapist (RTT) (2013: 86) and per treatment unit by 3.9 % to 485 (2013: 467). In a pairwise comparison of departments that were available in 2013 and 2019, the number of patients per radiation oncologist (p = 0.02) and per physicist (p = 0.0003) decreased significantly. The number of departments that own a dedicated PET-CT scanner more than doubled (2013: 4%; 2019: 9%) and the availability of stereotactic body radiation therapy (SBRT) increased by 31.8% to 85.7% of the departments (2013: 65%). Conclusion The case-related workload per radiation oncologist and per physicist continues to decrease but increases per RTT and treatment unit. This is likely driven by an increased use of complex techniques, multimodality imaging and the implementation of automation in radiation oncology departments.
Advanced Practitioners: Collaborators in Radiation Oncology
Journal of the Advanced Practitioner in Oncology, 2019
Advanced practitioners (APs), including physician assistants (PAs) and nurse practitioners (NPs), are medical professionals with advanced training, degrees, and certifications that qualify them to diagnose and treat medical conditions in a wide variety of health-care settings. As such, APs have been collaborators in radiation oncology practice for decades to complement the role of radiation oncologists. In 1999, Kelvin and Moore-Higgs first reported data on how APs participated in radiation oncology practice. Over the 20 years since that publication, more articles have described how APs have been collaborators to varying degrees in nearly all aspects of radiation oncology practice. However, significant legislative, regulatory, and educational barriers may limit the optimal practice of APs in radiation oncology. In order to mitigate projected shortages of radiation oncology services while maintaining high levels of patient satisfaction, enhanced collaboration with APs in radiation on...
Journal of Global Oncology, 2019
PURPOSE To evaluate and report the frequency of changes in radiation therapy treatment plans after peer review in a simulation review meeting once a week. MATERIALS AND METHODS Between July 1 and August 31, 2016, the radiation plans of 116 patients were discussed in departmental simulation review meetings. All plans were finalized by the primary radiation oncologist before presenting them in the meeting. A team of radiation oncologists reviewed each plan, and their suggestions were documented as no change, major change, minor change, or missing contour. Changes were further classified as changes in clinical target volume, treatment field, or dose. All recommendations were stratified on the basis of treatment intent, site, and technique. Data were analyzed by Statistical Package for the Social Sciences and are presented descriptively. RESULTS Out of 116 plans, 26 (22.4%) were recommended for changes. Minor changes were suggested in 15 treatment plans (12.9%) and a major change in 10 ...
Journal of the American College of Radiology, 2005
That study measured qualified medical physicist (QMP) work associated only with routine radiation oncology procedures. In the intervening years, medical physics practice has changed dramatically. Three-dimensional treatment planning, once considered a special procedure, is the standard of care for many patient presentations. Prostate seed brachytherapy, stereotactic procedures, and intensity-modulated radiation therapy now constitute a large portion of the time medical physicists devote to clinical duties. Special procedures now dominate radiation oncology, leading to the request for an updated work and staffing study for qualified medical physicists. Methods: The updated Abt Study of Medical Physicist Work Values for Radiation Oncology Physics Services: Round II was published in June 2003. Round II measures and reports QMP work associated with both routine and most contemporary special procedures. Additionally, staffing patterns are reported for a variety of practice settings. Results: A work model is created to allow medical physicists to defend QMP work on the basis of both routine and special procedures service mix. The work model can be used to develop a cost justification report for setting charges for radiation oncology physics services. The work and cost justification models may in turn be used to defend medical physicist staffing and compensation. Conclusion: The updated Abt study empowers medical physicists to negotiate service or employment contracts with providers on the basis of measured national QMP work force and staffing data.
Radiotherapy and Oncology, 2012
Progress in radiation oncology has been significant during the last decade and will continue to undergo even more dynamic development in the decade to come . Cancer is recognized as one of the major diseases with increasing frequency and relevance not only in the western world but also from the global perspective . One major reason is the aging population, which provides great challenges with respect to management and maintaining the quality of life. In this respect radiation oncology, as a minimally invasive procedure, will provide a real opportunity to achieve this.