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QuickStart radiotherapy: an inter-professional approach to expedite radiotherapy treatment in early breast cancer

Published online by Cambridge University Press:  20 May 2015

Grace Lee ,
Robert E. Dinniwell ,
Thomas G. Purdie ,
Mohammad Rahman ,
Sophie Foxcroft  and
Anthony Fyles
Grace Lee
Affiliation:
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
Robert E. Dinniwell
Affiliation:
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
Thomas G. Purdie
Affiliation:
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
Mohammad Rahman
Affiliation:
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
Sophie Foxcroft
Affiliation:
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
Anthony Fyles*
Affiliation:
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
*
Correspondence to: Anthony Fyles, Department of Radiation Oncology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario, Canada, M5G 2M9. Tel: 416 946 6522. Fax: 416 946 2111. E-mail: anthony.fyles@rmp.uhn.on.ca
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Abstract

Background and purpose

This study aims to develop an expedited radiotherapy (RT) process and evaluate its time savings in women requiring whole breast RT.

Material and methods

An inter-professional RT team streamlined the computed tomography (CT) simulation and treatment pathway for a ‘QuickStart’ process. Target delineation was performed by an advanced practice radiation therapist and approved by the radiation oncologist (RO) for planning. Automated breast planning software was used for treatment planning and standard quality checks were performed. To assess time savings, the initial 25 QuickStart patients were matched with women who underwent whole breast simulation on the same day (±3 days), treated using the conventional process.

Results

A total of 73 post-lumpectomy women were treated through the QuickStart process; the median consent-to-RT was 2 days (range: 0–13) and the mean CT simulation-to-RT treatment was 2 hours and 42 minutes (SD 0:30). In the subgroup analysis, QuickStart patients saved an average of 11 days from CT simulation-to-RT and had shorter median wait-times for both surgery/chemotherapy-to-RT (60 versus 38 days; p=0·002) and consultation-to-RT (7 versus 20 days; p<0·001).

Conclusions

Through inter-professional team efforts and the application of automated planning software, we have achieved a process that significantly decreases patient wait-times while maintaining the quality of whole breast RT.

Keywords

advanced practiceautomated planningbreast cancerradiotherapytreatment processwait-times
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 14 , Issue 3 , September 2015 , pp. 236 - 243
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Copyright
© Cambridge University Press 2015 

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