Take Action Protocol: A radiation therapist led approach to act on anatomical changes seen on CBCT.
Anatomical changes
CBCT
RTT led
Take action protocol
Traffic light protocol
Journal
Technical innovations & patient support in radiation oncology
ISSN: 2405-6324
Titre abrégé: Tech Innov Patient Support Radiat Oncol
Pays: England
ID NLM: 101762366
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
25
08
2020
revised:
29
10
2020
accepted:
01
12
2020
entrez:
19
5
2021
pubmed:
20
5
2021
medline:
20
5
2021
Statut:
epublish
Résumé
Until recently Traffic Light Protocols (TLP) have been developed to recognize and react to Anatomical Changes (ACs) seen on Cone Beam Computer Tomography (CBCT) scans for the most common treatment sites. This involves alerting the Radiation Oncologist (RO), handing over findings, and RO providing the final decision, making it quite labour-intensive for the ROs as well as the Radiation Therapists (RTTs). A new approach was developed to act on ACs: the Take Action Protocol (TAP). In this protocol the RTTs do not only have a role in detecting ACs, but also decide on the appropriate action and follow up, resulting in a significant shift in responsibility. In this study we present the TAP and evaluated the benefit and outcomes of the implementation of TAP compared to the TLP. During a pilot period of six months the TAP was applied for 34 bladder and prostate patients. In 2 bladder and 6 prostate patients further decision making by an RO was required (compared to all 34 in the TLP), showing a large reduction in workload. ACs were accurately assessed by RTTs in >99% of the cases. In 5/34 patients RTTs specialized in Image Guided Radiotherapy provided additional instructions to improve accurate use of the TAP. Two surveys conducted by both ROs and RTTs on the TLP and TAP showed that the perceived involvement of the ROs and burden of responsibility for RTTs was comparable between the two protocols. The identification of patients with truly clinical relevant ACs and the adaptation of treatment for the remaining fractions improved according to ROs and RTTs responses. The TAP provides a better balance between workload and efficiency in relation to the clinical relevance of acting on ACs.
Identifiants
pubmed: 34007910
doi: 10.1016/j.tipsro.2020.12.001
pii: S2405-6324(20)30031-7
pmc: PMC8110944
doi:
Types de publication
Journal Article
Langues
eng
Pagination
71-77Informations de copyright
© 2020 The Authors.
Déclaration de conflit d'intérêts
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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