Hostname: page-component-76fb5796d-5g6vh Total loading time: 0 Render date: 2024-04-26T22:11:24.984Z Has data issue: false hasContentIssue false

Palliative radiotherapy: modelling and evaluating the impact of factors in the treatment times and workload of orthovoltage units–a pilot study

Published online by Cambridge University Press:  01 September 2009

S.L. Donaghey*
Affiliation:
Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Addenbrookes Hospital, Cambridge CB2 2QQ, UK
*
Correspondence to: S.L. Donaghey, Clinical Oncology, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK. E-mail: sally.donaghey@gstt.nhs.uk

Abstract

Patients treated with palliative intent present a complex issue for radiotherapy departments in terms of their specific care needs, treatment times, and the productivity of orthovoltage resources. This study seeks to evaluate and quantify patient-related factors, treatment times, and to assess tools and data for future utilisation by radiotherapy departments. A modified Basic Treatment Equivalent (BTE) methodology was chosen, with stopwatch timings taken of treatments on orthovoltage units, over a 4-week period at two radiotherapy departments. Data collected included patient-related, treatment and equipment factors to assess their relative or specific effects on treatment times. Analysis considered the differences in data sets, significance and correlation. Forty-three fractions of treatment were recorded, across a range of treatment sites. The number of fields and delivery of first fractions/plan and treat episodes were found to result in significant differences in treatment time. The use of equipment, age and performance status were not found to be influential. Pain and skin viability symptoms had the greatest impact on treatment times–with these themselves being influenced by the impact of number of fields treated and first fractions. A full study should now be undertaken with a view to design a new equivalence model for the effective assessment of orthovoltage productivity.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Hoskin, P, Makin, W. Oncology for Palliative Medicine, 2nd Edition. Oxford University Press, Oxford, 2003, p. 37.CrossRefGoogle Scholar
Potter, J, Hami, F, Bryan, T, Quigley, C. Symptoms in 400 patients referred to palliative care services: prevalence and patterns. Palliat Med 2003; 17: 310314.CrossRefGoogle ScholarPubMed
Delaney, GP, Shafiq, RJ, Jalaludin, BB, Barton, MB. The Development of a New Basic Treatment Equivalent Model to Assess Linear Accelerator Throughput. Clin Oncol 2005; 17: 311317.CrossRefGoogle ScholarPubMed
Barbera, L, Jackson, LD, Schulze, K et al. Performance of different radiotherapy workload models. Int J Radiat Oncol Biol Phys 2003; 55(4): 11431149.CrossRefGoogle ScholarPubMed
Griffiths, S, Delaney, G, Jalaludin, B. An assessment of basic treatment equivalent at Cookridge hospital. Clin Oncol 2002; 14: 399405.CrossRefGoogle ScholarPubMed
Burnet, NG, Routsis, DS, Murrell, P et al. A tool to measure radiotherapy complexity and workload: derivation from the basic treatment equivalent (BTE) concept. Clin Oncol 2001; 13(1): 1423.Google ScholarPubMed
Delaney, GP, Gebski, V, Lunn, AD et al. Basic treatment equivalent (BTE): a new measure of linear accelerator workload. Clin Oncol 1997; 9: 234239.CrossRefGoogle ScholarPubMed
Cooke, K. X-ray interactions with matter. In: Cherry, P, Duxbury, A (ed). Practical Radiotherapy–Physics and Equipment. Greenwich Medical Media: London, 1998, pp. 39–49.Google Scholar
Delaney, GP, Gebski, V, Lunn, AD et al. An assessment of the basic treatment equivalent (BTE) model as measure of radiotherapy workload. Clin Oncol 1997; 9: 240244.CrossRefGoogle ScholarPubMed
Karnofsky, DA, Burchenal, JH. The clinical evaluation of chemotherapeutic agents in cancer. In: Macleod, CM (ed). Evaluation of Chemotherapeutic Agents. Columbia University Press: New York, 1949, pp. 191–205.Google Scholar
Delaney, GP, Gebski, V, Rus, M, Manderson, C, Langlands, A. The equivalent simple treatment visit (ESTV) model does not measure radiation oncology productivity under Australian conditions. Clin Oncol 1997; 9(4): 245247.CrossRefGoogle Scholar