Adamietz Irenäus A, Micke Oliver, Popp Wolfgang, Sack Horst
Department of Radiation Oncology, University of Bochum, Bochum, Germany,
Strahlenther Onkol. 2014 Sep;190(9):781-5. doi: 10.1007/s00066-014-0671-8. Epub 2014 May 13.
Attendance of staff and use of resources during treatment have an impact on costs. For palliative radiotherapy, no reliable data are available on the subject. Therefore, the measurement of selected variables (staff absorbance and room occupancy) based on daily palliative irradiation was the aim of our prospective study. The analysis is part of a larger study conducted by the German Society of Radiation Oncology (DEGRO).
PATIENTS, MATERIAL, AND METHODS: A total of 172 palliative radiation treatments were followed up prospectively between October 2009 and March 2010. The study was performed at two experienced radiotherapy departments (Herne and Bielefeld) and evaluated the attendance of medical personnel and room occupancy related to the selected steps of the treatment procedure: treatment planning and daily application of radiation dose.
Computed tomography for treatment planning engaged the unit for 19 min (range: 17-22 min). The localization of target volume required on average 28 min of a technician's working time. The mean attendance of the entire staff (radiation oncologist, physicist, technician) for treatment planning was 159 min, while the total room occupancy was 140 min. Depending on the type of treatment, the overall duration of a radiotherapy session varied on average between 8 and 18 min. The staff was absorbed by the first treatment session (including portal imaging) for 8-27 min. Mean room occupancy was 18 min (range: 6-65 min). The longest medical staff attendance was observed during an initial irradiation session (mean: 11 min). Radiotherapy sessions with weekly performed field verifications occupied the rooms slightly longer (mean: 10 min, range: 4-25 min) than daily radiotherapy sessions (mean: 9 min, range: 3-29 min). We observed that the patients' symptoms, their condition, and their social environment confounded the time schedule.
Target localization, treatment planning, and performance of palliative radiotherapy absorb resources to an extent comparable to nonpalliative treatment. Because of unexpected events, the time schedule before and during radiotherapy may reveal strong interindividual variability.
治疗期间工作人员的出勤情况和资源使用会对成本产生影响。对于姑息性放疗，目前尚无关于该主题的可靠数据。因此，我们前瞻性研究的目的是基于每日姑息性照射来测量选定变量（工作人员工作时间和房间占用时间）。该分析是德国放射肿瘤学会（DEGRO）开展的一项更大规模研究的一部分。
患者、材料与方法：2009年10月至2010年3月期间，对172例姑息性放射治疗进行了前瞻性随访。该研究在两个经验丰富的放疗科室（黑尔讷和比勒费尔德）进行，评估了与治疗过程选定步骤（治疗计划和每日放射剂量应用）相关的医务人员出勤情况和房间占用情况。
用于治疗计划的计算机断层扫描使设备使用了19分钟（范围：17 - 22分钟）。靶区定位平均需要技术人员28分钟的工作时间。治疗计划阶段全体工作人员（放射肿瘤学家、物理学家、技术人员）的平均工作时间为159分钟，而房间总占用时间为140分钟。根据治疗类型，放疗疗程的总时长平均在8至18分钟之间变化。第一次治疗疗程（包括射野成像）使工作人员投入8 - 27分钟。平均房间占用时间为18分钟（范围：6 - 65分钟）。在首次照射疗程期间观察到医务人员工作时间最长（平均：11分钟）。每周进行射野验证的放疗疗程占用房间的时间（平均：10分钟，范围：4 - 25分钟）比每日放疗疗程（平均：9分钟，范围：3 - 29分钟）略长。我们观察到患者的症状、病情及其社会环境会干扰时间安排。
靶区定位、治疗计划以及姑息性放疗的实施所消耗的资源与非姑息性治疗相当。由于意外事件，放疗前和放疗期间的时间安排可能显示出个体间的巨大差异。
