McNair H A, Hafeez S, Taylor H, Lalondrelle S, McDonald F, Hansen V N, Huddart R
1 Department of Radiotherapy, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, UK.
Br J Radiol. 2015 Apr;88(1048):20140690. doi: 10.1259/bjr.20140690. Epub 2015 Jan 7.
The implementation of plan of the day selection for patients receiving radiotherapy (RT) for bladder cancer requires efficient and confident decision-making. This article describes the development of a training programme and maintenance of competency.
Cone beam CT (CBCT) images acquired on patients receiving RT for bladder cancer were assessed to establish baseline competency and training needs. A training programme was implemented, and observers were asked to select planning target volumes (PTVs) on two groups of 20 patients' images. After clinical implementation, the PTVs chosen were reviewed offline, and an audit performed after 3 years.
A mean of 73% (range, 53-93%) concordance rate was achieved prior to training. Subsequent to training, the mean score decreased to 66% (Round 1), then increased to 76% (Round 2). Six radiographers and two clinicians successfully completed the training programme. An independent observer reviewed the images offline after clinical implementation, and a 91% (126/139) concordance rate was achieved. During the audit, 125 CBCT images from 13 patients were reviewed by a single observer and concordance was 92%.
Radiographer-led selection of plan of the day was implemented successfully with the use of a training programme and continual assessment. Quality has been maintained over a period of 3 years.
The training programme was successful in achieving and maintaining competency for a plan of the day technique.
为膀胱癌放疗患者实施每日放疗计划的选择需要高效且可靠的决策。本文描述了一个培训项目的开展及能力维持情况。
对接受膀胱癌放疗患者所获取的锥形束CT（CBCT）图像进行评估，以确定基线能力和培训需求。实施了一个培训项目，要求观察者在两组各20例患者的图像上选择计划靶区（PTV）。临床实施后，对所选的PTV进行离线审查，并在3年后进行一次审核。
培训前的平均符合率为73%（范围为53%-93%）。培训后，平均得分降至66%（第一轮），然后升至76%（第二轮）。6名放射技师和2名临床医生成功完成了培训项目。一名独立观察者在临床实施后对图像进行离线审查，符合率达到91%（126/139）。在审核期间，一名观察者对13例患者的125幅CBCT图像进行了审查，符合率为92%。
通过使用培训项目和持续评估，成功实施了由放射技师主导的每日放疗计划选择。质量在3年期间得以维持。
该培训项目成功实现并维持了每日放疗计划技术的能力。
