Denton Travis R, Shields Lisa B E, Hahl Michael, Maudlin Casey, Bassett Mark, Spalding Aaron C
The Norton Cancer Institute Radiation Center; Associates in Medical Physics.
J Appl Clin Med Phys. 2015 Nov 7;17(2):123-138. doi: 10.1120/jacmp.v17i2.5953.
Safety concerns may arise from a lack of standardization and ambiguity during the treatment planning and delivery process in radiation therapy. A standardized target and organ-at-risk naming convention in radiation therapy was developed by a task force comprised of several Radiation Oncology Societies. We present a nested-survey approach in a community setting to determine the methodology for radiation oncology departments to standardize their practice. Our Institution's continuous quality improvement (CQI) committee recognized that, due to growth from one to three centers, significant variability existed within plan parameters specific to patients' treatment. A multidiscipline, multiclinical site consortium was established to create a guideline for standard naming. Input was gathered using anonymous, electronic surveys from physicians, physicists, dosimetrists, chief therapists, and nurse managers. Surveys consisted of several primary areas of interest: anatomical sites, course naming, treatment plan naming, and treatment field naming. Additional concepts included capitalization, specification of laterality, course naming in the event of multiple sites being treated within the same course of treatment, primary versus boost planning, the use of bolus, revisions for plans, image-guidance field naming, forbidden characters, and standard units for commonly used physical quantities in radiation oncology practice. Guidelines for standard treatment naming were developed that could be readily adopted. This multidisciplinary study provides a clear, straightforward, and easily implemented protocol for the radiotherapy treatment process. Standard nomenclature facilitates the safe means of communication between team members in radiation oncology. The guidelines presented in this work serve as a model for radiation oncology clinics to standardize their practices.
在放射治疗的治疗计划和实施过程中,由于缺乏标准化和存在模糊性,可能会引发安全问题。由多个放射肿瘤学会组成的特别工作组制定了放射治疗中标准化的靶区和危及器官命名规范。我们在社区环境中采用嵌套式调查方法,以确定放射肿瘤学部门规范其操作的方法。我们机构的持续质量改进(CQI)委员会认识到,由于从一个中心发展到三个中心,患者治疗的特定计划参数存在显著差异。于是成立了一个多学科、多临床地点的联盟来制定标准命名指南。通过对医生、物理学家、剂量师、首席治疗师和护士经理进行匿名电子调查来收集意见。调查包括几个主要感兴趣的领域:解剖部位、疗程命名、治疗计划命名和治疗野命名。其他概念包括大写、左右侧的指定、在同一疗程内治疗多个部位时的疗程命名、初始计划与追加计划、使用填充物、计划修订、图像引导野命名、禁用字符以及放射肿瘤学实践中常用物理量的标准单位。制定了易于采用的标准治疗命名指南。这项多学科研究为放射治疗过程提供了一个清晰、直接且易于实施的方案。标准命名法有助于放射肿瘤学团队成员之间的安全沟通方式。本研究中提出的指南可作为放射肿瘤学诊所规范其操作的范例。