National Radiotherapy Trials Quality Assurance Group, Mount Vernon Cancer Centre, London, UK.
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK.
Clin Oncol (R Coll Radiol). 2021 Jul;33(7):461-467. doi: 10.1016/j.clon.2021.02.009. Epub 2021 Mar 23.
Adaptive radiotherapy (ART) is an emerging advanced treatment option for bladder cancer patients. Therapeutic radiographers (RTTs) are central to the successful delivery of this treatment. The purpose of this work was to evaluate the image-guided radiotherapy (IGRT) and ART experience of RTTs before participating in the RAIDER trial. A plan of the day (PoD) quality assurance programme was then implemented. Finally, the post-trial experience of RTTs was evaluated, together with the impact of trial quality assurance participation on their routine practice.
A pre-trial questionnaire to assess the experience of the RTT staff group in IGRT and ART in bladder cancer was sent to each centre. Responses were grouped according to experience. The PoD quality assurance programme was implemented, and the RAIDER trial commenced. During stage 1 of the trial, RTTs reported difficulties in delivering PoD and the quality assurance programme was updated accordingly. A follow-up questionnaire was sent assessing experience in IGRT and ART post-trial. Any changes in routine practice were also recorded.
The experience of RTTs in IGRT and ART pre-trial varied. For centres deemed to have RTTs with more experience, the initial PoD quality assurance programme was streamlined. For RTTs without ART experience, the full quality assurance programme was implemented, of which 508 RTTs completed. The quality assurance programme was updated (as the trial recruited) and it was mandated that at least one representative RTT (regardless of pre-trial experience) participated in the update in real-time. The purpose of the updated quality assurance programme was to provide further support to RTTs in delivering a complex treatment. Engagement with the updated quality assurance programme was high, with RTTs in 24/33 centres participating in the real-time online workshop. All 33 UK centres reported all RTTs reviewed the updated training offline. Post-trial, the RTTs' experience in IGRT and ART was increased.
Overall, 508 RTTs undertook the PoD quality assurance programme. There was a high engagement of RTTs in the PoD quality assurance programme and trial. RTTs increased their experience in IGRT and ART and subsequently updated their practice for bladder cancer and other treatment sites.
自适应放疗（ART）是膀胱癌患者的一种新兴先进治疗选择。治疗放射技师（RTT）是成功实施这种治疗的核心。本研究的目的是评估 RTT 在参与 RAIDER 试验之前在图像引导放疗（IGRT）和 ART 方面的经验。然后实施了计划日（PoD）质量保证计划。最后，评估了 RTT 在试验后的经验，以及试验质量保证参与对其常规实践的影响。
向每个中心发送了一份评估 RTT 工作人员组在膀胱癌 IGRT 和 ART 方面经验的预试验问卷。根据经验对回答进行分组。实施了 PoD 质量保证计划，并开始了 RAIDER 试验。在试验的第一阶段，RTT 报告在实施 PoD 方面遇到困难，因此相应地更新了质量保证计划。随后发送了一份后续问卷，评估试验后在 IGRT 和 ART 方面的经验。还记录了任何常规实践的变化。
RTT 在 IGRT 和 ART 方面的经验各不相同。对于被认为有更多经验的 RTT 的中心，最初的 PoD 质量保证计划得到了简化。对于没有 ART 经验的 RTT，实施了完整的质量保证计划，其中 508 名 RTT 完成了该计划。随着试验的招募，对质量保证计划进行了更新，并规定至少有一名代表 RTT（无论其预试验经验如何）实时参与更新。更新后的质量保证计划的目的是为 RTT 提供进一步支持，以提供复杂的治疗。RTT 对更新后的质量保证计划的参与度很高，24/33 个中心的 RTT 参加了实时在线研讨会。所有 33 个英国中心都报告说，所有 RTT 都离线审查了更新后的培训。试验后，RTT 在 IGRT 和 ART 方面的经验有所增加。
总的来说，有 508 名 RTT 参加了 PoD 质量保证计划。RTT 对 PoD 质量保证计划和试验的参与度很高。RTT 增加了他们在 IGRT 和 ART 方面的经验，并随后更新了他们对膀胱癌和其他治疗部位的实践。
