Department of Radiation Oncology, Cooper Medical School of Rowan University, MD Anderson Cancer Center at Cooper University Healthcare, Camden, New Jersey.
Department of Radiation Oncology, MD Anderson Cancer Center at Cooper University Healthcare, Camden, New Jersey.
Pract Radiat Oncol. 2022 Nov-Dec;12(6):e547-e555. doi: 10.1016/j.prro.2022.05.011. Epub 2022 Jun 3.
We report our experience of performing an extra, earlier physics plan check as recommended by the American Association of Physicists in Medicine Task Group 100 and Task Group 275 reports. We assessed utilization and timing of the extra check as well as the time required in a medium-sized clinic.
We retrospectively extracted and analyzed timestamp data from the record and verify system for the quality checklist (QCL) items related to treatment planning and physics "prechecks" for 3487 patients treated at our institution from February 2017 to February 2021. The dosimetry staff was interviewed for their perception of the value and efficacy of the practice.
Physics prechecks were requested for 19.0% of plans. The number of requests declined from 43.9% of cases in 2017 to 18.4% in 2018. The introduction of automated plan-check tools and a dosimetrist checklist further contributed to a drop in number of precheck requests to 3.5% in 2019. For patients who received a physics precheck, the treatment planning process was a median 3.6 hours longer compared with those without (P < .001). A total of 12.9% of the precheck requests were canceled by the dosimetrist after waiting a median time of 5.3 hours. There was a strong positive correlation (0.899) between a precheck being requested and the time remaining until treatment start. Higher complexity plans and plans with a specific concern (eg, possible collision) were more likely to have a precheck requested.
Physics prechecks have become standard practice for certain cases in our clinic. However, the perception in the department was that, as a universal practice, waiting for a precheck was not worth the time saved redoing work on the few cases in which an error was caught. Dosimetrist access to automated checking tools and checklists, which were motivated by the precheck process, contributed to this perception.
我们报告了按照美国医学物理学家协会工作组 100 和工作组 275 的建议进行额外早期物理计划检查的经验。我们评估了额外检查的利用情况和时间以及在中型诊所所需的时间。
我们从 2017 年 2 月至 2021 年 2 月在我们机构治疗的 3487 名患者的质量检查表（QCL）项目的记录和验证系统中提取并分析了与治疗计划和物理“预检查”相关的时间戳数据。对剂量学人员进行了访谈，了解他们对该实践的价值和效果的看法。
对 19.0%的计划请求进行了物理预检查。请求数量从 2017 年的 43.9%下降到 2018 年的 18.4%。自动化计划检查工具和剂量师检查表的引入进一步导致 2019 年预检查请求数量下降到 3.5%。对于接受物理预检查的患者，与未接受预检查的患者相比，治疗计划过程中位数延长了 3.6 小时（P<0.001）。在等待中位数时间为 5.3 小时后，剂量师取消了 12.9%的预检查请求。请求预检查和治疗开始前剩余时间之间存在很强的正相关关系（0.899）。复杂性较高的计划和存在特定问题（例如可能发生碰撞）的计划更有可能请求预检查。
在我们的诊所，物理预检查已成为某些病例的标准做法。然而，该部门的观点是，作为一种普遍做法，在极少数情况下，为了节省重新处理错误的时间而等待预检查是不值得的。剂量师可以访问自动化检查工具和检查表，这是预检查过程的动力，促成了这种观点。
