Chauhan Rohit Singh, Munshi Anusheel, Pradhan Anirudh
Department of Physics, GLA University, Mathura, Uttar Pradesh, India.
Department of Radiation Oncology, Manipal Hospitals, Dwarka, New Delhi, India.
J Med Phys. 2023 Apr-Jun;48(2):181-188. doi: 10.4103/jmp.jmp_113_22. Epub 2023 Jun 29.
Rising cancer incidences, complex treatment techniques, and workflows have all impacted the radiotherapy scheduling process. Intelligent appointment scheduling is needed to help radiotherapy users adapt to new practices.
We utilized van Herk's safety margin formula to determine the radiotherapy department's treatment scheduling window (TSW). In addition, we examined the influence of in-room imaging on linac occupancy time (LOT). Varian Aria™ software version 15.1 was used to collect retrospective data on LOT, treatment site, intent, techniques, special protocol, and in-room imaging.
Treatment scheduling windows varied across treatment sites. The mean TSW using van Herk's formalism was 31.5 min, significantly longer than the current TSW of 15 min ( = 0.036), with the pelvic site having the longest (43.8 min) and the brain site having the shortest (12 min). 28% of patients exceeded the in-practice TSW of 15 min. 46.2% of patients had multiple images per fraction, with the proportion being highest in pelvic patients (33%). Patients treated with palliative intent, intensity-modulated radiotherapy, special protocols (bladder protocol and gating), and multiple in-room images per fraction had significantly higher LOT. High treatment time uncertainty was observed in the pelvic and thorax sites, indicating the impact of in-room imaging frequency and on-couch treatment decisions on overall treatment time and indicating that current treatment practices should be reviewed and modified if necessary.
The time margin recipe can customize the treatment scheduling window and improve treatment practices. This formalism can help manage the radiotherapy department's workload and reduce patient wait times.
癌症发病率上升、治疗技术和流程日益复杂，均对放射治疗计划安排过程产生了影响。需要智能预约安排来帮助放射治疗使用者适应新的操作流程。
我们利用范·赫克的安全裕度公式来确定放射治疗科的治疗计划安排窗口（TSW）。此外，我们研究了机房内成像对直线加速器占用时间（LOT）的影响。使用瓦里安Aria™软件版本15.1收集关于LOT、治疗部位、目的、技术、特殊方案和机房内成像的回顾性数据。
不同治疗部位的治疗计划安排窗口有所不同。使用范·赫克公式计算的平均TSW为31.5分钟，显著长于当前的15分钟TSW（ = 0.036），其中盆腔部位最长（43.8分钟），脑部部位最短（12分钟）。28%的患者超过了实际操作中的15分钟TSW。46.2%的患者每次分次有多次图像，盆腔患者中的比例最高（33%）。接受姑息性治疗、调强放射治疗、特殊方案（膀胱方案和门控）以及每次分次有多次机房内图像的患者，其LOT显著更高。在盆腔和胸部部位观察到较高的治疗时间不确定性，这表明机房内成像频率和治疗床上的治疗决策对总体治疗时间有影响，也表明如有必要，应审查和修改当前的治疗操作。
时间裕度方法可以定制治疗计划安排窗口并改善治疗操作。这种方法有助于管理放射治疗科的工作量并减少患者等待时间。
