Sandford Michael J, Steel Jared G, Goodworth Josie R, Lodge Patrick J
Mid North Coast Cancer Institute, Mid North Coast Local Health District Coffs Harbour Health Campus, Coffs Harbour, NSW, 2450, Australia.
NSW Health, Sydney, NSW, 2065, Australia.
Phys Eng Sci Med. 2024 Dec;47(4):1781-1787. doi: 10.1007/s13246-024-01469-y. Epub 2024 Oct 15.
The treatment, planning, simulation, and setup of radiotherapy patients contain many processes subject to errors involving both staff and equipment. Cone-beam-CT (CBCT) provides a final check of patient positioning and corrections based on this can be made prior to treatment delivery. Statistical Process Control (SPC) techniques are used in various industries for quality management and error mitigation. The utility of SPC techniques to monitor process and equipment changes in our Head and Neck patient treatments was assessed by application to CBCT results from a quality-focused longitudinal study. Individuals and moving range (XmR) as well as exponentially-weighted moving average (EWMA) techniques were explored. The SPC techniques were sensitive to process changes and trends over the 12 years of data collected. A reduction in the random component of patient setup errors needing correction was observed. Systematic components of error remained more stable. An uptick in both datasets was observed correlating with the COVID-19 pandemic. Process control limits for use in prospective process monitoring were established. Challenges that arose from using SPC techniques in a retrospective study are outlined.
放射治疗患者的治疗、计划、模拟和摆位包含许多易出错的过程，涉及工作人员和设备。锥形束CT（CBCT）可对患者体位进行最终检查，并可在此基础上在治疗实施前进行校正。统计过程控制（SPC）技术在各行业用于质量管理和减少误差。通过将SPC技术应用于一项以质量为重点的纵向研究的CBCT结果，评估了SPC技术在监测我们头颈患者治疗过程和设备变化方面的效用。探讨了个体和移动极差（XmR）以及指数加权移动平均（EWMA）技术。在收集的12年数据中，SPC技术对过程变化和趋势很敏感。观察到需要校正的患者摆位误差的随机成分有所减少。误差的系统成分保持更稳定。在两个数据集中均观察到与COVID-19大流行相关的上升趋势。建立了用于前瞻性过程监测的过程控制限。概述了在回顾性研究中使用SPC技术所产生的挑战。
