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高级执业放射治疗师主导的阴道穹窿近距离放射治疗:服务提供的效率和效果评估。

Advanced practice radiation therapist led vaginal vault brachytherapy: An evaluation of efficiency and effectiveness of service delivery.

作者信息

Goodwin Rhona

机构信息

University Hospital Galway, Radiation Oncology Department, Newcastle Rd., Galway H91YR71, Ireland.

出版信息

Tech Innov Patient Support Radiat Oncol. 2024 Nov 27;32:100289. doi: 10.1016/j.tipsro.2024.100289. eCollection 2024 Dec.

Abstract

AIMS

An advanced practice radiation therapist (APRT) role in vaginal vault brachytherapy (VBT) was first introduced in 2015. The aim of this manuscript was to clarify how the introduction of an APRT can improve efficiencies within service delivery while maintaining non inferior clinical outcomes of recurrence.

MATERIALS AND METHODS

This was a single-centred retrospective comparative service evaluation of stage 1 endometrial cancer patients treated with postoperative high dose rate VBT alone. Sixty patients in total were included in the evaluation. They were divided into two equal groups of 'before' and 'after' based on the introduction of the APRT-led role and changes made to treatment processes. Quantitative analysis of waiting times from surgery to adjuvant VBT (weeks), duration of day one treatment procedure (minutes), rate of isolated vaginal recurrence and loco regional recurrence (vaginal and pelvic) were compared between the groups.

RESULTS

The mean time from surgery to treatment between the 'before' and 'after' groups was 13.1 and 9.1 weeks respectively. The mean time for day one treatment procedure was 91 min in the 'before' group and 59 min in the 'after' group. Vaginal free recurrence (VFR) was 100 % for both groups..

CONCLUSION

An APRT led vaginal vault service, with learnt role extension, allows for a more efficient and effective service delivery.

摘要

目的

2015年首次引入了高级实践放射治疗师(APRT)在阴道穹窿近距离放射治疗(VBT)中的角色。本手稿的目的是阐明引入APRT如何在维持复发的非劣效临床结果的同时提高服务提供的效率。

材料与方法

这是一项对仅接受术后高剂量率VBT治疗的I期子宫内膜癌患者进行的单中心回顾性比较服务评估。共有60名患者纳入评估。根据引入APRT主导的角色和治疗流程的变化,将他们分为“术前”和“术后”两组,每组人数相等。比较两组从手术到辅助VBT的等待时间(周)、第一天治疗程序的持续时间(分钟)、孤立性阴道复发率和局部区域复发率(阴道和盆腔)。

结果

“术前”组和“术后”组从手术到治疗的平均时间分别为13.1周和9.1周。“术前”组第一天治疗程序的平均时间为91分钟,“术后”组为59分钟。两组的阴道无复发生存率(VFR)均为100%。

结论

由APRT主导的阴道穹窿服务,随着角色扩展,可实现更高效的服务提供。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d66/11648264/bc1a4e7ea1e0/gr1.jpg

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