Duffton Aileen, Devlin Lynsey, Williamson Aoife, Grose Derek, Tolmie Eilidh, MacLaren Linda, McFadden Sharon, Muirhead Rebecca
The Beatson West of Scotland Cancer Centre, Glasgow, UK.
Institute of Cancer Sciences, University of Glasgow, UK.
Tech Innov Patient Support Radiat Oncol. 2025 Aug 14;35:100335. doi: 10.1016/j.tipsro.2025.100335. eCollection 2025 Sep.
Prospective studies on reirradiation are limited, with most available data being retrospective, resulting in challenges in standardising protocols, interpreting outcomes, and facilitating informed patient decisions. Advanced radiotherapy planning and delivery have increased treatment possibilities for complex cases, including reirradiation. However, considerable gaps and variability in reirradiation image-guided radiotherapy (IGRT) and treatment delivery exist. The aim of this work was to identify ways to optimise reirradiation IGRT protocols based on RTT feedback.
A quantitative and qualitative service improvement approach was selected, using a plan, do, check approach. RTT participants working in a single RT centre participated in focus group/nominal group technique sessions. Sessions were used to generate themes, challenges and solutions, which were then scored using Likert scale scoring criteria by all participants.
Eleven IGRT team members each with > 6 years experience participated in the sessions, (4 senior specialist clinical RTT, 2 team leader specialist RTT, 2 IGRT specialist RTT, 1 consultant RTT and 2 research RTT). Eight themes, 19 challenges and 35 solutions were identified. These included communication challenges and multi-professional team (MPT) involvement, RTT role and development, clinical information and treatment intent, standards and guidelines, individualised approach, technical planning considerations, imaging and verification techniques, and anatomical site-specific considerations.
The themes identified provide valuable insights that will inform future IGRT processes and inform future research collaborations on an international level, working towards improving reirradiation treatment for patients who would benefit. There are many opportunities for the RTT within the MPT, and advanced practice (AP) can provide the framework required to develop this for the benefit of patients.
关于再程放疗的前瞻性研究有限，现有数据大多为回顾性研究，这给标准化方案、解读结果以及帮助患者做出明智决策带来了挑战。先进的放射治疗计划与实施增加了复杂病例（包括再程放疗）的治疗可能性。然而，再程放疗图像引导放射治疗（IGRT）和治疗实施方面存在相当大的差距和变异性。本研究的目的是确定基于放疗技师（RTT）反馈优化再程放疗IGRT方案的方法。
采用定量和定性的服务改进方法，运用计划、执行、检查的方法。在单一放疗中心工作的RTT参与者参加了焦点小组/名义小组技术会议。会议用于生成主题、挑战和解决方案，然后由所有参与者使用李克特量表评分标准进行评分。
11名IGRT团队成员（每人有超过6年经验）参加了会议，（4名高级专科临床RTT、2名团队领导专科RTT、2名IGRT专科RTT、1名顾问RTT和2名研究RTT）。确定了8个主题、19个挑战和35个解决方案。这些包括沟通挑战和多专业团队（MPT）参与、RTT角色与发展、临床信息与治疗意图、标准与指南、个体化方法、技术规划考虑、成像与验证技术以及特定解剖部位考虑。
所确定的主题提供了宝贵的见解，将为未来的IGRT流程提供参考，并为国际层面的未来研究合作提供信息，致力于改善对可能受益患者的再程放疗治疗。MPT中的RTT有很多机会，高级实践（AP）可以提供为此发展所需的框架，以造福患者。
