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Time management in radiation oncology: development and evaluation of a modular system based on the example of rectal cancer treatment

The DEGRO-QUIRO trial

Zeitmanagement in der Radioonkologie: Entwicklung und Evaluation eines Modulsystems am Beispiel der Behandlung des Rektumkarzinoms

Die DEGRO-QUIRO-Studie

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Abstract

Purpose

The goal was to develop and evaluate a modular system for measurement of the work times required by the various professional groups involved in radiation oncology before, during, and after serial radiation treatment (long-term irradiation with 25–28 fractions of 1.8 Gy) based on the example of rectal cancer treatment.

Materials and methods

A panel of experts divided the work associated with providing radiation oncology treatment into modules (from the preparation of radiotherapy, RT planning and administration to the final examination and follow-up). The time required for completion of each module was measured by independent observers at four centers (Rostock, Bamberg, Düsseldorf, and Offenbach, Germany).

Results

A total of 1,769 data sets were collected from 63 patients with 10–489 data sets per module. Some modules (informed consent procedure, routine treatments, CT planning) exhibited little deviation between centers, whereas others (especially medical and physical irradiation planning) exhibited a wide range of variation (e.g., 1 h 49 min to 6 h 56 min for physical irradiation planning). The mean work time per patient was 12 h 11 min for technicians, 2 h 59 min for physicists, and 7 h 6 min for physicians.

Conclusion

The modular system of time measurement proved to be reliable and produced comparable data at the different centers. Therefore, the German Society of Radiation Oncology (DEGRO) decided that it can be extended to other types of cancer (head and neck, prostate, and breast cancer) with appropriate modifications.

Zusammenfassung

Ziel

Entwicklung und Evaluation eines Modulsystems zur Zeiterfassung vor, während und nach einer Bestrahlungsserie bei den beteiligten Berufsgruppen in der Radioonkologie am Beispiel des Rektumkarzinoms (Langzeitbestrahlung mit 25- bis 28-mal 1,8 Gy).

Material und Methoden

Von einer Expertengruppe wurden die Arbeitsschritte in der Radioonkologie in einzelne Module gegliedert (Aufklärung und Voruntersuchungen, Bestrahlungsplanung, Durchführung der Bestrahlung, Abschlussuntersuchungen und Nachsorge). An 4 Zentren (Rostock, Bamberg, Düsseldorf, Offenbach) wurden von unabhängigen Personen die Messungen des Zeitaufwandes durchgeführt.

Ergebnisse

1.769 Datensätze von 63 Patienten wurden erfasst. Pro Modul konnten zwischen 10 bis maximal 489 Datensätze erfasst werden. Einzelne Module (Aufklärung, Routinebestrahlung, Planungs-CT) zeigten kaum Abweichungen zwischen den Zentren, andere Module, insbesondere die medizinische und physikalische Bestrahlungsplanung wiesen deutliche Unterschiede auf (z. B. physikalische Bestrahlungsplanung: 1 h 49 min bis 6 h 56 min). Pro Patient ergibt sich in Summe folgender Zeitaufwand: MTRA 12 h 11 min, Physiker 2 h 59 min, ärztliches Personal 7 h 6 min.

Schlussfolgerungen

Das Modulsystem und die Durchführung der Messungen erwiesen sich als zuverlässig und die Daten zwischen den einzelnen Institutionen als vergleichbar. Es wurde daher von der DEGRO beschlossen, dass die erarbeiteten Module mit entsprechenden Modifikationen für weitere Tumoren (Kopf-Hals-Tumoren, Prostatakarzinom, Mammakarzinom) angewendet werden können.

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The corresponding author states that there are no conflicts of interest.

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Correspondence to R. Fietkau.

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Fietkau, R., Budach, W., Zamboglou, N. et al. Time management in radiation oncology: development and evaluation of a modular system based on the example of rectal cancer treatment . Strahlenther Onkol 188, 5–11 (2012). https://doi.org/10.1007/s00066-011-0003-1

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  • DOI: https://doi.org/10.1007/s00066-011-0003-1

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