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


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


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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).


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.


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.



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.


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.


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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  1. Bentzen SM, Heeren G, Cottier B et al (2005) Towards evidence-based guidelines for radiotherapy infrastructure and staffing needs in Europe: the ESTRO QUARTS project. Radiother Oncol 75:355–365

    Article  PubMed  Google Scholar 

  2. Brucker SY, Wallwiener M, Kreienberg R et al (2011) Optimizing the quality of breast cancer care at certified german breast centers: a benchmarking analysis for 2003–2009 with a particular focus on the interdisciplinary specialty of radiation oncology. Strahlenther Onkol 187:89–99

    Article  PubMed  Google Scholar 

  3. Budach W, Bolke E, Fietkau R et al (2011) Evaluation of time, attendance of medical staff, and resources during radiotherapy for head and neck cancer patients: the DEGRO-QUIRO trial. Strahlenther Onkol 187:449–460

    Article  PubMed  Google Scholar 

  4. Eich HT, Stepien A, Zimmermann C et al (2011) Neoadjuvant radiochemotherapy and surgery for advanced rectal cancer: prognostic significance of tumor regression. Strahlenther Onkol 187:225–230

    Article  PubMed  Google Scholar 

  5. Fels F, Kraft JW, Grabenbauer GG (2010) Geriatrics and radiation oncology. Part 1: how to identify high-risk patients and basic treatment principles. Strahlenther Onkol 186:411–422

    Article  PubMed  Google Scholar 

  6. Goldner G, Sljivic S, Oismueller R et al (2011) Prostate cancer radiotherapy in Austria: overview on number of patients, intention to treat, and treatment techniques based on data from 2007. Strahlenther Onkol 187:279–283

    Article  PubMed  Google Scholar 

  7. Lievens Y, Slotman BJ (2003) Radiotherapy cost-calculation and its impact on capacity planning. Expert Rev Pharmacoecon Outcomes Res 3:497–507

    Article  PubMed  Google Scholar 

  8. Numasaki H, Shibuya H, Nishio M et al (2011) Japanese structure survey of radiation oncology in 2007 with special reference to designated cancer care hospitals. Strahlenther Onkol187:167–174

    Article  Google Scholar 

  9. Ruggieri-Pignon S, Pignon T, Marty M et al (2005) Infrastructure of radiation oncology in France: a large survey of evolution of external beam radiotherapy practice. Int J Radiat Oncol Biol Phys 61:507–516

    Article  PubMed  Google Scholar 

  10. Slotman BJ, Cottier B, Bentzen SM et al (2005) Overview of national guidelines for infrastructure and staffing of radiotherapy. ESTRO-QUARTS: work package 1. Radiother Oncol 75:349–354

    Article  PubMed  Google Scholar 

  11. Teshima T, Numasaki H, Shibuya H et al (2008) Japanese structure survey of radiation oncology in 2005 based on institutional stratification of patterns of care study. Int J Radiat Oncol Biol Phys 72:144–152

    Article  PubMed  Google Scholar 

  12. Thiel HJ, Oechsler WA, Kastura B et al (1996) Costs-proceeds calculation for radiotherapy; comment. Strahlenther Onkol 172:128–147 (discussion 54)

    PubMed  CAS  Google Scholar 

  13. Van de Werf E, Lievens Y, Verstraete J et al (2009) Time and motion study of radiotherapy delivery: economic burden of increased quality assurance and IMRT. Radiother Oncol 93:137–140

    Article  Google Scholar 

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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).

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