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Evaluation of time, attendance of medical staff, and resources during stereotactic radiotherapy/radiosurgery

QUIRO-DEGRO Trial

Evaluation des medizinischen Personal- und Zeitaufwands sowie der Resourcen während der stereotaktischen Radiotherapie/Radiochirurgie

DEGRO-QUIRO-Studie

  • Original article
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Strahlentherapie und Onkologie Aims and scope Submit manuscript

Abstract

Background

The German Society of Radiation Oncology (“Deutsche Gesellschaft für Radioonkologie”, DEGRO) initiated a multicenter trial to develop and evaluate adequate modules to assert core processes and subprocesses in radiotherapy. The aim of this prospective evaluation was to methodical assess the required resources (technical equipment and medical staff) for stereotactic radiotherapy/radiosurgery.

Material and methods

At two radiotherapy centers of excellence (University Hospitals of Heidelberg and Marburg/Gießen), the manpower and time required for the implementation of intra- and extracranial stereotactic radiotherapy was prospectively collected consistently over a 3-month period. The data were collected using specifically developed process acquisition tools and standard forms and were evaluated using specific process analysis tools.

Results

For intracranial (extracranial) fractionated stereotactic radiotherapy (FSRT) and radiosurgery (RS), a total of 1,925 (270) and 199 (36) records, respectively, could be evaluated. The approximate time needed to customize the immobilization device was median 37 min (89 min) for FRST and 31 min (26 min) for RS, for the contrast enhanced planning studies 22 and 27 min (25 and 28 min), for physical treatment planning 122 and 59 min (187 and 27 min), for the first and routine radiotherapy sessions for FSRT 40 and 13 min (58 and 31 min), respectively. The median time needed for the RS session was 58 min (45 min). The corresponding minimal manpower needed was 2 technicians for customization of the immobilization device, 2.5 technicians and 1 consultant for the contrast-enhanced planning studies, 1 consultant, 0.5 resident and 0.67 medical physics expert (MPE) for physical treatment planning, as well as 1 consultant, 0.5 resident, and 2.5 technicians for the first radiotherapy treatment and 2.33 technicians for routine radiotherapy sessions.

Conclusion

For the first time, the resource requirements for a radiotherapy department for the maintenance, protection and optimization of operational readiness for the application of intra- and extracranial stereotactic radiotherapy was determined methodically.

Zusammenfassung

Hintergrund

Die Deutsche Gesellschaft für Radioonkologie (DEGRO) hat eine Multizenterstudie zur Entwicklung und Anwendung geeigneter Module zur Erhebung und Analyse von Kern- und Nebenprozessen in der stereotaktischen Radiotherapie durchgeführt. Ziel dieser Erhebung war es, die erforderlichen Ressourcen (technische Ausstattung und Personalbedarf) bei der stereotaktischen Radiotherapie/Radiochirurgie systematisch zu evaluieren.

Material und Methoden

An zwei strahlentherapeutischen Kompetenzzentren (Universitätskliniken Heidelberg und Marburg/Gießen) wurde der Personal- und Zeitaufwand für die Durchführung der intra- und extrakraniellen stereotaktischen Radiotherapie über einen Zeitraum von 3 Monaten prospektiv lückenlos erhoben. Die Daten wurden mit Hilfe hierfür entwickelter Prozesserhebungstools und Formularsätze erfasst und mittels spezieller Tools zur Prozessanalyse statistisch ausgewertet.

Ergebnisse

Zur intrakraniellen (extrakraniellen) fraktionierten stereotaktischen Radiotherapie (FSRT) und Radiochirurgie (RS) konnten insgesamt 1925 (270) bzw. 199 (36) Datensätze ausgewertet werden. Der durchschnittliche Zeitaufwand für die Erstellung der Lagerungshilfe betrug im Median 37 min (89 min) für die FRST bzw. 31 min (26 min) für die RS, für die Durchführung der Planungsuntersuchung 22 bzw. 27 min (25 bzw. 28 min), die Bestrahlungsplanung 122 bzw. 59 min (187 bzw. 27 min), sowie Erst- und Routinebestrahlung bei FSRT 40 bzw. 13 min (58 bzw. 31 min). Der mediane Zeitaufwand für die Durchführung der RS betrug 58 min (45 min). Der entsprechende minimale Personalaufwand lag im Median bei 2 MTRA (medizinisch-technischer Radiologieassistent) für die Erstellung der Lagerungshilfen, 2,5 MTRA und 1 Facharzt für die Durchführung der Planungsuntersuchungen, 1 Facharzt, 0,5 Assistenzarzt und 0,67 Medizinphysikexperte (MPE) für die Bestrahlungsplanung, sowie 1 Facharzt, 0,5 Assistenzarzt und 2,5 MTRA zur Durchführung der Erstbestrahlung und 2,33 MTRA für Routinebestrahlungen.

Schlussfolgerung

Mit Hilfe der erhobenen Daten wurde erstmals der Ressourcenbedarf einer strahlentherapeutischen Abteilung zur Aufrechterhaltung, Absicherung und Optimierung der Betriebsbereitschaft zur Anwendung der intra- und extrakraniellen Stereotaxie systematisch ermittelt.

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Acknowledgments

The authors would like to thank Andreas Topf and Jessica Schaller-Steiner from Prime Networks AG for their support in systematic data acquisition and analysis.

Conflict of interest

On behalf of all authors, the corresponding author states the following: no actual or potential conflicts of interest exist.

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Authors and Affiliations

  1. Department of Radiotherapy and Radiooncology, University of Heidelberg, INF 400, 69120, Heidelberg, Germany

    A. Zabel-du Bois, S. Milker-Zabel & J. Debus

  2. Prime Networks AG, Basel, Switzerland

    W. Popp

  3. Department of Radiation Oncology, University of Essen, Essen, Germany

    H. Sack

  4. Department of Radiotherapy and Radiation Oncology, Philipps-University Marburg, Marburg, Germany

    M. Henzel & R. Engenhart-Cabillic

Authors
  1. A. Zabel-du Bois
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  2. S. Milker-Zabel
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  3. M. Henzel
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  4. W. Popp
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  5. J. Debus
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  6. H. Sack
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  7. R. Engenhart-Cabillic
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Correspondence to A. Zabel-du Bois.

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Zabel-du Bois, A., Milker-Zabel, S., Henzel, M. et al. Evaluation of time, attendance of medical staff, and resources during stereotactic radiotherapy/radiosurgery. Strahlenther Onkol 188, 769–776 (2012). https://doi.org/10.1007/s00066-012-0140-1

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  • DOI: https://doi.org/10.1007/s00066-012-0140-1

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