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Compliance to the prescribed overall treatment time (OTT) of curative radiotherapy in normal clinical practice and impact on treatment duration of counteracting short interruptions by treating patients on Saturdays

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Abstract

Background and purpose

To evaluate the compliance of the prescribed OTT in a normal clinical practice and to establish the incidence, duration and causes of unplanned interruptions of radiation therapy. To quantify the impact of an institutional policy to maintain the OTT counteracting some short interruptions by treating patients on Saturday morning.

Material and methods

The treatment charts of all new patients treated with curative intent in a period of one year were reviewed retrospectively. All treatments started on Monday or Tuesday and split-course was not used. The difference between the actual realized and the planned OTT was calculated as a measure of compliance. Recalculations of OTT were made to quantify the impact of compensating short gaps by treating patients on Saturday. The cause of interruption was also recorded and classified.

Results

The charts of 478 consecutive patients treated with curative intent were reviewed. The overall incidence of unplanned interruptions was 76.6%. Public holidays and machine maintenance caused most of interruptions, and machine breakdown caused 13%. 17.9% of the interruptions were greater than 5 days and 5.6% greater than 10 days. Only 23.4% of patients finished their radiotherapy in the planned OTT (12.6% if no compensation on Saturday). 48.9% of head and neck cancer patients finished their treatment in the planned OTT (19.5% if no compensation on Saturday). The time in excess ranged up to 44 days, and the average time in excess was 3.3 days for the entire group (4.2 days if no compensation on Saturday). For head and neck cancer patients, the time in excess was 1.9 days (3.9 days if no compensation on Saturday).

Conclusions

This study has documented that the incidence and duration of unplanned interruptions of standard treatment schedules is a major problem in normal clinical practice. Most interruptions are short and due mainly to public holidays and machine maintenance and for these reasons they can be planned. In spite of the extra costs, counteracting some short interruptions by treating patients on Saturday is a good way to maintain the OTT without loss of local control.

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Authors and Affiliations

  1. Department of Radiation Oncology, Institut Català d’Oncologia, Av. Gran Via, s/n - km, 2,7, ES-08907, L’Hospitalet de Llobregat, Barcelona, Spain

    Miquel Maciá i Garau & Josep Solé Monné

  2. Grupo de Investigación Clínica en Oncología Radioterápica (GICOR), Madrid, Spain

    Miquel Maciá i Garau

  3. Department of Radiation Oncology, Hospital General de Catalunya, Sant Cugat del Vallés, Barcelona, Spain

    María José Cambra Serés & Maribel Peraire Llopis

  4. Department of Medical Physics, Hospital Arnau de Vilanova, Lleida, Spain

    Carlota Monfà Binefa

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  1. Miquel Maciá i Garau
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  2. Josep Solé Monné
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Correspondence to Miquel Maciá i Garau.

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Maciá i Garau, M., Solé Monné, J., Cambra Serés, M.J. et al. Compliance to the prescribed overall treatment time (OTT) of curative radiotherapy in normal clinical practice and impact on treatment duration of counteracting short interruptions by treating patients on Saturdays. Clin Transl Oncol 11, 302–311 (2009). https://doi.org/10.1007/s12094-009-0358-2

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  • DOI: https://doi.org/10.1007/s12094-009-0358-2

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