Pub Date : 2025-06-01Epub Date: 2025-04-20DOI: 10.1016/j.tipsro.2025.100312
Siret Kivistik , Eija Metsälä , Heli Virtanen
Objective
This integrative review investigates perceptions, educational expectations, and knowledge gaps of patients with breast cancer (BC) regarding radiotherapy (RT).
Methods
The included studies were analysed using a thematic analysis approach. Each segment of data was coded with open coding. The codes were gathered into subthemes as they emerged and into overarching themes, after which the data was analysed again.
Results
22 studies were included: 11 qualitative, 10 cross-sectional, and 1 case study. Our findings indicate that breast cancer patients perceptions of radiation therapy (RT) are influenced by their understanding of RT, its side effects, the treatment burden, emotional state or feelings, effectiveness if RT, prognosis, and viewing RT as the end-of-care phase. They expect education on the treatment pathway, psychosocial support, personalised aspects of RT, planning, delivery, follow-up, and side effects. Additionally, women undergoing RT have knowledge gaps related to preparedness and support, unforeseen risks and side effects, as well as daily practical issues.
Conclusion
Tailored, culturally sensitive education is essential to bridge gaps in understanding, manage anxiety, and build trust. It requires individualized communication strategies and psychosocial support. By integrating personalized information and leveraging technological solutions, healthcare providers can empower patients, improve adherence, and enhance outcomes, particularly in resource-limited settings.
{"title":"Perceptions, educational expectations and knowledge gaps of patients with non-metastatic breast cancer regarding radiotherapy: Integrative review","authors":"Siret Kivistik , Eija Metsälä , Heli Virtanen","doi":"10.1016/j.tipsro.2025.100312","DOIUrl":"10.1016/j.tipsro.2025.100312","url":null,"abstract":"<div><h3>Objective</h3><div>This integrative review investigates perceptions, educational expectations, and knowledge gaps of patients with breast cancer (BC) regarding radiotherapy (RT).</div></div><div><h3>Methods</h3><div>The included studies were analysed using a thematic analysis approach. Each segment of data was coded with open coding. The codes were gathered into subthemes as they emerged and into overarching themes, after which the data was analysed again.</div></div><div><h3>Results</h3><div>22 studies were included: 11 qualitative, 10 cross-sectional, and 1 case study. Our findings indicate that breast cancer patients perceptions of radiation therapy (RT) are influenced by their understanding of RT, its side effects, the treatment burden, emotional state or feelings, effectiveness if RT, prognosis, and viewing RT as the end-of-care phase. They expect education on the treatment pathway, psychosocial support, personalised aspects of RT, planning, delivery, follow-up, and side effects. Additionally, women undergoing RT have knowledge gaps related to preparedness and support, unforeseen risks and side effects, as well as daily practical issues.</div></div><div><h3>Conclusion</h3><div>Tailored, culturally sensitive education is essential to bridge gaps in understanding, manage anxiety, and build trust. It requires individualized communication strategies and psychosocial support. By integrating personalized information and leveraging technological solutions, healthcare providers can empower patients, improve adherence, and enhance outcomes, particularly in resource-limited settings.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"34 ","pages":"Article 100312"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-04-04DOI: 10.1016/j.tipsro.2025.100309
Donna Caldwell , Aileen Duffton , Chloe Wilkinson
Background
The primary role of the Clinical Trials Radiographer (CTR) within the UK workforce is the set-up and initiation of new trials, and recruitment of patients. There is very little published evidence to indicate the impact and value of the CTR. The aim of this study is to describe the evolving role of the CTR and to quantify impact on set-up, and recruitment to Radiotherapy (RT) clinical trials.
Results
The number of trials approved and opened annually, number of open studies within the portfolio, and number of patients recruited have all increased alongside the number of CTR hours.
Conclusion
The data provides quantitative evidence to support the impact of the CTR role and its value in a RT department’s research infrastructure. This reinforces the need to consider the CTR position in long term funding and future workforce planning.
{"title":"The impact of Clinical Trials Radiographers on set-up and recruitment to radiotherapy trials","authors":"Donna Caldwell , Aileen Duffton , Chloe Wilkinson","doi":"10.1016/j.tipsro.2025.100309","DOIUrl":"10.1016/j.tipsro.2025.100309","url":null,"abstract":"<div><h3>Background</h3><div>The primary role of the Clinical Trials Radiographer (CTR) within the UK workforce is the set-up and initiation of new trials, and recruitment of patients. There is very little published evidence to indicate the impact and value of the CTR. The aim of this study is to describe the evolving role of the CTR and to quantify impact on set-up, and recruitment to Radiotherapy (RT) clinical trials.</div></div><div><h3>Results</h3><div>The number of trials approved and opened annually, number of open studies within the portfolio, and number of patients recruited have all increased alongside the number of CTR hours.</div></div><div><h3>Conclusion</h3><div>The data provides quantitative evidence to support the impact of the CTR role and its value in a RT department’s research infrastructure. This reinforces the need to consider the CTR position in long term funding and future workforce planning.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"34 ","pages":"Article 100309"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-05-17DOI: 10.1016/j.tipsro.2025.100315
Harvinderjit Vicky Singh , Esten Nakken , Lena Fauske
Introduction
This study explored the experiences of women with South Asian ethnicity who received chemoradiotherapy for cervical cancer in Norway. Research on how they cope with radiotherapy, as well as the challenges they face in relation to cancer care, is crucial to generate new knowledge about the situation of minority women. This study sought to promote a more equitable healthcare service and provide more personalised information for minority women.
Methods
This study has a qualitative, exploratory design and applied a phenomenological and hermeneutical approach based on individual in-depth interviews with seven South Asian women. These women moved to Norway after the age of 18 and subsequently received chemoradiotherapy for cervical cancer. The interviews were conducted in each woman’s own language. The data were interpreted via reflexive thematic analysis.
Results
The data analysis revealed that a lack of cultural understanding among healthcare professionals made the treatment experience challenging for the interviewed women, while a lack of familiarity with the Norwegian language made health information less accessible to them. Linguistic and cultural barriers rendered the women vulnerable, both during their treatment and during the scheduled clinical follow-up period, which was often reported to be a lonely experience.
Conclusion
The experiences of minority women with cervical cancer who are treated with radiotherapy are influenced by challenges related to culture and language. This highlights a clear need for individually tailored health information and access to professional interpreters. Additionally, there is a need for support groups conducted in minority languages.
{"title":"Bridging cultural and linguistic barriers: South Asian minority women’s experiences of radiotherapy for cervical cancer in Norway","authors":"Harvinderjit Vicky Singh , Esten Nakken , Lena Fauske","doi":"10.1016/j.tipsro.2025.100315","DOIUrl":"10.1016/j.tipsro.2025.100315","url":null,"abstract":"<div><h3>Introduction</h3><div>This study explored the experiences of women with South Asian ethnicity who received chemoradiotherapy for cervical cancer in Norway. Research on how they cope with radiotherapy, as well as the challenges they face in relation to cancer care, is crucial to generate new knowledge about the situation of minority women. This study sought to promote a more equitable healthcare service and provide more personalised information for minority women.</div></div><div><h3>Methods</h3><div>This study has a qualitative, exploratory design and applied a phenomenological and hermeneutical approach based on individual in-depth interviews with seven South Asian women. These women moved to Norway after the age of 18 and subsequently received chemoradiotherapy for cervical cancer. The interviews were conducted in each woman’s own language. The data were interpreted via reflexive thematic analysis.</div></div><div><h3>Results</h3><div>The data analysis revealed that a lack of cultural understanding among healthcare professionals made the treatment experience challenging for the interviewed women, while a lack of familiarity with the Norwegian language made health information less accessible to them. Linguistic and cultural barriers rendered the women vulnerable, both during their treatment and during the scheduled clinical follow-up period, which was often reported to be a lonely experience.</div></div><div><h3>Conclusion</h3><div>The experiences of minority women with cervical cancer who are treated with radiotherapy are influenced by challenges related to culture and language. This highlights a clear need for individually tailored health information and access to professional interpreters. Additionally, there is a need for support groups conducted in minority languages.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"34 ","pages":"Article 100315"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-05-14DOI: 10.1016/j.tipsro.2025.100314
Marike J. Ulehake , Ellen J.L. Brunenberg , Marcel Verheij , Janneke P.C. Grutters
Background and purpose
There is an increasing need for understanding the added value of radiotherapeutic innovations before their widespread adoption. For multi-purpose innovations such as the Magnetic Resonance Linear Accelerator (MR-Linac), determining their value within a specific clinical context does not conclusively answer the broader question whether the innovation justifies the required investment. Exploratory analyses can be informative during early development and use of the innovation. We aim to develop and demonstrate an online, flexible tool to facilitate early economic evaluation of the MR-Linac.
Materials and methods
We developed a tool that enables users to compare the total costs and incremental effects needed of MRI-guided radiotherapy (MRIgRT) with conventional treatment by inputting data specific to their context. Costs included in the tool are both medical technology and personnel-related expenses. The effects, required to justify potential additional costs, are expressed in Quality Adjusted Life Years (QALYs). By default, input values are used tailored to the Dutch clinical context.
Results
When users input data specific to their context or situation, the tool generates figures that display the (additional) costs and effects of MRIgRT compared to conventional treatment. These figures enable users to explore the impact of key variables on the (additional) costs and QALYs required to justify any potential extra costs associated with MRIgRT.
Conclusion
The tool and accompanying example allow for exploratory early HTA analyses, which can offer insights into the cost-effectiveness of MRIgRT. These insights can be valuable for guiding decisions regarding the purchase and utilization of innovative radiotherapeutic technologies.
{"title":"Exploratory health economic analyses to support decisions within the innovation process in radiotherapy: Magnetic Resonance Linear Accelerator as a case study","authors":"Marike J. Ulehake , Ellen J.L. Brunenberg , Marcel Verheij , Janneke P.C. Grutters","doi":"10.1016/j.tipsro.2025.100314","DOIUrl":"10.1016/j.tipsro.2025.100314","url":null,"abstract":"<div><h3>Background and purpose</h3><div>There is an increasing need for understanding the added value of radiotherapeutic innovations before their widespread adoption. For multi-purpose innovations such as the Magnetic Resonance Linear Accelerator (MR-Linac), determining their value within a specific clinical context does not conclusively answer the broader question whether the innovation justifies the required investment. Exploratory analyses can be informative during early development and use of the innovation. We aim to develop and demonstrate an online, flexible tool to facilitate early economic evaluation of the MR-Linac.</div></div><div><h3>Materials and methods</h3><div>We developed a tool that enables users to compare the total costs and incremental effects needed of MRI-guided radiotherapy (MRIgRT) with conventional treatment by inputting data specific to their context. Costs included in the tool are both medical technology and personnel-related expenses. The effects, required to justify potential additional costs, are expressed in Quality Adjusted Life Years (QALYs). By default, input values are used tailored to the Dutch clinical context.</div></div><div><h3>Results</h3><div>When users input data specific to their context or situation, the tool generates figures that display the (additional) costs and effects of MRIgRT compared to conventional treatment. These figures enable users to explore the impact of key variables on the (additional) costs and QALYs required to justify any potential extra costs associated with MRIgRT.</div></div><div><h3>Conclusion</h3><div>The tool and accompanying example allow for exploratory early HTA analyses, which can offer insights into the cost-effectiveness of MRIgRT. These insights can be valuable for guiding decisions regarding the purchase and utilization of innovative radiotherapeutic technologies.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"34 ","pages":"Article 100314"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-04-29DOI: 10.1016/j.tipsro.2025.100313
S. Boisbouvier , F. Hermant , A. Béasse
Radiation therapy (RT) is one of the main treatment modalities for cancer. In France, radiation therapists (RTTs) undergo a combined training program in radiography, nuclear medicine, and RT. In the context of rising cancer cases and greater utilisation of RT, RT departments face a workforce shortage. This study investigates the interest of final-year radiography students in working in RT and explores deterrents to their career choice.
A survey was conducted in January 2024 among French radiography students who had completed at least 3 weeks of RT clinical placement. The survey included closed and open-ended questions on career preferences and highlighted barriers to working in RT. Data analysis included absolute number, frequency of students wishing to work in RT according to the age range of the students. A Chi square test was used to assess the influence of the age range on the desire to work in RT field. A thematic analysis of free-text responses was also performed.
The results indicated a low interest in a career in RT among students, with the main reasons being psychological and educational barriers. Enhancing RT-specific education, improving clinical placements, addressing emotional resilience, and modernising training programmes are crucial to attract future RTTs and address workforce shortages in this critical field.
{"title":"Radiography students wishing to work in the field of radiation therapy: A French experience","authors":"S. Boisbouvier , F. Hermant , A. Béasse","doi":"10.1016/j.tipsro.2025.100313","DOIUrl":"10.1016/j.tipsro.2025.100313","url":null,"abstract":"<div><div>Radiation therapy (RT) is one of the main treatment modalities for cancer. In France, radiation therapists (RTTs) undergo a combined training program in radiography, nuclear medicine, and RT. In the context of rising cancer cases and greater utilisation of RT, RT departments face a workforce shortage. This study investigates the interest of final-year radiography students in working in RT and explores deterrents to their career choice.</div><div>A survey was conducted in January 2024 among French radiography students who had completed at least 3 weeks of RT clinical placement. The survey included closed and open-ended questions on career preferences and highlighted barriers to working in RT. Data analysis included absolute number, frequency of students wishing to work in RT according to the age range of the students. A Chi square test was used to assess the influence of the age range on the desire to work in RT field. A thematic analysis of free-text responses was also performed.</div><div>The results indicated a low interest in a career in RT among students, with the main reasons being psychological and educational barriers. Enhancing RT-specific education, improving clinical placements, addressing emotional resilience, and modernising training programmes are crucial to attract future RTTs and address workforce shortages in this critical field.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"34 ","pages":"Article 100313"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-05-24DOI: 10.1016/j.tipsro.2025.100316
Evren Ozan Göksel
Purpose
This study aims to evaluate the dosimetric accuracy of the Lung with Respiratory (LWR) technique in the Radixact Synchrony real-time tumor tracking system using data from actual patients undergoing lung SBRT.
Material and methods
This retrospective study included 20 patients treated with the Synchrony LWR technique for primary lung cancer or lung metastases. Mid-ventilation breath-hold CT and 4DCT images were acquired for treatment planning and tumor motion evaluation. Gamma analysis was performed using the PTW 1500 detector. Three verification plans were generated for each patient: one for gamma analysis without motion (GAWoM), one for point dose measurement with motion (PDWM), and one for gamma analysis with motion (GAWM). Patient specific respiratory motion was simulated using a CIRS motion platform. The relationship between respiratory patterns, treatment plan parameters, and the dose delivery accuracy of the Synchrony system was evaluated using correlation analysis.
Results
The PDWM results demonstrated a strong agreement between the planned and measured doses, with a maximum difference of less than 2%. The gamma passing rates of 3D dose measurements for all patients’ Synchrony plans were found to be within the clinically acceptable level. While GAWM results were slightly lower than GAWoM results, correlation analysis revealed a strong positive relationship between the two. A moderate negative correlation was observed between the modulation factor and GAWM, similar to GAWoM. Additionally, a strong negative correlation was observed between beam-on time and both GAWoM and GAWM. Furthermore, no significant correlation was found between GAWM and respiratory pattern-related variables, including superior-inferior and lateral motion amplitude or respiratory rate per minute.
Conclusion
The results of the correlation analyses indicate that the dose delivery accuracy of the Synchrony LWR technique is comparable to that of static target irradiation, independent of the patient’s respiratory pattern or the planning parameters used.
{"title":"Evaluation of dose delivery accuracy of the lung with the respiratory technique of the Radixact Synchrony real-time tumor tracking system","authors":"Evren Ozan Göksel","doi":"10.1016/j.tipsro.2025.100316","DOIUrl":"10.1016/j.tipsro.2025.100316","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to evaluate the dosimetric accuracy of the Lung with Respiratory (LWR) technique in the Radixact Synchrony real-time tumor tracking system using data from actual patients undergoing lung SBRT.</div></div><div><h3>Material and methods</h3><div>This retrospective study included 20 patients treated with the Synchrony LWR technique for primary lung cancer or lung metastases. Mid-ventilation breath-hold CT and 4DCT images were acquired for treatment planning and tumor motion evaluation. Gamma analysis was performed using the PTW 1500 detector. Three verification plans were generated for each patient: one for gamma analysis without motion (GAWoM), one for point dose measurement with motion (PDWM), and one for gamma analysis with motion (GAWM). Patient specific respiratory motion was simulated using a CIRS motion platform. The relationship between respiratory patterns, treatment plan parameters, and the dose delivery accuracy of the Synchrony system was evaluated using correlation analysis.</div></div><div><h3>Results</h3><div>The PDWM results demonstrated a strong agreement between the planned and measured doses, with a maximum difference of less than 2%. The gamma passing rates of 3D dose measurements for all patients’ Synchrony plans were found to be within the clinically acceptable level. While GAWM results were slightly lower than GAWoM results, correlation analysis revealed a strong positive relationship between the two. A moderate negative correlation was observed between the modulation factor and GAWM, similar to GAWoM. Additionally, a strong negative correlation was observed between beam-on time and both GAWoM and GAWM. Furthermore, no significant correlation was found between GAWM and respiratory pattern-related variables, including superior-inferior and lateral motion amplitude or respiratory rate per minute.</div></div><div><h3>Conclusion</h3><div>The results of the correlation analyses indicate that the dose delivery accuracy of the Synchrony LWR technique is comparable to that of static target irradiation, independent of the patient’s respiratory pattern or the planning parameters used.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"34 ","pages":"Article 100316"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-05-02DOI: 10.1016/j.tipsro.2025.100311
Wei Yang Calvin Koh , Hong Qi Tan , Kah Seng Lew , Wan Ting Alice Kor , Nur Atiqah Binte Samsuri , Jason Wei Siang Chan , Clifford Ghee Ann Chua , James Kuan Huei Lee , Andrew Wibawa , Zubin Master , Sung Yong Park
Introduction
Real-Time Gated Proton Therapy (RGPT) has been used in proton therapy to mitigate respiratory motion challenges. This study presents the first comprehensive description of the RGPT clinical workflow at the National Cancer Centre Singapore (NCCS) and introduces a novel Failure Modes and Effects Analysis (FMEA) for RGPT.
Methods
We detail the workflow for prostate and liver/lung proton treatments. The FMEA, following AAPM TG-100 guidelines, evaluated potential failure modes based on occurrence, detectability, and severity. This comprehensive risk assessment approach allows for the establishment of robust Quality Assurance (QA) protocols, enhancing treatment safety and efficacy. The FMEA was performed by two disciplinary groups, namely the medical physicists and radiation therapists. Intraclass Correlation Coefficient (ICC) is used as the metric to assess the consistency of ratings among participants.
Results
Since implementation, 15 patients (13 prostate, 2 liver) have been treated with RGPT. The study identified 96 potential failure modes, with 47 evaluated by two disciplines. Inter-rater concordance analysis revealed strong agreement within one group, while combined groups showed lower consistency, highlighting potential differences in risk perception between disciplines. Notably, severity ratings demonstrated better correlations among raters compared to other categories, suggesting a shared understanding of the potential impact of failures.
Conclusion
This study provides valuable insights for institutions implementing RGPT, potentially enhancing treatment workflow, patient safety, and QA procedures. The detailed workflow description and FMEA results offer a foundation for standardizing RGPT practices and prioritizing risk mitigation strategies. Future research should focus on multi-institutional collaborations to further refine RGPT protocols and risk assessments.
{"title":"Real-time gated proton therapy: Introducing clinical workflow and failure modes and effects analysis (FMEA)","authors":"Wei Yang Calvin Koh , Hong Qi Tan , Kah Seng Lew , Wan Ting Alice Kor , Nur Atiqah Binte Samsuri , Jason Wei Siang Chan , Clifford Ghee Ann Chua , James Kuan Huei Lee , Andrew Wibawa , Zubin Master , Sung Yong Park","doi":"10.1016/j.tipsro.2025.100311","DOIUrl":"10.1016/j.tipsro.2025.100311","url":null,"abstract":"<div><h3>Introduction</h3><div>Real-Time Gated Proton Therapy (RGPT) has been used in proton therapy to mitigate respiratory motion challenges. This study presents the first comprehensive description of the RGPT clinical workflow at the National Cancer Centre Singapore (NCCS) and introduces a novel Failure Modes and Effects Analysis (FMEA) for RGPT.</div></div><div><h3>Methods</h3><div>We detail the workflow for prostate and liver/lung proton treatments. The FMEA, following AAPM TG-100 guidelines, evaluated potential failure modes based on occurrence, detectability, and severity. This comprehensive risk assessment approach allows for the establishment of robust Quality Assurance (QA) protocols, enhancing treatment safety and efficacy. The FMEA was performed by two disciplinary groups, namely the medical physicists and radiation therapists. Intraclass Correlation Coefficient (ICC) is used as the metric to assess the consistency of ratings among participants.</div></div><div><h3>Results</h3><div>Since implementation, 15 patients (13 prostate, 2 liver) have been treated with RGPT. The study identified 96 potential failure modes, with 47 evaluated by two disciplines. Inter-rater concordance analysis revealed strong agreement within one group, while combined groups showed lower consistency, highlighting potential differences in risk perception between disciplines. Notably, severity ratings demonstrated better correlations among raters compared to other categories, suggesting a shared understanding of the potential impact of failures.</div></div><div><h3>Conclusion</h3><div>This study provides valuable insights for institutions implementing RGPT, potentially enhancing treatment workflow, patient safety, and QA procedures. The detailed workflow description and FMEA results offer a foundation for standardizing RGPT practices and prioritizing risk mitigation strategies. Future research should focus on multi-institutional collaborations to further refine RGPT protocols and risk assessments.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"34 ","pages":"Article 100311"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-06-04DOI: 10.1016/j.tipsro.2025.100319
Thijs Ackermans , Paul Cremers , Janne Dingemans , Carol Ou , Marcel Verheij , Maria Jacobs
Background and Purpose
Technological advancements have the potential to mitigate RTT shortages, burnout levels, and turnover rates. However, it is unclear if RTTs currently experience technostress (stress or anxiety from being overwhelmed by technology) and how extensive digital tool usage impacts key job performance indicators (e.g., job engagement, satisfaction, and turnover intentions). This study investigates the impact of digital tools used and expected digital transformation on RTTs’ technostress and key job performance indicators.
Materials and Methods
A survey was distributed to RTTs across all Dutch radiotherapy centers, resulting in 265 respondents. The survey included validated questionnaires on digital tool use, technostress, job autonomy, innovative work behavior and job performance indicators. Relationships were assessed using linear regression models and paired samples T-tests (p < 0.05).
Results
The number of digital tools used had no significant effect (p < 0.05) on key job performance indicators and was not related to technostress. Technostress negatively impacted key job performance indicators, but explained less than 7 % of the variance. Other factors, such as job autonomy, had a greater influence. When presented with a description of the future perspective of their job role after the expected digital transformation, RTTs reported small declines in key job performance indicators.
Conclusion
Current RTT performance is not affected by the number of digital tools used, as RTTs are used to working with digital tools. RTTs showed no technostress. After the predicted digital transformation RTTs remained satisfied and engaged. Ensuring RTTs feel skilled and empowered with decision-making authority is crucial before introducing new digital tools.
{"title":"The impact of digital tools and the expected digital transformation in radiotherapy on Dutch radiation therapists (RTTs)","authors":"Thijs Ackermans , Paul Cremers , Janne Dingemans , Carol Ou , Marcel Verheij , Maria Jacobs","doi":"10.1016/j.tipsro.2025.100319","DOIUrl":"10.1016/j.tipsro.2025.100319","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Technological advancements have the potential to mitigate RTT shortages, burnout levels, and turnover rates. However, it is unclear if RTTs currently experience technostress (stress or anxiety from being overwhelmed by technology) and how extensive digital tool usage impacts key job performance indicators (e.g., job engagement, satisfaction, and turnover intentions). This study investigates the impact of digital tools used and expected digital transformation on RTTs’ technostress and key job performance indicators.</div></div><div><h3>Materials and Methods</h3><div>A survey was distributed to RTTs across all Dutch radiotherapy centers, resulting in 265 respondents. The survey included validated questionnaires on digital tool use, technostress, job autonomy, innovative work behavior and job performance indicators. Relationships were assessed using linear regression models and paired samples T-tests (p < 0.05).</div></div><div><h3>Results</h3><div>The number of digital tools used had no significant effect (p < 0.05) on key job performance indicators and was not related to technostress. Technostress negatively impacted key job performance indicators, but explained less than 7 % of the variance. Other factors, such as job autonomy, had a greater influence. When presented with a description of the future perspective of their job role after the expected digital transformation, RTTs reported small declines in key job performance indicators.</div></div><div><h3>Conclusion</h3><div>Current RTT performance is not affected by the number of digital tools used, as RTTs are used to working with digital tools. RTTs showed no technostress. After the predicted digital transformation RTTs remained satisfied and engaged. Ensuring RTTs feel skilled and empowered with decision-making authority is crucial before introducing new digital tools.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"34 ","pages":"Article 100319"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2025-02-21DOI: 10.1016/j.tipsro.2025.100307
Milad Mirzaei , Suki Gill , Mahsheed Sabet , Martin A. Ebert , Pejman Rowshanfarzad , Jake Kendrick , Angela Jacques , Clare Herbert , Jeremy Croker , Sean Bydder , Joshua Dass , Edward Bailey , Rohen White , Catherine Moffat , Colin Tang , Adriano Polpo , Nicholas Bucknell
Purpose
Daily image-guided radiotherapy (IGRT) for prostate cancer reduces treatment-related toxicity. However, positional and anatomical variations can result in patient re-setup, increased treatment time, and additional imaging dose. A simple technique of two distinct imaging modalities was investigated: initially, an anteroposterior kilovoltage (AP-kV) planar image was acquired, followed by cone beam computed tomography (CBCT). To determine whether this dual imaging modality (DIM) can reduce repeat CBCTs with an AP-kV screening image compared to CBCT alone, i.e. a single imaging modality (SIM).
Methods
Patients were enrolled sequentially before and after the new departmental protocol for IGRT. Initially, all patients had a CBCT prior to treatment (SIM group) as usual. For the DIM group, AP-kV imaging was added to the first three fractions, and subsequent AP-kV imaging (on demand) for patients unable to maintain adequate bladder and bowel compliance. Sixty intact prostate or post-prostatectomy patients were included: 30 before the change in protocol (SIM group) and 30 after (DIM group). Bladder volume, rectal filling, and positioning errors were evaluated.
Results
In the SIM group, 30 patients underwent a total of 1116 CBCTs. In the DIM group, 30 patients had 156 AP-kV images and 1077 CBCTs. In the SIM group, 166 were repeat CBCTs with a median of 4 repeat CBCTs per patient. In DIM group, 132 were repeat CBCTs with a median of 3 repeat CBCTs per patient. We found a significant difference in incidence of repeat CBCTs due to suboptimal bladder filling (p = 0.028) and rectal gas (p = 0.045), indicating the number of repeat CBCTs was significantly lower in patients imaged with DIM.
Conclusion
The DIM technique was found to be superior to the SIM technique, as it allowed the desired bladder volume, rectal condition, and patient positioning to be achieved prior to CBCT, reducing the need for repeat CBCTs.
{"title":"Treatment efficiency and quality improvement via double imaging modality (DIM) versus single imaging modality (SIM) image-guided radiotherapy for prostate cancer","authors":"Milad Mirzaei , Suki Gill , Mahsheed Sabet , Martin A. Ebert , Pejman Rowshanfarzad , Jake Kendrick , Angela Jacques , Clare Herbert , Jeremy Croker , Sean Bydder , Joshua Dass , Edward Bailey , Rohen White , Catherine Moffat , Colin Tang , Adriano Polpo , Nicholas Bucknell","doi":"10.1016/j.tipsro.2025.100307","DOIUrl":"10.1016/j.tipsro.2025.100307","url":null,"abstract":"<div><h3>Purpose</h3><div>Daily image-guided radiotherapy (IGRT) for prostate cancer reduces treatment-related toxicity. However, positional and anatomical variations can result in patient re-setup, increased treatment time, and additional imaging dose. A simple technique of two distinct imaging modalities was investigated: initially, an anteroposterior kilovoltage (AP-kV) planar image was acquired, followed by cone beam computed tomography (CBCT). To determine whether this dual imaging modality (DIM) can reduce repeat CBCTs with an AP-kV screening image compared to CBCT alone, <em>i.e.</em> a single imaging modality (SIM).</div></div><div><h3>Methods</h3><div>Patients were enrolled sequentially before and after the new departmental protocol for IGRT. Initially, all patients had a CBCT prior to treatment (SIM group) as usual. For the DIM group, AP-kV imaging was added to the first three fractions, and subsequent AP-kV imaging (on demand) for patients unable to maintain adequate bladder and bowel compliance. Sixty intact prostate or post-prostatectomy patients were included: 30 before the change in protocol (SIM group) and 30 after (DIM group). Bladder volume, rectal filling, and positioning errors were evaluated.</div></div><div><h3>Results</h3><div>In the SIM group, 30 patients underwent a total of 1116 CBCTs. In the DIM group, 30 patients had 156 AP-kV images and 1077 CBCTs. In the SIM group, 166 were repeat CBCTs with a median of 4 repeat CBCTs per patient. In DIM group, 132 were repeat CBCTs with a median of 3 repeat CBCTs per patient. We found a significant difference in incidence of repeat CBCTs due to suboptimal bladder filling (p = 0.028) and rectal gas (p = 0.045), indicating the number of repeat CBCTs was significantly lower in patients imaged with DIM.</div></div><div><h3>Conclusion</h3><div>The DIM technique was found to be superior to the SIM technique, as it allowed the desired bladder volume, rectal condition, and patient positioning to be achieved prior to CBCT, reducing the need for repeat CBCTs.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"33 ","pages":"Article 100307"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2025-01-31DOI: 10.1016/j.tipsro.2025.100303
Amanda Moreira , Tara Rosewall , Yat Tsang , Patricia Lindsay , Peter Chung , Winnie Li
Purpose
Adaptive radiation therapy (ART) is a close-looped process where anatomic changes observed during treatment are identified, leading to plan modification prior to treatment delivery. The aim of this study was to explore the status of ART across Canada and review the impact of adaptive technologies on the roles and responsibilities of Radiation Therapists (RTTs).
Materials and Methods
Study information and a link to a 30-question survey was sent via email to the RTT manager of all cancer centres across Canada (n = 48). The survey questions included centre demographics, presence of offline and/or online ART activities as standard of care, corresponding roles and responsibilities of the multidisciplinary team, and training activities. The survey was administered electronically and closed after a 3-week accrual period. Responses were analyzed using descriptive statistics.
Results
Thirty-two out of 48 centres responded across all ten provinces (67 % response rate). Twenty-five centres (78 %) currently perform ART, all of which practiced offline ART while 5 practiced online ART. Most common responses for lack of ART were ‘technical limitations’ and ‘lack of resources’. RTTs are responsible for 50 % (offline) versus 58 % (online) ART respectively, with the most notable change being the addition of target delineation to their daily practice.
Conclusions
The status of ART varies across Canada. Offline ART is commonly practiced, but online ART remains an infrequent process due to technical limitations and lack of resources. As centres move towards implementing online ART, the role of the RTT will need to be redefined with corresponding upskilling to support the emergent treatment paradigm.
{"title":"Pan-Canadian assessment of image guided adaptive radiation therapy and the role of the radiation therapist","authors":"Amanda Moreira , Tara Rosewall , Yat Tsang , Patricia Lindsay , Peter Chung , Winnie Li","doi":"10.1016/j.tipsro.2025.100303","DOIUrl":"10.1016/j.tipsro.2025.100303","url":null,"abstract":"<div><h3>Purpose</h3><div>Adaptive radiation therapy (ART) is a close-looped process where anatomic changes observed during treatment are identified, leading to plan modification prior to treatment delivery. The aim of this study was to explore the status of ART across Canada and review the impact of adaptive technologies on the roles and responsibilities of Radiation Therapists (RTTs).</div></div><div><h3>Materials and Methods</h3><div>Study information and a link to a 30-question survey was sent via email to the RTT manager of all cancer centres across Canada (n = 48). The survey questions included centre demographics, presence of offline and/or online ART activities as standard of care, corresponding roles and responsibilities of the multidisciplinary team, and training activities. The survey was administered electronically and closed after a 3-week accrual period. Responses were analyzed using descriptive statistics.</div></div><div><h3>Results</h3><div>Thirty-two out of 48 centres responded across all ten provinces (67 % response rate). Twenty-five centres (78 %) currently perform ART, all of which practiced offline ART while 5 practiced online ART. Most common responses for lack of ART were ‘technical limitations’ and ‘lack of resources’. RTTs are responsible for 50 % (offline) versus 58 % (online) ART respectively, with the most notable change being the addition of target delineation to their daily practice.</div></div><div><h3>Conclusions</h3><div>The status of ART varies across Canada. Offline ART is commonly practiced, but online ART remains an infrequent process due to technical limitations and lack of resources. As centres move towards implementing online ART, the role of the RTT will need to be redefined with corresponding upskilling to support the emergent treatment paradigm.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"33 ","pages":"Article 100303"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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