Refinement of the basic treatment equivalent model to reflect radiotherapy treatment throughput using Australasian...

Area of Science:

• Medical Physics
• Radiation Oncology
• Health Services Research

Background:

• Current measures of linear accelerator throughput in radiotherapy are limited.
• A previous model showed improved sensitivity but had shortcomings.
• Accurate throughput measurement is crucial for optimizing radiotherapy services.

Purpose of the Study:

• To develop a more sensitive basic treatment equivalent (BTE) model for measuring linear accelerator throughput.
• To address limitations of previous throughput models in radiation oncology.
• To identify key factors influencing radiotherapy treatment duration.

Main Methods:

• A prospective study involving 26 radiation oncology departments in Australia and New Zealand.
• Timing of 7929 radiotherapy treatment fractions across 2424 patients over 4 weeks.
• Multivariate analysis to identify factors impacting treatment duration, including patient and treatment characteristics.

Main Results:

• Treatment duration is significantly influenced by fraction type, beam type, number of fields, shielding blocks, junctions, port films, and Eastern Cooperative Oncology Group (ECOG) performance status.
• Patient age, number of compensators, and sex were not significant factors.
• A new model incorporating these factors provides a more sensitive measure of linear accelerator throughput than simpler metrics.

Conclusions:

• Linear accelerator throughput is inadequately measured by simply counting patients or fields treated per unit time.
• A more sensitive model considering multiple complexity factors is necessary for accurate throughput assessment.
• While improved, the developed model still exhibits some insensitivity, suggesting further refinement may be needed.