A tool to measure radiotherapy complexity and workload: derivation from the basic treatment equivalent (BTE) concept.

Area of Science:

• Medical Physics
• Radiation Oncology
• Health Services Research

Background:

• Current radiotherapy workload metrics (patients, fractions, fields) fail to capture treatment complexity.
• Increasing complexity in radiotherapy necessitates accurate workload quantification.
• Standard appointment times (e.g., 10 minutes) are insufficient for effective radiotherapy scheduling.

Purpose of the Study:

• To evaluate the Basic Treatment Equivalent (BTE) model for measuring radiotherapy workload and complexity.
• To develop and refine models for predicting radiotherapy treatment duration.
• To assess the impact of treatment complexity on scheduling and resource allocation.

Main Methods:

• Measured radiotherapy treatment times for 1298 sessions across 269 patients.
• Assessed the original BTE model and developed three new predictive models, including the 'Addenbrooke's complex model' with site/technique variables.
• Analyzed discrepancies between measured times and standard appointment durations.

Main Results:

• 50% of treatments exceeded the standard 10-minute appointment time (mean 10.9 minutes).
• The refined 'Addenbrooke's complex model' predicted treatment times within 2 minutes for 70% of sessions.
• The models accounted for 59.4% of the variation in observed treatment times.

Conclusions:

• Developed models effectively represent radiotherapy complexity and improve linear accelerator scheduling.
• These models can assess the impact of new techniques, trial protocols, and advanced technologies (e.g., multileaf collimators).
• The models offer valuable tools for future linear accelerator provision planning and radiotherapy costing.