Contouring workload in adjuvant breast cancer radiotherapy

Area of Science:

• Radiation Oncology
• Medical Physics
• Health Services Research

Background:

• Accurate contouring of clinical target volumes (CTVs) and organs at risk (OARs) is critical for effective breast cancer radiation therapy.
• The time required for this process can significantly impact departmental workflow and resource allocation.

Purpose of the Study:

• To quantify the worktime associated with contouring in adjuvant breast cancer radiation treatment.
• To identify specific factors influencing contouring duration and overall treatment approval time.

Main Methods:

• Retrospective analysis of 203 breast cancer cases.
• Recording of contouring times for CTVs and OARs by senior and junior radiation oncologists.
• Evaluation of factors including patient demographics, surgical details, radiation technique, operator, planning system, and timing of contouring initiation.

Main Results:

• Mean contouring time was 34 minutes per patient (4.72 structures).
• Time from contouring start to approval averaged 29.4 hours.
• Factors increasing contour time included breast-conserving surgery, prone setup, junior operators, morning starts, and end-of-week starts.
• Junior operators and end-of-week starts significantly increased approval time.

Conclusions:

• Contouring is a substantial time commitment in breast cancer radiation therapy.
• Workflow optimization is possible by targeting identified influencing factors.
• Further prospective studies are needed to develop cost-effective solutions for contouring efficiency.