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Stereotactic Radiosurgery for Gynecologic Cancer
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RTT-led IGRT for cervix cancer; training, implementation and validation.

S E Alexander1, N Hopkins1, S Lalondrelle1,2

  • 1The Royal Marsden NHS Foundation Trust, United Kingdom.

Technical Innovations & Patient Support in Radiation Oncology
|February 26, 2020
PubMed
Summary

A refined training program enabled Radiation Therapists to accurately assess soft-tissue targets during Image-Guided Radiation Therapy (IGRT) for cervical cancer, improving treatment precision.

Keywords:
Cervical cancerCompetency assessmentCone-beam computed tomographyImage guided radiotherapyRTT trainingRTT-ledRadiation Therapists (RTT)

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Radiotherapy Technology

Background:

  • Image-guided radiation therapy (IGRT) for cervical cancer faces challenges due to significant organ motion.
  • Accurate soft-tissue assessment is crucial for improving treatment accuracy in IGRT.

Purpose of the Study:

  • To develop and refine a training and competency program (TCP) for Radiation Therapists (RTTs).
  • To enable RTT-led online soft-tissue assessment for improved IGRT in cervical cancer.
  • To evaluate the effectiveness of the TCP through a prospective audit.

Main Methods:

  • A multidisciplinary team developed a TCP with didactic and practical sessions.
  • Initial training focused on offline assessment; a redesigned program emphasized online assessment with decision support.
  • RTT proficiency was assessed against a clinician gold-standard using CBCT images.

Main Results:

  • The initial TCP had low pass rates (4/16).
  • The redesigned TCP achieved high pass rates (21/21, ≥80% agreement).
  • A prospective audit demonstrated 96% concordance between RTT and clinician reviews during daily online IGRT.

Conclusions:

  • Multidisciplinary collaboration and program redesign were key to RTT skill development.
  • Summative competency assessment facilitated successful clinical implementation.
  • RTT-led soft-tissue IGRT for cervical cancer was successfully implemented.