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DART: diagnostic-CT-enabled planning: a randomized trial in palliative radiation therapy (study protocol)
Melissa O'Neil1, Timothy K Nguyen1, Joanna Laba1
1Department of Radiation Oncology, London Health Sciences Centre, Western University, P.O. Box 5010, STN B, 800 Commissioners Rd. E, London, Ontario, N6A 5W9, Canada.
BMC Palliative Care
|December 9, 2022
Summary
This study evaluates a new "sim-free" palliative radiotherapy (PRT) planning method using diagnostic CT scans. The approach aims to reduce patient time at cancer centers and speed up treatment delivery for advanced cancer symptoms.
Area of Science:
- Radiation Oncology
- Medical Imaging
- Cancer Treatment
Background:
- Palliative radiotherapy (PRT) manages advanced cancer symptoms, with over half of treatments delivered palliatively.
- Expeditious treatment planning is crucial for symptomatic patients requiring PRT.
- Conventional CT simulation for planning creates bottlenecks and delays treatment initiation.
Purpose of the Study:
- To assess the efficacy, acceptability, and scalability of diagnostic-CT-enabled planning for PRT.
- To compare a "sim-free" PRT pathway with conventional CT simulation planning.
- To evaluate the potential of using standard diagnostic CT scans to replace dedicated CT simulations.
Main Methods:
- A randomized, phase II study involving 33 PRT patients.
- Patients randomized 1:2 between conventional CT simulation (Arm 1) and diagnostic CT-enabled planning (Arm 2).
- Stratification by treatment target volume (bone/soft tissue vs. intrathoracic disease); primary endpoint: time spent at cancer center.
Main Results:
- The study aims to determine if diagnostic-CT-enabled planning is non-inferior to conventional CT simulation.
- Secondary endpoints include plan deliverability, acceptability, and stakeholder perceptions.
- Analysis will focus on time savings and efficiency gains.
Conclusions:
- A "sim-free" PRT pathway using diagnostic imaging offers potential resource optimization.
- This workflow requires minimal investment and streamlines current PRT models.
- Benefits include eliminating an imaging procedure, reducing patient time at the cancer center, and expediting treatment.
