Workflow optimization of brachytherapy-based very accelerated partial breast irradiation.

Area of Science:

• Oncology
• Radiation Oncology
• Medical Physics

Background:

• Accelerated partial breast irradiation (APBI) is a Level 1 evidence procedure for low-risk breast cancer.
• Brachytherapy-based very accelerated partial breast irradiation (vAPBI) enables adjuvant irradiation in 1-4 fractions.
• Efficient organization is critical for vAPBI implementation.

Purpose of the Study:

• To report on the optimization of vAPBI organization.
• To establish a new organization for vAPBI based on a single fraction.
• To offer an efficient, simple, and rapid adjuvant irradiation with reduced hospital visits for low-risk breast cancer patients.

Main Methods:

• Developed a 4-5 hour vAPBI program merging consultation, imaging, anesthesia, catheter placement, irradiation, and discharge.
• Collaborated with radiation oncologists, medical physicists, radiation therapists, and medical secretaries.
• Utilized telemedicine for initial consultation followed by an in-person day for the procedure.

Main Results:

• A total dose of 16 Gy in 1 fraction was delivered.
• The entire process from initial consultation to treatment completion took approximately 5 hours.
• Patients were discharged on the same day of treatment.

Conclusions:

• Optimized vAPBI organization enables a 5-hour procedure from consultation to treatment completion.
• This approach requires only one round trip for the patient.
• Strict interdisciplinary staff organization is essential for successful implementation.