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Real-World Implementation of Simulation-Free Radiation Therapy (SFRT-1000): A Propensity Score-Matched Analysis of
Thilo Schuler1, Stephanie Roderick2, Shelley Wong2
1Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia; Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
International Journal of Radiation Oncology, Biology, Physics
|October 1, 2024
Summary
Simulation-Free Radiation Therapy (SFRT) is feasible for routine palliative care, significantly reducing wait times and improving patient pain response. This scalable approach enhances access to radiation therapy globally.
Area of Science:
- Radiation Oncology
- Medical Physics
- Clinical Cancer Research
Background:
- Simulation-Free Radiation Therapy (SFRT) feasibility is established, but its real-world impact and scalability in routine care are not well-documented.
- Palliative radiation therapy (RT) is crucial for symptom management in cancer patients, with access being a global challenge.
Purpose of the Study:
- To evaluate the routine care impact and scalability of Simulation-Free Radiation Therapy (SFRT).
- To assess SFRT's effect on consultation-to-RT time and on-couch treatment duration.
- To analyze patient-reported outcomes, including toxicity and pain response, for SFRT.
Main Methods:
- Retrospective cohort study at an Australian tertiary cancer center, including patients receiving palliative RT.
- SFRT was considered unless specific immobilization, technique, or dose requirements were indicated.
- Comparison with a simulation-based palliative RT cohort using statistical tests and propensity score matching; electronic patient-reported outcomes were collected.
Main Results:
- Over 2849 palliative RT courses, 1000 (52.5% utilization) received SFRT between 2018-2024, with increasing adoption.
- SFRT reduced median consultation-to-RT time from 7.0 to 5.1 days (P < .0001).
- Median on-couch treatment duration increased slightly (17.8 to 20.5 mins, P < .0001), with 9% grade 3 acute toxicity and significant pain reduction in treated patients.
Conclusions:
- The SFRT-1000 cohort demonstrates that SFRT is scalable for routine care, offering patient and workflow benefits.
- SFRT is a viable new paradigm implementable across various settings with local adaptations.
- SFRT has the potential to improve global access to essential palliative radiation therapy.
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