Identifying best practices for RTTs and dosimetrists: a Delphi consensus study on standardizing workflows in proton...

Area of Science:

• Medical Physics
• Radiation Oncology
• Radiotherapy Practice

Background:

• Proton therapy (PT) guidelines have identified gaps, particularly concerning radiation therapists (RTTs) and dosimetrists.
• Existing guidelines lack specific details for RTTs in European proton therapy centers (PTCs).

Purpose of the Study:

• To achieve consensus on best practices for RTTs across seven key workflows in European PTCs.
• To address identified gaps in PT guidelines relevant to RTT expertise.

Main Methods:

• A Delphi consensus methodology was employed, involving three rounds of responses scored on a 5-point Likert scale.
• Twenty-six statements derived from an RTT workshop were evaluated by experts.
• Consensus was defined as >66% agreement/disagreement, with strong consensus at ≥80%.

Main Results:

• Forty experts from 15 European PTCs participated, reaching consensus on 24 statements across seven workflows.
• Consensus highlighted the need for specialized RTT training in PT, including uncertainties, pediatric care, and AI.
• Agreed practices include RTTs actively monitoring treatment, sharing knowledge, using individual beam setups in treatment planning, and performing additional plan checks for quality assurance.

Conclusions:

• This Delphi study establishes a foundation for developing practical PT guidelines for RTTs in Europe.
• Consensus supports specialized training and defined roles for RTTs in PTCs.
• Multidisciplinary collaboration remains essential for optimal PT delivery.