Basic Treatment Equivalent (BTE): a new measure of linear accelerator workload

Area of Science:

• Radiation Oncology
• Medical Physics
• Health Services Research

Background:

• Current linear accelerator workload measurement in radiation oncology relies on treatment fields per unit time, neglecting complexity.
• This method provides an inaccurate basis for cost assessment and patient throughput comparisons between departments.

Purpose of the Study:

• To develop a simple, reproducible model for measuring linear accelerator workload in Australasian radiation oncology departments.
• To account for variations in treatment complexity, providing a realistic basis for cost assessment and patient throughput comparison.

Main Methods:

• Prospective study measuring the duration of 2371 radiotherapy fractions over 4 weeks.
• Multivariate modeling identified factors influencing fraction duration, including treatment complexity variables.
• Derived and validated the 'Basic Treatment Equivalent' (BTE) model at Westmead Hospital.

Main Results:

• Fraction duration was significantly influenced by the number of fields, shielding blocks, first treatment fraction, need for anesthesia, and performance status.
• The derived BTE model accurately reflected predicted resource utilization during a subsequent 1-week study.
• The BTE model demonstrated a more accurate reflection of linear accelerator workload compared to previous measures.

Conclusions:

• The developed BTE model offers a more realistic assessment of linear accelerator workload by incorporating treatment complexity.
• Further prospective testing and Australasian validation are required before widespread adoption.
• The BTE model has significant implications for workload reporting, cost analysis, and patient scheduling in radiation oncology.