Abstract
Audrey Tetreault-Laflamme1, Luc Ouellet2, Isabelle Gauthier2, Annie Ebacher2, Myriam Bouchard2
1CHUM, Montreal, QC
2CHUS, Sherbrooke, QC
Purpose: Radiation treatment interruptions and prolonged overall treatment time can decrease cancer control. However, these can be planned and prevented. The purpose of this study is to assess impacts of implementing a software-based management of radiation treatment interruptions in clinical practice.
Materials and Methods: Institutional guidelines for management of treatment interruptions were developed based on the 2008 Royal College of Radiologists guidelines. Software designed according to those new guidelines has been in use, at our centre, since November 2012. In this program, patients are divided into three categories: category 1 contains patients whose treatment period must not be prolonged for more than two days, for example those treated for head and neck, cervical or lung cancers; category 2a represents patients whose treatment time must not be prolonged for more than three days and includes most other cancer sites; and category 2b patients are the ones whose treatment must not exceed five extra days, for instance, breast or prostate cancer patients. We retrospectively revised treatment charts of all patients treated with curative intent at Centre Hospitalier Universitaire de Sherbrooke from November 2010 to November 2013. We compared treatment delays and the number of weekend days needed to compensate these delays before and after software implementation.
Results: 5181 patients were treated during that period; 3057 treated with curative intent were analyzed. 20.4% were category 1 patients, 27.8% were category 2a patients and 51.8% were category 2b patients. 81.8% and 86.3% of patients whose treatments had been interrupted in 2011 and 2012 had completed treatments within acceptable delays according to guidelines; in comparison, this number increased to 94.9% in 2013. In category 1 patients, interrupted cases whose treatments were completed within acceptable delays represented 40.8%, 61.6%, and 82.2% in 2011, 2012, and 2013 respectively. These values were 86.7%, 90.4% and 95.4% in category 2a patients, and 94.7%, 95.6% and 99.1% for category 2b patients. Furthermore, the number of weekend days on which more than five patients received treatments decreased from 30 to 11 from 2011 to 2013.
Conclusions: The use of software based on explicit guidelines for management of radiation treatment interruptions reduces treatment times and facilitates efficient organization with a meaningful reduction of off-hour resources.
