A Bridge Between Academic and Community Radiation Oncology Treatment Planning

Abstract

Purpose: To evaluate Telesynergy (TS) as a method of interactive treatment planning between academic and community radiation oncology departments.Methods: Through a grant from the National Cancer Institute to improve cancer outcomes for underserved populations, community radiation oncologists at New Hanover Regional Medical Center (NHRMC) in Wilmington, North Carolina, partnered with those at the University of North Carolina (UNC) in Chapel Hill, North Carolina. TS suites were installed at both sites to facilitate teleconferencing and review of treatment planning for intensitymodulated radiation therapy (IMRT). Patients with locally advanced head and neck cancer at NHRMC who were enrolled on a clinical trial of chemoirradiation underwent IMRT planning utilizing commercial software. NHRMC physicians contoured tumor targets and adjacent healthy organs. Physics staff at NHRMC generated an initial IMRT plan for each patient. Radiation oncologists at UNC then reviewed individual IMRT plans via TS conferences. Results and Conclusion:Between August 2004 and August 2005, seven IMRT plans were reviewed in eight TS conferences. Physician contours of tumor targets and healthy organs, dose volume histograms, IMRT beams, and isodose distributions were shared during each TS conference successfully. Median time for each session was 35 minutes (range, 30 to 75). Physician satisfaction with the interactive planning process was high at both NHRMC and UNC. A cycle would likely evolve of initial intensive use of TS conferences, to gradual use for ongoing quality control, then greater use as the treatment planning technology undergoes its next change. Complex IMRT treatment planning review was feasible between an academic and community hospital via TS with a high level of physician participant satisfaction.

National Cancer Institute’s Cancer Disparities Research Partnership Program: Experience and Lessons Learned

“…Establishing clinical consultation sites at remote centers resulted in saved patient travel time, and it also provided employment opportunities for healthcare workers on the reservations and at satellite Pennsylvania hospitals. These successes were important lessons learned from the conduct of clinical trials and medical care for remote disparities communities ( 12 – 14 ).…”

“…Table 5 details how it was used. Videoconferencing facilitated communication between awardees and their mentors for treatment planning ( 12 ) and follow-up consultations at remote settings (e.g., South Dakota and Pennsylvania). It was also used among CDRP sites predominantly for training clinical research staff, tumor board conferences, research consultations, and sharing of ideas.…”

Experience of a Videoconference System with Medical Information Desktop Sharing for Radiation Therapy and Evaluation of Its Usefulness

“…The system reported here has sufficiently realized our needs, though a level 1 system was the simplest in the classification of Olsen et al It should be emphasized that medical information desktop sharing reported here seems to be the first in the field of radiation oncology. There are some reports on applications of telemedicine for radiation therapy [4][5][6][7]. Suzuki et al [4] introduced a web-based remote radiation treatment planning system that allowed staff at an affiliated hospital to obtain support from a fully staffed central institution.…”

“…Our video conference system was not equipped with a function to make radiation therapy plans remotely; however, we did not need such a function because radiation therapy plans made by a doctor sent to an affiliated hospital could be checked in the videoconference and corrected on the spot. Maguire et al [5] reported their initial experience with a telemedicine workstation as a method for interactive intensity-modulated radiation therapy (IMRT) planning for patients with advanced head and neck squamous cell carcinoma between a university hospital and a distant regional community hospital. As an example of telemedicine applied to radiation oncology in a developing country, Agrawal et al [6] reported the establishment of a telemedicine linkage with a remote medical institute to facilitate teaching, training, and carry out collaborative clinical and translational research.…”

Training the Trainees in Radiation Oncology with Telemedicine as a Tool in a Developing Country: A Two-Year Audit

“…Keishiro Suzuki has demostrated the development of a web-based, remote radiation treatment planning system which allowed staff at an affiliated hospital to obtain support from a fully staffed central institution [ 6 ]. In a study by Maguire et al, telemedicine was shown to bridge the academic and community radiation oncology treatment planning [ 7 ]. They have demonstrated that complex radiation treatment planning review was feasible between an academic and community hospital via telesynergy network with a high level of physician satisfaction.…”