Building a New Model of Care for Rapid Breast Radiotherapy Treatment Planning: Evaluation of the Advanced Practice Radiation Therapist in Cavity Delineation

Lee, G.; Dinniwell, R.; Liu, Fei‐Fei; Fyles, Anthony; Han, Kathy; Conrad, Tatiana; Levin, Wilfred; Marshall, Andrea; Purdie, Thomas G.; Koch, Christine

doi:10.1016/j.clon.2016.07.013

Cited by 16 publications

(11 citation statements)

References 24 publications

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“…The analysis revealed high consistency between the different professional figures: the mean concordance index was 0.81 and 0.84 for the RO and CSRT, respectively. Similar results were found in other studies [16,30].…”

Section: Discussionsupporting

confidence: 93%

The emerging role of radiation therapists in the contouring of organs at risk in radiotherapy: analysis of inter-observer variability with radiation oncologists for the chest and upper abdomen

Arculeo

Miglietta

Nava

et al. 2020

ecancer

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Aims: To compare the contouring of organs at risk (OAR) between a clinical specialist radiation therapist (CSRT) and radiation oncologists (ROs) with different levels of expertise (senior-SRO, junior-JRO, fellow-FRO). Methods: On ten planning computed tomography (CT) image sets of patients undergoing breast radiotherapy (RT), the observers independently contoured the contralateral breast, heart, left anterior descending artery (LAD), oesophagus, kidney, liver, spinal cord, stomach and trachea. The CSRT was instructed by the JRO e SRO. The inter-observer variability of contoured volumes was measured using the Dice similarity coefficient (DSC) (threshold of ≥ 0.7 for good concordance) and the centre of mass distance (CMD). The analysis of variance (ANOVA) was performed and a p-value < 0.01 was considered statistically significant. Results: Good overlaps (DSC > 0.7) were obtained for all OARs, except for LAD (DSC = 0.34 ± 0.17, mean ± standard deviation) and oesophagus (DSC = 0.66 ± 0.06, mean ± SD). The mean CMD < 1 cm was achieved for all the OARs, but spinal cord (CMD = 1.22 cm). By pairing the observers, mean DSC > 0.7 and mean CMD < 1 cm were achieved in all cases. The best overlaps were seen for the pairs JRO-CSRT(DSC = 0.82; CMD = 0.49 cm) and SRO-JRO (DSC = 0.80; CMD = 0.51 cm). Conclusions: Overall, good concordance was found for all the observers. Despite the short training in contouring, CSRT obtained good concordance with his tutor (JRO). Great variability was seen in contouring the LAD, due to its difficult visualization and identification of CT scans without contrast.

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Section: Discussionsupporting

confidence: 93%

The emerging role of radiation therapists in the contouring of organs at risk in radiotherapy: analysis of inter-observer variability with radiation oncologists for the chest and upper abdomen

Arculeo

Miglietta

Nava

et al. 2020

ecancer

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“…In breast cancer, there was good agreement between RTT and radiation oncologist in CT simulation and planning of breast RT and, low inter-observer variability between RTT and clinician in breast CTV voluming [36,37]. This is further supported by the introduction of advanced RTTs in the delineation of non-complex cavity treatments and RTT led breast boost delineation [28,38].…”

Section: Target and Organs At Risk Volume Delineationsmentioning

confidence: 82%

“…RTT led reviews set the precedent, with evidence of success for nearly two decades. Excellent agreement in toxicity scoring and patient satisfaction has been described by several authors [24,28,40,41]. A national survey of UK management for prostate cancer patients described patients being reviewed on treatment by clinical oncologists and RTTs, with 22% of treatment review RTTs being independent prescribers [42].…”

Section: Rtt-led Reviews/toxicity Assessmentmentioning

confidence: 95%

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Advanced practice: An ESTRO RTTC position paper

Duffton

Devlin

Tsang

et al. 2019

Technical Innovations & Patient Support in Radiation Oncolo

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European Society for radiotherapy and oncology (ESTRO) committee The ESTRO Radiation Therapist committee (RTTC) is made up of 14 representatives (including 2 elected members of the RTT alliance) working as radiation therapists (RTTs) in clinical departments and academic institutes. The role of the RTT in Europe has been described in previous ESTRO documents, with clear guidelines and definitions as to the educational standards required of an undergraduate practitioner (level 6) [1] and advanced/specialist practitioner (7&8) [2]. From here on, this paper will refer to our profession as RTT.

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“…In radiation oncology centres specifically, radiation therapists (RT) performing advanced practitioner roles were introduced in the United Kingdom at the turn of the century [1] , and in the Canadian province of Ontario shortly after [2] . Discussion papers, frameworks elaborating expectations of practice and formal recognition pathways exist across multiple jurisdictions [3] , [4] , [5] , [6] , [7] , [8] , and many reports of local practice outcomes as a result of radiation therapy advanced practitioner implementation have been published during the last two decades [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] .…”

Section: Introductionmentioning

confidence: 99%

Navigating uncertainty: The implementation of Australian radiation therapy advanced practitioners

Matthews¹,

Duchesne²,

Baird³

2021

Technical Innovations & Patient Support in Radiation Oncolo

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Radiation therapy advanced practice has been implemented in several international jurisdictions; however, it is yet to be systematically integrated into Australian radiation oncology centres. This paper presents the outcomes of a doctoral research study to explore the factors that may be influencing the implementation of radiation therapy advanced practice in Australia. Using a constructivist grounded theory methodological approach to guide procedures, data collection occurred via 6 nationally facilitated online (video mediated) focus groups, and during interviews and observations at 5 purposively selected clinical case study locations. Data analysis led to the development of a grounded theory 'navigating uncertainty' to describe the process influencing the implementation of radiation therapy advanced practice in Australia. Navigating uncertainty is explained by three inter-related contextual processes of conceptualising radiation therapy advanced practice, integrating radiation therapy advanced practice, and becoming the radiation therapy advanced practitioner. The research suggests that the process of actively finding a way to accommodate uncertainty is necessary for advanced practice implementation objectives to be realised.

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Building a New Model of Care for Rapid Breast Radiotherapy Treatment Planning: Evaluation of the Advanced Practice Radiation Therapist in Cavity Delineation

Cited by 16 publications

References 24 publications

The emerging role of radiation therapists in the contouring of organs at risk in radiotherapy: analysis of inter-observer variability with radiation oncologists for the chest and upper abdomen

The emerging role of radiation therapists in the contouring of organs at risk in radiotherapy: analysis of inter-observer variability with radiation oncologists for the chest and upper abdomen

Advanced practice: An ESTRO RTTC position paper

Navigating uncertainty: The implementation of Australian radiation therapy advanced practitioners

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