Clinical safety assessment of the Halcyon system

Pawlicki, Todd; Atwood, Todd; McConnell, Kristen; Kim, Gwe-Ya

doi:10.1002/mp.13736

Cited by 13 publications

(12 citation statements)

References 15 publications

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“…Also, markers necessary to distinguish from a neuroendocrine tumour are negative IHC for synaptophysin, chromogranin A, TTF-1, c-Kit, S-100 protein and CD34 [ 28 ]. Positive IHC for p53 has also been reported in about 30% of pancreatic acinar carcinomas [ 29 ]. Some of the markers mentioned before were obtained in this case report, stating that not all markers mentioned before are available in our pathology department, but its classification and differentiation from a neuroendocrine tumour was possible.…”

Section: Discussionmentioning

confidence: 99%

Gastric collision tumour with probable ectopic pancreatic origin

Gonzáles¹,

Arroyo-Gárate²,

Estrella³

et al. 2022

ecancer

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Introduction Mixed histology tumours are rarely found in the stomach. Of these, collision tumours are mainly composed of adenocarcinomas and sarcomas or lymphomas. This is the seventh case reported in the literature of an acinar cell carcinoma arising from an ectopic pancreas located in the stomach and the first described within a collision tumour. Clinical case We present the case of a 58-year-old female patient diagnosed with gastric cancer who, after undergoing a total gastrectomy, presented with a pathology report describing findings compatible with gastric collision tumour with components of tubular adenocarcinoma and acinar cell carcinoma of probable pancreatic ectopic aetiology. Discussion At the beginning of the 20th century, collision tumours were rarely described. Those located in the stomach are an infrequent pathology and are rarely diagnosed preoperatively. A collision tumour is composed of two independent neoplastic tissue with tumour areas separated in two different histological patterns and, in case of metastasis, this separation must also be clearly identified. There are different theories about its carcinogenesis and the debate regarding the ideal treatment is still ongoing. Conclusion This is the first report of a malignant gastric tumour with probable heterotopic pancreatic origin that collides with gastric adenocarcinoma.

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Section: Discussionmentioning

confidence: 99%

Gastric collision tumour with probable ectopic pancreatic origin

Gonzáles¹,

Arroyo-Gárate²,

Estrella³

et al. 2022

ecancer

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“…Staffing costs could thus not have been reduced further. Perhaps using another LINAC that optimises treatment speed through gantry mobility and MLC motion, such as the Varian® Halcyon [ 28 , 29 ], could significantly lower teletherapy costs.…”

Section: Discussionmentioning

confidence: 99%

Cost analysis of total neoadjuvant therapy with 5 × 5 Gy radiation therapy versus conventional chemoradiotherapy for locally advanced rectal cancer among Peruvians

Robles-Díaz¹,

Changra²

2022

ecancer

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Background and Objectives Conventional long-course radiotherapy (LCRT) and a new paradigm of short-course radiotherapy with total neoadjuvant therapy (SCRT-TNT) are used in locally advanced rectal cancer (RC). There are few economic assessment reports available on TNT that focus on cost analysis in a country with limited funding for healthcare systems. The objective of this study was to perform a cost analysis comparing SCRT-TNT versus LCRT. Materials and Methods In 2020–2021, a prospective registry was created to document RC patients who received neoadjuvant therapy and the costs of cancer treatments, transportation and the time patients and family members spent in the hospital. This registry outlined the direct and indirect costs of LCRT versus SCRT-TNT. Results LCRT and SCRT-TNT regimens have direct costs that range from S/.5,993.30 to S/.27,928.36 and from S/.3,409.81 to S/.18,159.42, respectively. FOLFOX regimens are the most expensive. Administering radiotherapy in 28 3D sessions and 5 sessions of intensity-modulated radiation therapy (IMRT) or volumetric-modulated arc therapy (VMAT) sessions costs S/.2,603.88, S/.1,277.19 and S/.1,027.77, respectively. The indirect cost of FOLFOX regimens is twice that of the similar modality that combines irradiation and Oxaliplatin IV and Capecitabine VO (CAPOX). SCRT-TNT regimens with CAPOX reduce costs by at least 50%, while SCRT-TNT regimens with FOLFOX reduce costs by 32%. Conclusion Despite using IMRT/VMAT, SCRT-TNT is a less expensive approach for patients with RC when compared to LCRT. The costs to patients using SCRT-TNT are much lower, but it is also a better option because it saves hospital resources.

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“…Pawlicki et al. have provided more detailed descriptions of the analysis procedure as applied in radiotherapy settings 13,14 . Table 2 shows the criteria considered in the analysis for each of the three operational objectives.…”

Section: Methodsmentioning

confidence: 99%

A system‐based operational assessment of external beam radiotherapy

Wong

Pawlicki

2022

Medical Physics

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Purpose Advanced technologies have led to improvements in modern radiotherapy over the years. However, adoption of advanced technologies can present challenges to existing clinical operations and negatively impact safety. The purpose of this work is to perform an assessment of modern radiotherapy for the operational objectives of safety, efficiency, and financial viability. Methods This work focuses on external beam radiotherapy (EBRT). The operational assessment included department management, treatment planning, treatment delivery, and associated workflows for three equipment configurations of Ethos, Halcyon, and TrueBeam with the ARIA information system, Eclipse treatment planning, and IDENTIFY surface guidance. Systems‐theoretic process analysis (STPA) was used to analyze the related workflows. Control actions, unsafe contexts of those control actions, and associated causal scenarios that can lead to unsafe radiation and non‐radiation physical injury (safety objective), reduced treatment capacity (efficiency objective), and costs that exceed budget (financial viability objective) were identified. Results The number of control actions (and causal scenarios) were 18 (254), 18 (267), and 20 (267) for the equipment configurations of Halcyon, TrueBeam, and Ethos, respectively. The extent that safety, efficiency, and financial viability were impacted is similar across the different equipment configurations, but there were some noteworthy differences related to information transfer and workflow bottlenecks potentially impacting access to care. Seventy‐five percent of the scenarios across all three configurations were related to safety. Overall, 29% of the scenarios impacted more than one operational objective and 48% were related to human decisions during the process of care. Planned or unplanned process changes were responsible for 8% of the causal scenarios. Conclusions Broad‐based clinical improvements may be realized by addressing causal scenarios that impact multiple objectives. Redesigning the roles and responsibilities of the clinical team and some aspects of the radiotherapy workflow may be helpful to fully realize the benefits of advanced technologies. Radiotherapy may benefit from additional tools to improve the consistency between decisions and actions when system or process changes occur.

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Clinical safety assessment of the Halcyon system

Cited by 13 publications

References 15 publications

Gastric collision tumour with probable ectopic pancreatic origin

Gastric collision tumour with probable ectopic pancreatic origin

Cost analysis of total neoadjuvant therapy with 5 × 5 Gy radiation therapy versus conventional chemoradiotherapy for locally advanced rectal cancer among Peruvians

A system‐based operational assessment of external beam radiotherapy

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