Safety and feasibility of STAT RAD: Improvement of a novel rapid tomotherapy-based radiation therapy workflow by failure mode and effects analysis

Jones, Ryan; Handsfield, Lydia L.; Read, Paul W.; Wilson, Dan; Ausdal, Ray Van; Schlesinger, David; Siebers, Jeffrey V.; Chen, Quan

doi:10.1016/j.prro.2014.03.016

Cited by 19 publications

(13 citation statements)

References 17 publications

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“…At our institution, we are exploring the feasibility of replacing current routine phantom QA methods for TomoTherapy-based treatments when we adopt the comprehensive QA approach advocated by TG100. 33…”

Section: Discussionmentioning

confidence: 99%

“…In this time of hypofractionation and adaptive planning, physicists and physicians need quality assurance that is capable of detecting clinically significant errors and then evaluating the impact of delivery errors on the patient geometry. 33 Recent studies have suggested alternative methods for patient-specific QA that provide increased sensitivity to dose errors compared with the phantom-based measurements, such as dose recalculation from flat panel-based 2D fluence measurement and from the treatment machine's log file from Varian ® and Elekta ® linear accelerators. [12][13][14][15][16] As additional QA, some centers also include an independent, secondary dose calculation, either using another treatment planning system or Monte Carlo (MC)-based code.…”

Section: Introductionmentioning

confidence: 99%

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Phantomless patient‐specific TomoTherapy QA via delivery performance monitoring and a secondary Monte Carlo dose calculation

et al. 2014

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MCLogQA is a new TomoTherapy QA process that validates the planned dose before delivery and analyzes the delivered dose using the treatment exit detector and log file data. The MCLogQA procedure is an effective and efficient alternative to traditional phantom-based TomoTherapy plan-specific QA because it allows for comprehensive 3D dose verification, accounts for tissue heterogeneity, uses patient CT density tables, reduces total QA time, and provides for a comprehensive QA methodology for each treatment fraction.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Phantomless patient‐specific TomoTherapy QA via delivery performance monitoring and a secondary Monte Carlo dose calculation

et al. 2014

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“…Other works consistent with the TG-100 philosophy dealing with RT applications have been reported in the literature. [10][11][12][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Quality in radiation therapy from a more qualitative perspective than that of TG 100 has been the subject of several additional recent publications. A consortium of UK professional bodies together with the National Patient Safety Agency has developed a document entitled "Towards Safer Radiotherapy."…”

Section: Comparison With Previous Workmentioning

confidence: 99%

The report of Task Group 100 of the AAPM: Application of risk analysis methods to radiation therapy quality management

et al. 2016

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The increasing complexity of modern radiation therapy planning and delivery challenges traditional prescriptive quality management (QM) methods, such as many of those included in guidelines published by organizations such as the AAPM, ASTRO, ACR, ESTRO, and IAEA. These prescriptive guidelines have traditionally focused on monitoring all aspects of the functional performance of radiotherapy (RT) equipment by comparing parameters against tolerances set at strict but achievable values. Many errors that occur in radiation oncology are not due to failures in devices and software; rather they are failures in workflow and process. A systematic understanding of the likelihood and clinical impact of possible failures throughout a course of radiotherapy is needed to direct limit QM resources efficiently to produce maximum safety and quality of patient care. Task Group 100 of the AAPM has taken a broad view of these issues and has developed a framework for designing QM activities, based on estimates of the probability of identified failures and their clinical outcome through the RT planning and delivery process. The Task Group has chosen a specific radiotherapy process required for "intensity modulated radiation therapy (IMRT)" as a case study. The goal of this work is to apply modern risk-based analysis techniques to this complex RT process in order to demonstrate to the RT community that such techniques may help identify more effective and efficient ways to enhance the safety and quality of our treatment processes. The task group generated by consensus an example quality management program strategy for the IMRT process performed at the institution of one of the authors. This report describes the methodology and nomenclature developed, presents the process maps, FMEAs, fault trees, and QM programs developed, and makes suggestions on how this information could be used in the clinic. The development and implementation of risk-assessment techniques will make radiation therapy safer and more efficient.

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“…The American Cancer Society estimated that annually in 2019 there are 1.76 million new cases of cancer with 606,880 cancer deaths (1). Most cancer deaths are associated with a decreased quality of life and painful end-of-life, likely due to loco-regional or metastatic disease progression (2, 3). Palliative radiotherapy (RT) allows for the management of patients with advanced stage cancer.…”

Section: Introductionmentioning

confidence: 99%

“…Palliative radiotherapy (RT) allows for the management of patients with advanced stage cancer. Palliative RT directly relieves obstructions, bleeding, and cancer-related pain for patients not a candidate for or responding to opioid medication (2–13).…”

Section: Introductionmentioning

confidence: 99%

STAT-ART: The Promise and Practice of a Rapid Palliative Single Session of MR-Guided Online Adaptive Radiotherapy (ART)

et al. 2019

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This work describes a novel application of MR-guided online adaptive radiotherapy (MRgoART) in the management of patients whom urgent palliative care is indicated using statum-adaptive radiotherapy (STAT-ART). The implementation of STAT-ART, as performed at our institution, is presented including a discussion of the advantages and limitations compared to the standard of care for palliative radiotherapy on conventional c-arm linacs. MR-based treatment planning techniques of STAT-ART for density overrides and deformable image registration (DIR) of diagnostic CT to the treatment MR are also addressed.

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Safety and feasibility of STAT RAD: Improvement of a novel rapid tomotherapy-based radiation therapy workflow by failure mode and effects analysis

Cited by 19 publications

References 17 publications

Phantomless patient‐specific TomoTherapy QA via delivery performance monitoring and a secondary Monte Carlo dose calculation

Phantomless patient‐specific TomoTherapy QA via delivery performance monitoring and a secondary Monte Carlo dose calculation

The report of Task Group 100 of the AAPM: Application of risk analysis methods to radiation therapy quality management

STAT-ART: The Promise and Practice of a Rapid Palliative Single Session of MR-Guided Online Adaptive Radiotherapy (ART)

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