Time trial: A prospective comparative study of the time-resource burden for three-dimensional conformal radiotherapy and intensity-modulated radiotherapy in head and neck cancers
Time trial: A prospective comparative study of the time-resource burden for three-dimensional conformal radiotherapy and intensity-modulated radiotherapy in head and neck cancers
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DOI：
10.4103/0973-1482.52800
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发表时间：
2009-04-01
影响因子：
1.3
通讯作者：
Agarwal, Jaiprakash
中科院分区：
文献类型：
--
作者：
Murthy, Vedang;Gupta, Tejpal;Agarwal, Jaiprakash
一项正在进行的机构随机临床试验比较了三维适形放疗（3D CRT）和调强放疗（IMRT），为我们提供了一个机会来记录和比较这些高精度技术在头颈癌中的时间和人力负担。材料和方法：对正在进行的试验中连续20例患者进行队列研究。放疗计划和输送过程被划分为明确的步骤，并根据普遍的部门实践分配人力资源。计算每个步骤的工时。结果：12例患者行IMRT， 8例行3D CRT。随机化前的步骤（直到并包括轮廓的批准）在两组之间是共同的，并且预期，完成每个步骤所需的时间是相似的。计划步骤在随机化后进行，3D CRT（312分钟，5.2人小时）和IMRT（325.6分钟，5.4人小时）的中位时间相似。两组的治疗时间中位数各不相同，3D CRT为15.2分钟（0.6人小时），而IMRT为27.8分钟（0.9人小时）（P < 0.001）。IMRT组的总治疗时间也明显更长（中位27.7 vs 17.8人小时，P < 0.001）。IMRT整个过程耗时48.5人小时，而3D CRT平均耗时37.3人小时。在IMRT中，每个分数的监测单位和实际“光束”时间也在统计上更长。结论：IMRT比3D CRT需要更多的工时，主要区别在于提供分步注射IMRT所需的时间和与IMRT相关的患者特异性质量保证。
Introduction: An ongoing institutional randomized clinical trial comparing three-dimensional conformal radiotherapy (3D CRT) and intensity-modulated radiotherapy (IMRT) provided us an opportunity to document and compare the time-manpower burden with these high-precision techniques in head and neck cancers. Materials and Methods: A cohort of 20 consecutive patients in the ongoing trial was studied. The radiotherapy planning and delivery process was divided into well-defined steps and allocated human resource based on prevalent departmental practice. Person-hours for each step were calculated. Results: Twelve patients underwent IMRT and eight patients had 3D CRT. The prerandomization steps (upto and including approval of contours) were common between the two arms, and expectedly, the time taken to complete each step was similar. The planning step was carried out postrandomization and the median times were similar for 3D CRT (312 min, 5.2 person-hours) and IMRT (325.6 min, 5.4 person-hours). The median treatment delivery time taken per fraction varied between the two arms, with 3D CRT taking 15.2 min (0.6 person-hours), while IMRT taking 27.8 min (0.9 person-hours) (P 0.001). The total treatment time was also significantly longer in the IMRT arm (median 27.7 versus 17.8 person-hours, P 0.001). The entire process of IMRT took 48.5 person-hours while 3D CRT took a median of 37.3 person-hours. The monitor units delivered per fraction and the actual "beam-on" time was also statistically longer with IMRT. Conclusions: IMRT required more person-hours than 3D CRT, the main difference being in the time taken to deliver the step-and-shoot IMRT and the patient-specific quality assurance associated with IMRT.