Aims: The aim of this study was to evaluate the treatment course length in category 1 patients and establish protocols to ameliorate both scheduled or unexpected prolongation in busy single linac regional radiotherapy centres.
Methods: We performed a retrospective study, identifying all patients commencing radiotherapy between March 2019 and May 2019 in our two Wide Bay Centers. The analysis was stratified into three groups: 1) patients with no treatment prolongation, 2) patients with acceptable prolongation of radiotherapy, and 3) patients with non-acceptable prolongation of therapy. The third group was further divided into two subgroups: unacceptable prolongation due to clinical reason and unexplained unacceptable prolongation of radiotherapy.
Results: 43 of 302 (14%) patients were category 1. Among these, 18.6% had no treatment prolongation, 39.5% had acceptable prolongation of radiotherapy. 42% had unacceptable prolongation of radiotherapy, with 14% of this subgroup prolonged due to clinical reasons and 28% were due to unexplained unacceptable prolongation.
Conclusion: Based on the results, we recommend:
Firstly, modifications need to be made to our existing Radiation Oncologist (RO) Portal, treatment booking system to allow specific identification of category 1 patients.
In Mosaiq radiation oncology information system, we recommend setting up an automation of flagging category 1 patients and calculating their optimal finish date. When courses are populated in Mosaiq, this should automatically flag patients whose treatments will extend beyond the optimal finish date due to scheduled interruption. This will allow ROs to plan compensation in advance for known interruptions.
When unscheduled interruptions occur, new treatment schedules will be populated in Mosaiq and thus any additional delays for category 1 patients can be identified and rectified in the same manner.
A Mosaiq alert system should be set up for all category 1 patients that will alert the users of any appointment changes that could result in treatment prolongation.