ArticleClinical and translational radiation oncology2025
Clinical implementation of RTT-only CBCT-guided online adaptive focal radiotherapy for bladder cancer.
Article in Clinical and translational radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Online adaptive radiotherapy: International strategies for AI-enabled workflow efficiency and radiation therapist-led delivery for sustainable practice.Technical innovations & patient support in radiation oncology · 2026Article
- The Unseen Pillars of Precision: A Qualitative Study on Feedback, Communication, and Motivation Among Medical Technologists in Radiation Oncology.Journal of cancer education : the official journal of the American Association for Cancer Education · 2026Article
- Structure visibility and online adaptation suitability of a new high-performance ring-gantry cone-beam computed tomography imaging system in thoracic radiotherapy.Physics and imaging in radiation oncology · 2026Article
- Terminology Proposal for Adaptive Particle Therapy Classification and Strategies.International journal of particle therapy · 2026Article
- Clinical experience with an online adaptive radiotherapy for prostate cancer: successful treatment time optimization.BMC cancer · 2026Article
- Simulation-free cone beam CT-based online adaptive radiotherapy for metastatic spinal cord compression.Acta oncologica (Stockholm, Sweden) · 2025Article
- Current status and upcoming developments for online adaptive proton therapy enabling a closed feedback loop for near real-time adaptation.Frontiers in oncology · 2025Review
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Authors and funding
12 authors.
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Abstract
Purpose: The study assesses the clinical implementation of radiation therapist (RTT)-only Conebeam CT (CBCT)-guided online adaptive focal radiotherapy (oART) for bladder cancer, by describing the training program, analyzing the workflow and monitoring patient experience. Materials and methods: Bladder cancer patients underwent treatment (20 sessions) on a ring-based linac (Ethos, Varian, a Siemens Healthineers Company, USA). Commencing April 2021, 14 patients were treated by RTTs supervised by the Radiation Oncologist (RO) and Medical Physics Expert (MPE) in a multidisciplinary workflow. From March 2022, 14 patients were treated solely by RTTs. RTT training included target delineation lessons and practicing oART in a simulation environment. We analyzed the efficiency of the RTT-only workflow regarding session time, adjustments by RTTs, attendance of the RO and MPE at the linac, and qualitative assessment of gross tumor volume (GTV) delineation. Patient experience was monitored through questionnaires. Results: A training program resulted in a skilled team of RTTs, ROs and MPEs.The RTT-only workflow demonstrated shorter session times compared to the multidisciplinary approach. Among 14 patients treated using the RTT-only workflow, RTTs adjusted 99% of bladder volumes and 44% of GTV. 79% of the sessions proceeded without MPEs and ROs. All GTV delineations were RO-approved, thus considered clinically acceptable, and 87% required minor or no adjustments. Patient satisfaction was reported in 18 of 21 cases. Conclusions: The RTT-only oART workflow for bladder cancer, complemented by a training program and on-call support from ROs and MPEs, demonstrated success. Patient experience is positive. It is currently introduced as standard in our clinic.
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