ArticleCureus2025
Effect of Same-Day Volumetric Modulated Arc Therapy on Resource Utilization in Rapid Access Palliative Radiotherapy Clinics Using a Radiation Oncologist-Initiated Automated Planning Script.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
purposeRapid access palliative (RAP) radiotherapy (RT) clinics enable patients to access urgent same-day consultation, simulation, and treatment. This study aimed to examine the effect of same-day volumetric modulated arc therapy (VMAT) implementation using the Northern Plan Automation Service Treatment Planning Automation Service (NoPAUSE-TPAS) on patient throughput in RAP-RT clinics at a regional cancer center. Methods:This retrospective study included all patients seen in RAP-RT clinics between February and August 2024 following the introduction of NoPAUSE-TPAS, compared to a data set from January to July 2019, prior to the introduction of NoPAUSE-TPAS. Baseline characteristics were analyzed using descriptive statistics. Measures of resource utilization and quality pertaining to consultations, computed tomography simulation slots, and treatment delivery were assessed.
resultsRAP-RT clinics saw 202 patients in 2024 and 213 in 2019. In 2019, 195 (91.5%) patients received RT to 249 sites, compared to 189 (93.6%) patients who received RT to 246 sites in 2024. Most patients (n=148 (69.5%) in 2019; n=143 (70.8%) in 2024) received RT to one site. Bone was the most common site treated (n=176 (70.7%) in 2019; n=177 (71.9%) in 2024). The most common fractionation was 8 Gy/1 (n=128 (51.5%) in 2019; n=156 (63.4%) in 2024). Of the bone metastases, 117 (66.5%) were treated with a single fraction in 2019, compared to 144 (81.4%) in 2024. Most patients (n=185 (94.9%) in 2019; n=171 (90.5%) in 2024) started RT the same date as consultation. Within the 2024 cohort, 133 (54.1%) sites were treated with an unplanned technique and 113 (45.9%) with VMAT. Of the sites treated, 192 (78%) were eligible for NoPAUSE-TPAS. Of the eligible sites, 113 (58.9%) received treatment with VMAT, with 96 (84.9%) of these delivered on the same date as consultation. The median time for NoPAUSE-TPAS optimization was 12 minutes. Conclusions:Same-day VMAT using NoPAUSE-TPAS was implemented in RAP-RT clinics with no scheduling changes impacting patient throughput and similar resource utilization compared to historical data. Utilizing automation technology to improve efficiency can enable same-day VMAT for palliative RT.
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