Diagnostic CT-Enabled Planning (DART) : Results of a Randomized Trial in Palliative Radiation Therapy
Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved..
PURPOSE: Using diagnostic computed tomography (dCT) scans instead of CT simulation (CTsim) scans can increase departmental efficiency and reduce patient burden. The goal of the DART trial was to assess the efficacy and acceptability of dCT-based planning workflows with a focus on patient experiences, plan deliverability and adequacy of target coverage, and workflows.
METHODS AND MATERIALS: Patients undergoing same-day CTsim and treatment for palliative radiation therapy to thoracic, abdominopelvic, or proximal limb targets with a recent dCT (within 28 days) in a reproducible position were eligible. After stratifying by target type (bone or soft tissue vs. visceral), participants were randomized (1:2 ratio) between CTsim-based (CTsim arm) vs. dCT-based planning (dCT arm). The primary endpoint was time in center (TIC), defined as total time spent in the cancer center on first day of treatment, from first radiation department appointment to first fraction completion. Secondary endpoints included plan deliverability, adequacy of target coverage, and stakeholder acceptability.
RESULTS: Thirty-three patients (42 treatment sites) were enrolled between June 2022 and April 2023. The median age was 72 (interquartile range [IQR]: 67-78), 73% were male, and the most common primary cancers were lung (33%), prostate (24%), and breast (12%). The most common dose and fractionations were 8 Gy in 1 and 20 Gy in 5 fractions (50% and 43% of plans, respectively). TIC was 4.7 ± 1.1 hours (mean ± SD) in the CTsim arm vs. 0.41 ± 0.14 hours in the dCT arm (P < .001). All dCT plans were deliverable. All plans in both arms were rated as "acceptable" (80% CTsim; 81% dCT) or "acceptable with minor deviation" (20% CTsim; 19% dCT). Patient perception of acceptability was similar in both arms with the exception of time burden, which was rated as "acceptable" by 50% in the CTsim arm vs. 90% in the dCT arm (P = .025).
CONCLUSION: dCT-based radiation planning substantially reduced TIC without detriment in plan deliverability or quality and had a tangible impact on patient experience with reduced patient-reported time burden.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
International journal of radiation oncology, biology, physics - (2024) vom: 12. Apr. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
O'Neil, Melissa [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Revised 13.04.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1016/j.ijrobp.2024.03.005 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM371028701 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM371028701 | ||
| 003 | DE-627 | ||
| 005 | 20240415232441.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240415s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.ijrobp.2024.03.005 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1375.xml |
| 035 | |a (DE-627)NLM371028701 | ||
| 035 | |a (NLM)38613562 | ||
| 035 | |a (PII)S0360-3016(24)00396-1 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a O'Neil, Melissa |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Diagnostic CT-Enabled Planning (DART) |b Results of a Randomized Trial in Palliative Radiation Therapy |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 13.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: Using diagnostic computed tomography (dCT) scans instead of CT simulation (CTsim) scans can increase departmental efficiency and reduce patient burden. The goal of the DART trial was to assess the efficacy and acceptability of dCT-based planning workflows with a focus on patient experiences, plan deliverability and adequacy of target coverage, and workflows | ||
| 520 | |a METHODS AND MATERIALS: Patients undergoing same-day CTsim and treatment for palliative radiation therapy to thoracic, abdominopelvic, or proximal limb targets with a recent dCT (within 28 days) in a reproducible position were eligible. After stratifying by target type (bone or soft tissue vs. visceral), participants were randomized (1:2 ratio) between CTsim-based (CTsim arm) vs. dCT-based planning (dCT arm). The primary endpoint was time in center (TIC), defined as total time spent in the cancer center on first day of treatment, from first radiation department appointment to first fraction completion. Secondary endpoints included plan deliverability, adequacy of target coverage, and stakeholder acceptability | ||
| 520 | |a RESULTS: Thirty-three patients (42 treatment sites) were enrolled between June 2022 and April 2023. The median age was 72 (interquartile range [IQR]: 67-78), 73% were male, and the most common primary cancers were lung (33%), prostate (24%), and breast (12%). The most common dose and fractionations were 8 Gy in 1 and 20 Gy in 5 fractions (50% and 43% of plans, respectively). TIC was 4.7 ± 1.1 hours (mean ± SD) in the CTsim arm vs. 0.41 ± 0.14 hours in the dCT arm (P < .001). All dCT plans were deliverable. All plans in both arms were rated as "acceptable" (80% CTsim; 81% dCT) or "acceptable with minor deviation" (20% CTsim; 19% dCT). Patient perception of acceptability was similar in both arms with the exception of time burden, which was rated as "acceptable" by 50% in the CTsim arm vs. 90% in the dCT arm (P = .025) | ||
| 520 | |a CONCLUSION: dCT-based radiation planning substantially reduced TIC without detriment in plan deliverability or quality and had a tangible impact on patient experience with reduced patient-reported time burden | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Laba, Joanna M |e verfasserin |4 aut | |
| 700 | 1 | |a Nguyen, Timothy K |e verfasserin |4 aut | |
| 700 | 1 | |a Lock, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Goodman, Christopher D |e verfasserin |4 aut | |
| 700 | 1 | |a Huynh, Elizabeth |e verfasserin |4 aut | |
| 700 | 1 | |a Snir, Jonatan |e verfasserin |4 aut | |
| 700 | 1 | |a Munro, Vikki |e verfasserin |4 aut | |
| 700 | 1 | |a Alce, Jenna |e verfasserin |4 aut | |
| 700 | 1 | |a Schrijver, Lidia |e verfasserin |4 aut | |
| 700 | 1 | |a Lemay, Sylvia |e verfasserin |4 aut | |
| 700 | 1 | |a MacDonald, Tara |e verfasserin |4 aut | |
| 700 | 1 | |a Warner, Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a Palma, David A |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t International journal of radiation oncology, biology, physics |d 1976 |g (2024) vom: 12. Apr. |w (DE-627)NLM000375381 |x 1879-355X |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:12 |g month:04 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.ijrobp.2024.03.005 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 12 |c 04 | ||