43 need to also address human resources. Focusing on human resources and essentially developing people can be the key to establishing accurate, safe and effective Radiation Treatments. Methods: New radiotherapy simulation procedures were implemented at HCMC Oncology Hospital following a comprehensive review of current practices. Template documents were produced and new clinical patient positioning principles were adopted. Results: New implemented procedures are now standard practice. Treatment is now more accurate and consistent which means more consistent and predicable outcomes. Due to many challenges, successful implementation was not easy, requiring emphasis on concepts of multidisciplinary teamwork, effective communication and leadership. By setting patient outcomes as the ultimate focus, & through careful planning, we have shown that development can be possible even with limited resources and huge patient loads. 15.6. Stories at Work: Writing to Learn, Care, and Collaborate in Radiation Therapy Presenter: Gail Williams, Odette Cancer Centre, Sunnybrook Health Science Centre, Canada Authors: Kari Osmar, Sarah Whyte, Ariella Damelin and Marnie Peacock Introduction: Learning in the radiation therapy workplace tends to focus on hard clinical skills such as the use and mastery of electronic applications, image matching and treatment delivery. At the undergraduate level, training programs have begun to teach health professionals how to write and read stories. Narrative training has been advocated for practicing health professionals. Education in narrative writing has been shown to increase empathy, communication and wellbeing. Experiential narrative writing workshops in a large urban cancer centre were offered in two phases. First phase, a 90-minute introductory workshop was offered to four separate groups: practicing radiation therapists (2 groups), radiation therapists and oncology nurses together, and radiation therapy students. Second phase, participants were invited to continue with a narrative writing course consisting of four 60-minute sessions. Workshops were led by an experienced narrative facilitator and researcher. A second experienced researcher observed the sessions and conducted follow-up interviews to document the process and effects of the workshops on learning and practice. Methods: This qualitative research study was completed using descriptive and exploratory methods. The facilitator and observer wrote field notes for Phase 1 and Phase 2. Research observer completed, transcribed and coded interviews for Phase 1 and Phase 2. Results: Thematic analysis revealed both elements and effects. Elements included that these are stories at work not stories about work, the challenge, the quality and the continuity. Effects included pleasure, presence, community and craft. These effects do not come through imparting information or close analysis of professional experience, but rather through the opportunity to engage with oneself, colleagues and patients in meaningful and challenging ways outside of professional identities. 15.7. The quality of student tutoring in radiation therapy unit Presenter: Aino-Liisa Jussila, Oulu University of Applied Sciences, Oulu, Finland Authors: Aino-Liisa Jussila, Anna-Tuulia Tero, Katariina Kamsula and Annukka Tuomikoski Introduction: The supervised tutorial periods are essential parts in the development of professional skills of radiographer students. Students` feedback about their learning environment and supervision gives the base for developing their studying circumstances further and enabling their professional growth. To describe how radiographer students experienced their clinical learning environment and supervision given by supervising radiographers in radiation therapy unit through four aspects which are department atmosphere, premises of the art of radiation therapy on the department, premises of learning on the department, and supervisory relationship. Methods: Data was collected among radiographer students (n=82) by the validated CLES © evaluation scale of Clinical Learning Environment and Supervision (Saarikoski 2002) in 2011, 2012 and 2013. The electric CLES © questionnaire consists of 27 items Results: The students evaluated the clinical learning environment and radiographers` clinical supervision as very good. “Atmosphere in the department” was supporting their learning positively. "The premises of the art of radiation therapy on the department” and “the premises of learning on the department” indicated that students were relating the learning environment with the quality on the art of radiation therapy and patient relationships. “Supervisory relationship” between tutoring radiographers and students 15.8. Potential workflow improvement in radiotherapy by means of patient positioning and transfer system Presenter: George Chiu, Department of Radiotherapy, Hong Kong Sanatorium and Hospital Authors: George Chiu1. Ka Fai Cheng1, Wing Lun Mui1 And Ben Yu2, 1Department of Radiotherapy, Hong Kong Sanatorium and Hospital, 2Medical Physics and Research Department, Hong Kong Sanatorium and Hospital Introduction: This study investigated the potential workflow improvement of patient logistics in radiotherapy by means of a patient positioning and transfer system (PPTS). Feasibility studies of PPTS were carried out in three major categories including dosimetric compatibility, positioning reproducibility and workflow improvement. In dosimetric compatibility, studies were conducted to investigate the physical properties in beam attenuation, induced skin dose and plan dosimetry in various treatment plans of 6MV photons. In positioning reproducibility, geometric accuracy was tested by means of repeated transfer and repositioning of the transfer sled by the provided docking system without and with 10 subjects to simulate patients receiving thoracic treatments. Relative displacements of isocentre were recorded and random errors were calculated. In workflow improvement, studies were conducted to compare the machine occupancy in 10 patients without and with the implementation of the PPTS. Methods: Transmission factors at different locations and skin doses at 20x20cm2 and 4x4cm2 were measured. Dosimetric differences in 8 different treatment plans were studied. Geometric accuracy, relative displacements of isocentre and random errors were recorded. Results: Transmission factors ranged 0.91-1.00. Skin doses increased 8.6%- 24.9%. Dosimetric difference was < 2%. Random error was <1.1mm in all directions. Average machine occupancies in current and new PPTS were found 17.4 min and 12.5 min respectively. Conclusion: The dosimetric difference induced by the PPTS is clinically insignificant. The positioning reproducibility governed by the fixation system of the PPTS is highly reliable. Implementation of PPTS with laser guided setup rooms nearby the treatment machine can significantly reduce the machine occupancy of patients in radiotherapy procedures. It is a feasible solution for busy radiotherapy departments which requiring high patient throughputs without scarifying setup accuracy for patients. 15.9. A Comparison of Two Systems of Patient Immobilization for Prostate Radiotherapy Presenter: Peter White, The Hong Kong Polytechnic University Authors: White P, Chui KY, Lee CS, Lee WC, Ng HM & Yik SC Introduction: Background Reproducibility of different immobilization systems, which may affect set-up errors, remains uncertain. Immobilization systems and their corresponding set-up errors influence the clinical target volume to planning target volume (CTV-PTV) margins and thus may result in undesirable treatment outcomes. This study compared the reproducibility of patient positioning with Hipfix system and whole body alpha cradle with respect to localized prostate cancer and investigated the existing CTV-PTV margins in the clinical oncology departments of two hospitals in Hong Kong. Aims and objectives The aims of this study were to improve the potency of VMAT by achieving more precise patient positioning and to study the corresponding CTV-PTV margins. The ultimate goal was to benefit both staff and patients directly through easier reproducibility of the treatment position as well as reducing treatment times, improving local control and reducing radiation side-effects respectively. With reference to RapidArc treatment for prostate cancer, the objectives of this project were to: 1. Compare the setup reproducibility of patient positioning with Hipfix and alpha cradle for T1-T3 prostate cancer patients. 2. Investigate the existing CTV-PTV margins in the clinical oncology departments of two regional hospitals. Methods: 7 sets of AP, cranial-caudal and medial-lateral deviations were collected from each patient. Reproducibility of positioning in hospitals was compared using a total vector error (TVE) parameter. CTV-PTV margins were computed using van Herk’s formula.
ISRRT | Book Of Abstracts
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