ESTRO 2025 - Abstract Book

S4264

RTT - Education, training, advanced practice and role developments

ESTRO 2025

the oART workflow, with clinicians present for the first fraction 1,2 . Three years on, we have evaluated the program of introducing these “Advanced Adaptors” to identify how much input was required from clinicians.

Material/Methods: Records of patients treated with Advanced Adaptor-led oART were reviewed to identify how many fractions at which a clinician was present, how many documented offline dose monitoring reviews had been performed by a clinician, and whether these reviews generated any actions. We also assessed problems detected by Advanced Adaptors and whether these concerns required escalation to a clinician or were successfully resolved without further escalation. Results: 42 patients were identified: 17 were treated for bladder cancer and 25 for prostate cancer. All patients were prescribed 20 fractions over four weeks. In total 655 Advanced Adaptor-led fractions were noted. Five patients had clinicians present for the first week of treatment but in four cases this was for ongoing Advanced Adaptor training. Five patients had clinicians present on the first three fractions. For the remaining patients clinicians were routinely present only on fraction one unless concerns were raised. The median number of documented routine clinician offline reviews was one per patient course (range 0-3). Of these, four patients required a clinician to attend an additional fraction to address concerns. However, no corrective action was required for any of these patients. Additionally, 26 patients had issues identified and appropriately managed or escalated by Advanced Adaptors. These included clinical issues around bowel preparation and bladder filling, lack of achievement of plan clinical goals, and QA issues. No concerns were raised about plan selection. Conclusion: Advanced Adaptor-led, clinician-lite oART using CBCT guidance is feasible with clinician present for the initial fraction and without regular ‘routine’ dose monitoring review. In our experience most escalations were raised by the advanced adaptor team as they arose. As such, oART does require remote resource available for advice and support from a multidisciplinary team of physics staff and clinicians rather than presence at the console.

Keywords: Adaptive Radiotherapy, oART

References: 1 PD-0735 Developing training for RTT-led CBCT guided daily online adaptive radiotherapy for urological cancer. Graham S et.al: Radiotherapy and Oncology, Volume 182, S601-S602 2 Pathway for radiation therapists online advanced adapter training and credentialing. Shepherd, Meegan et al: Technical Innovations and Patient Support in Radiation Oncology, Volume 20, 54-60

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Proffered Paper Identifying best practices for RTTs and dosimetrists: A Delphi consensus study on standardizing workflow steps Jenneke Jacobs 1 , Eva van Weerd 1 , Astrid Moerman 1 , Catarina Henriques Xavier 1 , Yvonne L.B. Klaver 1,2 , Morten Høyer 3 , Esther G.C. Troost 4,5 , Vossco Nguyen 6 , Lene Jørgensen 3 , Michael Zorneth 7 , Stacey Kelly 8 , Julia Thiele 4 , Nicola Bizzocchi 7 , Harmen Bijwaard 9,10 , Mischa S. Hoogeman 1,11 1 Radiotherapy, HollandPTC, Delft, Netherlands. 2 Radiation Oncology, Leiden University Medical Centre, Leiden, Netherlands. 3 Radiotherapy, Danish Centre for Particle Therapy, Aarhus, Denmark. 4 Radiotherapy and Radiation Oncology, Faculaty of Medicine and University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany. 5 Helmholtz-Zentrum Dresden-Rossendorf, Institut für Radioonkologie – OncoRay, Dresden, Germany. 6 Radiotherapy, University College London Hospitals NHS Foundation Trust, London, United Kingdom. 7 Radiotherapy, PSI, Villigen, Switzerland. 8 Radiotherapy, The christie NHS Foundation Trust, Manchester, United Kingdom.