ESTRO 2025 - Abstract Book

S4296

RTT - Service evaluation, quality assurance and risk management

ESTRO 2025

saw lessons in patient prioritisation, capacity balancing between photons and proton services and the recovery of normal workflows.

Material/Methods: The backup planning pathway for 36 patients was analysed. Patients were categorised into several groups: resting, substituted with photon therapy, referred onto another PBT centre, and returned to their referring centres. Time spent on each task throughout the planning process was documented, with a focus on Adult and Paediatric H&N, Adult and Paediatric neurology and CSI cases. Key variables included patient prioritisation, photon machine capacity constraints—especially concerning general anaesthetic patients—and the availability of dosimetrists and physics for planning tasks. Techniques employed in planning primarily included VMAT plans but also a 3D conformal PH1 CSI.

Results: 36 patients were affected by this breakdown incident. Refer to Table 1 for breakdown of outcomes. Table 1- Breakdown of patient outcomes during PBT downtime

The planning order was H&N Adults, Ph2 cranial boosts, paediatric H&N, paediatric neurology, pelvis plans, adult neurology, adult pelvis and adult thorax. The treatment order was paediatric neuro, Ph2 cranial boost, paediatric H&N, paediatric pelvis, adult H&N, adult neurology. The disparity between planning and treatment order came from, incorrect prioritisation of cases, extra planning time required for complex cases and peer reviews. One case required a rescan to switch to the photon service, one CSI case required a technique change to a 3D conformal pathway which required extra time. Conclusion: The reactive approach to backup planning in PBT requires adaptation to ensure continuity of patient care during machine downtimes. This evaluation provides the groundwork for implementing these changes to improve overall operational efficiency. Proactive planning should be considered for a smaller cohort of patients to facilitate shorter turnaround times. Extra resources must be factored in for complex cases, ensuring these are actioned safely. It is also crucial to identify and coordinate with key stakeholders to maintain service during breakdowns. This evaluation hopes to provide guidance to emerging PBT centres, on navigating workflows and maintaining patient care during extended machine downtimes.

Keywords: Proton, Breakdown, Replan

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Digital Poster Enhancing patient safety through MARRTA risk management and SAFRON incident analysis Ana M Vilchez Simo 1 , Maria L Vazquez de la Torre 1 , Benito Andrarde 2 , Jaime Reverter Perez 2 , Saul Lopez Soliño 2 , Patricia Willisch Santamaría 1 , Maria Luisa Lopez Louzara 1 , Montserrat Santos 3 , Paula Costas 3 , victor Muñoz Garzon 1