Time is not on your side.
Top Line: Increasing technological advancements for radiation treatment delivery are great...right?
The Study: Here is a pragmatic study that looks at the relative time expenditure of rad onc staff to create plans more complex than good ol’ 3D-conformal treatments. All times to complete radiation plans at a single Canadian institution were recorded throughout 2020. These times were then used to create “resource utilization factors,” or ratios of planning time using 3D planning time as the denominator. The computed resource allocation factors for 3D was 1.0 (clearly), IMRT 2.4, VMAT non-complex 2.9, and VMAT complex (i.e. the use of gating, MR or PET fusion, or fraction sizes ≥4 Gy) 4.3. Average time per task/discipline is broken down in table 1. Resource utilization factors were then computed in a retrospective dataset (2012-2019) to assess for any change in utilization over time. From 2012 to 2020, patient volume increased 45%, while time-based planning increased by almost 150%, clearly demonstrating the average time spent planning per treatment course is increasing dramatically. Over the same time period, staffing across dosimetry, physics and physicians increased only 29%, also suggesting time required per employee is ballooning.
TBL: “Human resource utilization is the predominant factor when considering the impact of technological changes on the radiotherapy process.” | Thind, Int J Radiat Oncol Biol Phys 2021