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The Special Medical Physics Consult Process for Reirradiation Patients.


ABSTRACT: Purpose:To present a systematic approach to the reirradiation special medical physics consult (ReRT-SMPC) process. Materials and Methods:An in-house reirradiation committee of physicians and physicists was formed to develop a streamlined and well-documented approach to ReRT-SMPCs. Dosimetric goals and considerations for tissue repair were generated by the committee with input from the literature, clinical trial guidelines, and physician experience. Procedural workflow was also defined. Results:The total number of ReRT-SMPCs performed in our department in 2018 was 401, corresponding to 369 unique patients and 16% of the total number of patients receiving external beam radiation in our department that year. This constituted a large increase over the 183 ReRT-SMPCs performed in 2017. We have found that a standardized ReRT-SMPC workflow helps to safeguard patients, documents the clinical decision-making process for medical and legal purposes, and facilitates the peer-review process. The data being collected from each consult along with toxicity and outcomes data can be used to help inform future re-treatment guidelines. Conclusions:As the number of patients returning for additional courses of radiation continues to increase, a uniform method for the ReRT-SMPC workflow and analysis is a powerful tool for ensuring patient safety, understanding and predicting treatment toxicity, and refining reirradiation dosimetric limits.

SUBMITTER: Paradis KC 

PROVIDER: S-EPMC6817723 | biostudies-literature | 2019 Oct-Dec

REPOSITORIES: biostudies-literature

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<h4>Purpose</h4>To present a systematic approach to the reirradiation special medical physics consult (ReRT-SMPC) process.<h4>Materials and methods</h4>An in-house reirradiation committee of physicians and physicists was formed to develop a streamlined and well-documented approach to ReRT-SMPCs. Dosimetric goals and considerations for tissue repair were generated by the committee with input from the literature, clinical trial guidelines, and physician experience. Procedural workflow was also def  ...[more]

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