Implementation of a Surface Guide Radiotherapy (SGRT) system a Spain Multicenter Experience

ABSTRACT

Purpose or Objective The surface-guided radiotherapy (SGRT) VisionRT® system uses a combination of real-time optical and laserbased imaging to accurately position patients receiving radiotherapy. The aim of this study is to analyse the implementation efficiency of SGRT in four Genesis Care radiotherapy centers in Spain and to collect the RTT impressions regarding this system. Materials and Methods The system was implemented at GenesisCare facilities in Madrid, Barcelona, Alicante, and Málaga starting on August 15, 2020. Prior to this implementation, the centers were trained in a training program consisting of A) An online course;B) A didactic weekend course;and C) Go live supervision during the first treatments for three days. The course was delivered by an expert VisionRT® trainer and a qualified radiotherapy technician. After two months of implementation, we collected the diagnostic and staging information of patients treated with the VisionRT system between the go live and October 16,2020. To evaluate the efficacy, we considered a goal of patients with SGRT in the practice > 75% High, 75%- 50% moderate, < 50% low. Tattoo base method set up was allow for head and neck immobilization, skin cancer or clinician discretion. A questionnaire was carried out to the RTT working in these centers. The questionnaire contained a 1-5 satisfaction scale asking about the SGRT system 1. very poor;2. poor;3. fair;4. good;or 5. very good regarding six points. These were safety (patient ID recognition), set up (precision increase, time reduction), management (no covid contact), confidence (technique), improvement (daily practice), and patient satisfaction (RTT point of view). Results 93.4 % of the patients in these four centers were positioned under SGRT conditions, and 6.6 % were positioned with a tattoo-based method. OF the total of 295 patients with SGRT, 212 of them were positioned without tattoos. The evaluated patients have breast cancer (43.0%), prostate cancer (18.6%), metastatic cancer (8.1 %) or lung cancer (5.4%). 21 RTT responded to the questionnaire. Results are as follows 1. Safety 61.9% very good and 38.1% good;2. Set-up 61.9% very good, 28.6% good, and 9.5% moderate;3. Accuracy increase 42.8% very good, 19% good, 28.6% fair, 4.8% poo,r and 4.8% very poor;4. Management (contactless COVID) 47.6% very good, 14.3% good, 23.8% fair, and 14.3% poor;5. Confidence (real time) 9.6% very good, 47.6% good, 33.2% fair, and 9.6% poor;5. Improvement 52.4% very good, 23.8% good, 23.8% fair;6. Patient satisfaction with tattoo less from the technician point of view 90.4% very good, 4.8% good, and 4.8% moderate. Conclusion The implementation of SGRT was carried out with high efficiency considering that 93,4% of care were delivered with this technique. RTT consider this technique very good for safety, accuracy, confidence, and improvement in the daily practice.