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. 2019 Jun 8;4(4):559-565.
doi: 10.1016/j.adro.2019.05.007. eCollection 2019 Oct-Dec.

The Special Medical Physics Consult Process for Reirradiation Patients

Kelly C Paradis  1 , Charles Mayo  1 , Dawn Owen  1 , Daniel E Spratt  1 , Jason Hearn  1 , Benjamin Rosen  1 , Rojano Kashani  1 , Jean Moran  1 , Daniel S Tatro  1 , Whitney Beeler  1 , Karen Vineberg  1 , Dylan C Smith  1 , Martha M Matuszak  1
Affiliations

The Special Medical Physics Consult Process for Reirradiation Patients

Kelly C Paradis et al. Adv Radiat Oncol. .

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.

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Figures

Figure 1
Figure 1
Stacked line graph of the number of reirradiation special medical physics consults performed monthly over a 2-year period from 2017 to 2018. Results broken out by body region.
See this image and copyright information in PMC

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