Abstract
Introduction: With recent clinical adoption of online adaptive radiotherapy and the increased workload associated with adaptive radiotherapy, proper staffing for medical physicists is paramount to safe clinical operation. However, there is currently no consensus on the full-time equivalent (FTE) requirements for safe administration of CBCT-guided online adaptive radiotherapy. This study aims to quantitatively assess medical physics workload and staffing needs of a CBCT-guided online adaptive radiotherapy program. Methods: We conducted a detailed analysis of the CBCT-guided adaptive planning and treatment workflows, encompassing tasks such as patient consultation, treatment planning, plan review, training, quality assurance, and treatment delivery. Utilizing data from machine logs, clinical database queries, and staff surveys, we present a framework for estimating FTE values for different staffing scenarios, considering medical physicists’ roles as planners, adaptors, or both. Results: FTE calculations, based on an example workload of 100 adaptive and 200 nonadaptive patients per year, for three staffing scenarios were provided: medical physicists as planners and adaptors (2.9 FTE), medical physicists as planners but not adaptors (2.6 FTE), and medical physicists as adaptors but not planners (1.4 FTE). These findings offer calculation guidance and benchmarks for staffing requirements in CBCT-guided online adaptive radiotherapy programs, emphasizing the need for specific staffing models to accommodate the complexities of adaptive radiotherapy. Conclusion: This study outlines a framework for calculating FTE requirements for medical physicists in a CBCT-guided online adaptive radiotherapy program. By analyzing the processes for three common adaptive radiotherapy workflows, this work can provide effective workforce planning and resource allocation estimates. This analysis can be used either prior to the implementation of an online adaptive radiotherapy program, for program development, or as a review of current practices to ensure operational efficiency and proper staffing levels are maintained.
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