Abstract
<h3>Purpose/Objective(s)</h3> Simulation free RT (SF-RT) is an emerging technique in which a patient's (pts) diagnostic imaging is used for simulation (sim) and treatment planning. SF-RT may increase the speed of treatment planning while reducing pt visits. In palliative care, minimizing time in the radiation oncology (RO) department and expediting treatment is critical. We evaluated clinical data for pts treated with palliative SF-RT compared to pts treated with palliative CT sim RT (CT-RT) in a retrospective matched cohort analysis. <h3>Materials/Methods</h3> From 1/2020 to 11/2020, 30 sessions of palliative SF-RT were performed at a single institution. A session was defined as a single course of palliative RT. Pts received both single and multi-fraction regimens. Time points collected included time of order approval, plan approval, and first treatment. A matched cohort of pts treated with palliative CT-RT was acquired via Reweight Mahalanobis Distance Matching matched on age, total dose, and treatment site. Descriptive statistics were calculated on all variables and statistical significance was evaluated using the Chi-square method for categorical variables and the t-test method for continuous variables. <h3>Results</h3> 30 sessions of palliative SF-RT were matched with 30 sessions of palliative CT-RT, with the median distance matching being 0.073 (0.018-0.147). Median age of pts treated with SF-RT was 61 (56-73) and median age of pts treated with CT-RT was 62 (55-72). The majority of pts in both groups were treated on an outpatient basis. The most common site treated in both groups was spine. 70% of SF-RT sessions were single fraction, and 57% of CT-RT sessions were single fraction. Mean time from order approved to plan approved was 1.8 days (d) (+/- 1.8 d) for SF-RT sessions and 3.0 d (+/- 3.4 d) for CT-RT sessions. Mean time from plan approved to first treatment was 2.3 d (+/- 2.8 d) for SF-RT sessions and 2.0 d (+/- 2 d) for CT-RT sessions. Mean time from order approved to first treatment was 4.1 d (+/- 3.3 d) for SF-RT and 5.0 d (+/- 3.8 d) for CT-RT. There were no statistically significant differences between variables. <h3>Conclusion</h3> SF-RT led to an average of .9 d faster time from order approval to first treatment while requiring one less patient visit to the RO department when compared to CT-RT. These data demonstrate the potential for SF-RT to increase the efficiency of palliative RT while reducing pt visits to the RO department.
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