Brachytherapy Training Survey of Radiation Oncology Residents

Marcrom, S.; Kahn, Jenna; Colbert, Lauren E.; Freese, C.; Doke, Kaleigh; Yang, Joanna C.; Yashar, Catheryn M.; Luu, Michael; Kamrava, Mitchell

doi:10.1016/j.ijrobp.2018.10.023

Cited by 78 publications

(70 citation statements)

References 11 publications

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“…While these requirements may ensure that residents have broader exposure to brachytherapy during training, some may argue that 22 procedures over a four-year program remains low for a physician expected to perform independently upon graduation, when compared to the minimum caseloads mandated for most interventional and surgical training programs. Data from recent residents indicate an association between number of brachytherapy cases performed and confidence in starting a brachytherapy practice [ 12 ]. Externships during residency and fellowships after residency can provide further hands-on opportunities to gain expertise, but may be impeded by time constraints, lack of standardization, or financial disincentives.…”

Section: Discussionmentioning

confidence: 99%

“…Despite this evidence, the use of brachytherapy has declined in the United States, with concurrent increases in use of EBRT or SAbR boost [6,10]. There are many potential causes for underutilization of brachytherapy, including unfavorable reimbursement policies, use of EBRT boost, patients' access issues, insufficient resident training, and intensive workflow [6,[11][12][13][14][15].…”

Section: Purposementioning

confidence: 99%

See 1 more Smart Citation

Brachytherapy utilization for cervical cancer in Western United States border counties: seeking to understand referral patterns for outcome improvement

Feng¹,

McDaniels-Davidson²,

Martı́nez³

et al. 2021

jcb

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Purpose: Standard of care for definitive treatment of locally advanced cervical cancer (LACC) is concurrent chemoradiation followed by a brachytherapy boost. Only 55.8% of women in the United States receive brachytherapy, with even lower proportions in San Diego and Imperial Counties. The purpose of this study was to investigate brachytherapy practice and referral patterns in Western United States border region.Material and methods: A short survey was sent to 28 radiation oncologists in San Diego and Imperial Counties, who treat patients with gynecologic malignancies. Descriptive statistics were used for analysis.Results: Seventeen (61%) physicians responded to the survey. All physicians reported some training in cervical cancer brachytherapy during residency, with median 6 months. Only two physicians reported personally treating all cervical cancer patients with brachytherapy; however, 92% of remaining physicians would recommend brachytherapy for patients if given time and access. The most common reason for referral (78%) was patients deemed to require hybrid or interstitial brachytherapy implants. Barriers to referral included patients' preference, insurance status, their resources, or logistics. No changes were reported for brachytherapy practices during the COVID-19 pandemic, except the addition of pre-procedural testing for SARS-CoV-2. Ninety-two percent of physicians identified inadequate maintenance of skills as a barrier to performing brachytherapy, but 77% were not interested in additional training. External beam radiation therapy boosts were rarely recommended in case scenarios describing potentially curable patients.Conclusions: The importance of brachytherapy is widely recognized for conferring a survival benefit, but barriers to implementation include inadequate training or maintenance of skills, and larger systematic issues related to reimbursement policy, social support, and financial hardship. As most established providers were uninterested in additional brachytherapy training, future approaches to improve patients' access should be multidimensional and reflect the value of brachytherapy in definitive treatment of patients with LACC.

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Section: Discussionmentioning

confidence: 99%

Section: Purposementioning

confidence: 99%

Brachytherapy utilization for cervical cancer in Western United States border counties: seeking to understand referral patterns for outcome improvement

Feng¹,

McDaniels-Davidson²,

Martı́nez³

et al. 2021

jcb

View full text Add to dashboard Cite

show abstract

“…This may reflect a lack of pediatric cases for training radiation oncology residents as well as the technical expertise that is not readily available in many centers. A recent survey of radiation oncology residents reported that the increased number of brachytherapy cases performed during residency was associated with increased confidence in starting a brachytherapy practice 9 …”

Section: Discussionmentioning

confidence: 99%

Training and education of pediatric radiation oncologists: A survey from the 2019 Pediatric Radiation Oncology Society meeting

Paulino

Dieckmann

Esiashvili

et al. 2020

Pediatric Blood & Cancer

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To examine the educational background, clinical practice, and preferences regarding continuing medical education (CME) among radiation oncologists who attended the 2019 meeting of the Pediatric Radiation Oncology Society (PROS), a survey consisting of 20 questions was distributed asking for demographic and educational background, clinical practice, and preferences regarding pediatric radiation oncology CME. Of 188 participants, 130 (69.2%) returned the questionnaire. More than 80% reported access to CT simulation, three‐dimensional radiotherapy, and general anesthesia while <30% had access to intraoperative radiotherapy, proton, and heavy particle therapy. After residency, 12.1% did further training in pediatric radiation oncology. When asked about further training in pediatrics after residency, 88.8% answered that there should be a formal training program beyond residency in order to treat children. More than 75% acquired knowledge in pediatric radiation oncology through journals, books, live meetings, and tumor boards. The results of this survey may help Pediatric Radiation Oncology Society (PROS) in creating guidelines and recommendations for improvement in pediatric radiation oncology training and practice support as well as the development of CME activities most likely to benefit practitioners.

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“…A 2019 questionnaire sent to US radiation oncology residents in the Association of Residents in Radiation Oncology showed that confidence in brachytherapy practice had a rate of 54%, low compared to a staggering rate of 97% in SBRT/SRS procedures. The survey also presented a significant relationship between increased number of brachytherapy cases performed and increased confidence rate for starting brachytherapy practice 4 .…”

Section: Introductionmentioning

confidence: 93%

Multimaterial three-dimensional printing in brachytherapy: Prototyping teaching tools for interstitial and intracavitary procedures in cervical cancers

et al. 2020

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Purpose: As the utilization of brachytherapy procedures continues to decline in clinics, a need for accessible training tools is required to help bridge the gap between resident comfort in brachytherapy training and clinical practice. To improve the quality of intracavitary and interstitial HDR brachytherapy education, a multi-material modular 3D printed pelvic phantom prototype simulating normal and cervix pathological conditions has been developed. Methods and Materials: Patient anatomy was derived from pelvic CT and MRI scans from 50 representative patients diagnosed with localized cervical cancer. Dimensions measured from patients’ uterine body and uterine canal sizes were used to construct a variety of uteri based off of the averages and standard deviations of the subjects in our study. Soft-tissue anatomy was 3D printed using Agilus blends (shore 30 and 70), and modular components in Vero (shore 85). Results: The kit consists of four uteri, a standard bladder, standard rectum, two embedded GTVs and four clip-on GTV attachments. The three anteverted uteri in the kit are based on the smallest, the average, and the largest dimensions from our patient set while the retroverted uterus assumes average dimensions. Conclusions: This educational HDR gynecological pelvic phantom is an accessible and cost-effective way to improve radiation oncology resident training in intracavitary/interstitial brachytherapy cases. Implementation of this phantom in resident education will allow for more thorough and comprehensive physician training through its ability to transform the patient scenario. It is expected that this tool will help improve confidence and efficiency when performing brachytherapy procedures in patients.

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Brachytherapy Training Survey of Radiation Oncology Residents

Cited by 78 publications

References 11 publications

Brachytherapy utilization for cervical cancer in Western United States border counties: seeking to understand referral patterns for outcome improvement

Brachytherapy utilization for cervical cancer in Western United States border counties: seeking to understand referral patterns for outcome improvement

Training and education of pediatric radiation oncologists: A survey from the 2019 Pediatric Radiation Oncology Society meeting

Multimaterial three-dimensional printing in brachytherapy: Prototyping teaching tools for interstitial and intracavitary procedures in cervical cancers

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