Reirradiation practices of Radiation Therapists (RePoRT) study

Reirradiation for patients with new, recurrent or metastatic tumors is complex and requires intensive collaboration between Radiation Oncologists, Medical Physicists, and Radiation Therapists (RTT). Aside from dosimetry, little has been reported on the role of the RTT in reirradiation. The study characterized the reirradiation patterns-of-practice of RTTs to understand the knowledge and skills being applied in this increasingly important area of cancer care. A cross-sectional, survey was conducted of all RTTs practicing in Canada over a 3-month period. The 48-item questionnaire asked RTTs the frequency of performing a range of reirradiation activities, to self-rate their competency levels, and to identify enablers and barriers to reirradiation practice. The survey was distributed by email and data were analyzed with descriptive statistics or thematic analysis for free-text responses. Responses from 214 RTTs revealed frequent and significant involvement in all steps of reirradiation pathway, ranging from pre-treatment imaging and positioning to patient supportive care. There was lower involvement in advanced reirradiation dosimetry techniques, which coincided lower competency self-ratings and knowledge gaps in this area. Access to prior patient records, standardized reirradiation workflows and multi-disciplinary communication were the most common elements reported as important for reirradiation practice. RTT reported frequent and significant involvement in all steps of the reirradiation care pathway. Providing focused education and training for RTTs on reirradiation, coupled with team workflow optimization may enable more effective, safe and streamlined reirradiation care for patients.