Time-action and patient experience analyses of locally advanced cervical cancer brachytherapy

Time-action and patient experience analyses of locally advanced cervical cancer brachytherapy

Perez, S.M. (TU Delft Medical Instruments & Bio-Inspired Technology; Erasmus MC)
van Paassen, Rosemarijn (Erasmus MC)
Wauben, L.S.G.L. (TU Delft Medical Instruments & Bio-Inspired Technology)
Straathof, R. (TU Delft Medical Instruments & Bio-Inspired Technology; Erasmus MC)
van de Berg, N.J. (TU Delft Medical Instruments & Bio-Inspired Technology; Erasmus MC)
Dankelman, J. (TU Delft Medical Instruments & Bio-Inspired Technology)
Heijmen, Ben J.M. (Erasmus MC)
Kolkman–Deurloo, Inger–Karine K. (Erasmus MC)
Nout, Remi A. (Erasmus MC)

2024

BACKGROUND AND PURPOSE: Although MRI-based image guided adaptive brachytherapy (IGABT) for locally advanced cervical cancer (LACC) has resulted in favorable outcomes, it can be logistically complex and time consuming compared to 2D image-based brachytherapy, and both physically and emotionally intensive for patients. This prospective study aims to perform time-action and patient experience analyses during IGABT to guide further improvements. MATERIALS AND METHODS: LACC patients treated with IGABT were included for the time-action (56 patients) and patient experience (29 patients) analyses. Times per treatment step were reported on a standardized form. For the patient experience analysis, a baseline health status was established with the EQ-5D-5L questionnaire and the perceived pain, anxiety and duration for each treatment step were assessed with the NRS-11. RESULTS: The median total procedure time from arrival until discharge was 530 (IQR: 480–565) minutes. Treatment planning (delineation, reconstruction, optimization) required the most time and took 175 (IQR: 145–195) minutes. Highest perceived pain was reported during applicator removal and treatment planning, anxiety during applicator removal, and duration during image acquisition and treatment planning. Perceived pain, anxiety and duration were correlated. Higher pre-treatment pain and anxiety scores were associated with higher perceived pain, anxiety and duration. CONCLUSION: This study highlights the complexity, duration and impact on patient experience of the current IGABT workflow. Patient reported pre-treatment pain and anxiety can help identify patients that may benefit from additional support. Research and implementation of measures aiming at shortening the overall procedure duration, which may include logistical, staffing and technological aspects, should be prioritized.

Anxiety
Brachytherapy
Duration of therapy
Pain
Uterine cervical neoplasms
Workflow

http://resolver.tudelft.nl/uuid:37eb9fdf-a31c-4d1e-9ad0-c23a3e3d4e02

https://doi.org/10.1016/j.brachy.2024.01.007

1538-4721

Brachytherapy, 23 (3), 274-281

Institutional Repository

journal article

© 2024 S.M. Perez, Rosemarijn van Paassen, L.S.G.L. Wauben, R. Straathof, N.J. van de Berg, J. Dankelman, Ben J.M. Heijmen, Inger–Karine K. Kolkman–Deurloo, Remi A. Nout