Authors (including presenting author) :
Hung HM(1), Wu PY(1), Chan K(1)
Affiliation :
(1)Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital
Introduction :
Prostate cancer ranks third in cancer incidence among men in Hong Kong. Radiotherapy (RT) is a standard of care in the definitive treatment. Evolution in RT techniques including image guidance, hypofractionation, stereotactic ablative radiotherapy and perirectal spacers have led to improvement in clinical outcomes and reduction in toxicity, but also increased treatment complexity. There is high demand for a coordinated multidisciplinary team (MDT) effort to deliver quality patient-centered care. While radiation therapists usually contribute in various steps in RT planning and delivery, the process remains fragmented. To address these challenges, the first-ever advanced practitioner pilot program in Hong Kong was developed in December 2023. A radiation therapist specialist in urological cancer was established to enhance patient-centered care and service efficiency in RT.
Objectives :
The program aims to streamline the patient care pathway by coordinating multidisciplinary services, provide comprehensive counseling and support, deliver expertise in RT planning and treatment, and monitor for treatment-related toxicity. The specialist serves as a central point of contact through the patient’s RT journey, and facilitates interdisciplinary communication.
Methodology :
The specialist role involved coordination of regular Uro-Oncology MDT meetings, provision of pre-RT patient education, baseline and post-RT quality-of-life assessments, overseeing image verification in precision RT, and running therapist-led treatment review clinics, under the supervision of the Uro-Oncology team. The pilot program service throughput and efficiency were evaluated. In addition, satisfaction survey was randomly administered to 50 patients to evaluate patient experience.
Result & Outcome :
In the period of Jan-Dec 2024, the specialist managed total of 119 patients. This included 119 pre-treatment education sessions, 341 treat review clinics, 276 quality-of-life assessments, and 2899 sets of cone beam CT verification sessions. The radiation therapist-led service translated to approximately 406 hours of professional time otherwise required for doctors, resulting in substantial improvement in operational efficiency.
Patient satisfaction survey yielded overall very positive responses, with 27 out of 29 questions receiving either "Agree" or "Strongly Agree" ratings.
Pilot advanced-practice radiation therapist role in urological cancer demonstrated enhancement in operational efficiency, promoted patient-centered care and maintained service quality in the era of precision RT. Additionally, it provides new opportunities for the professional development of radiation therapists, allowing their expertise exercised in the patient care pathway in a structured manner.
