S2937
RTT- RTT operational practice and workflow innovations
ESTRO 2026
structured interviews with a radiation oncologist, a medical physicist, and radiation therapists were conducted and analysed using thematic analysis [2] to identify further opportunities for workflow optimisation. Results:
institution to a range of non-gynaecological pelvic treatment sites and is generalisable to other radiotherapy centres seeking to apply a framework for justification of unscheduled radiotherapy imaging. References: Gemma Eminowicz, VR et al (2017). Understanding the impact of pelvic organ motion on dose delivered to target volumes during IMRT for cervical cancer. Radiotherapy and Oncology, 122(1), 116-121I Gazsi, LM et al (2024). The Impact of Pre-treatment Image Guidance on Tumour and Normal Tissue Dosimetry during VMAT for Cervical Cancer. doi:https://doi.org/10.59277/RomJPhys.2025.70.701S.E . Alexander SE et al (2019). RTT-led IGRT for cervix cancer; training, implementation and validation. Technical Innovations & Patient Support in Radiation Oncology. doi:https://doi.org/10.1016/j.tipsro.2019.10.007Royal College of Radiologists. (2021). On Target 2: Updated Guidance for Image-Guided Radiotherapy. Royal College of Radiologists Keywords: IGRT, Gynaecological, OAR Proffered Paper 3265 Improving efficiency and maximizing patient capacity: optimizing workflows in a proton therapy center Eva van Weerd 1 , Petra C.H. Dirkx 1 , Emma C.M. Buijsman 1,2 1 Radiotherapy, Holland Proton Therapy Centre, Delft, Netherlands. 2 Radiology, Leiden University Medical Center, Leiden, Netherlands Purpose/Objective: Proton therapy capacity is limited worldwide due to the small number of centres and high operational costs. Optimizing fraction times and workflow efficiency is essential to increase patient access. This study systematically evaluated clinical workflows at Holland Proton Therapy Center (HollandPTC), quantified the impact of implemented measures on fraction times, and identified additional opportunities for workflow optimization. Material/Methods: The workflow was analysed for all indications by performing a structured waste analysis using Lean methodology [1] to identify non-value-adding steps. Improvement measures were categorized into (1) interventions aimed at reducing fraction times and (2) measures optimising treatment planning and gantry capacity. Mean actual treatment times before and after implementation were compared using routinely collected clinical data, and treatment time slots were reassessed accordingly. Additionally, four semi-
Waste analysis highlighted several inefficiencies in the imaging workflow, treatment planning and gantry occupancy. Post-fraction imaging was reduced or
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