Main Session
Sep 28
PQA 03 - Digital Health Innovation and Informatics, Patient Safety & Quality, and Radiation and Cancer Biology

2454 - Multidisciplinary Rapid Access Bone Metastasis Clinic: Expeditious Workflow from Referral to Palliative Radiotherapy

10:45am - 12:00pm ET
Poster Hall - Exhibit Hall A
Screen: 28
POSTER

Presenter(s)

Ahmed Fetooh, MD, MPH Headshot
Ahmed Fetooh, MD, MPH - MD Anderson Cancer Center, Houston, TX

A. Fetooh1,2, P. Pandey2, Z. El Kouzi2, M. A. Sanchez2, L. Colbert2, M. P. Mitchell2, D. R. Grosshans2, N. Heredia1, and C. J. Hassanzadeh2; 1UTHealth Houston School of Public Health, Houston, TX, 2Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX

Purpose/Objective(s):

Rapid-access clinic models aim to expedite palliative radiation therapy (RT) assessment and treatment for bone metastases. We performed a workflow-based quality improvement analysis to identify current trends in reducing time from referral to start of palliative radiotherapy for patients with painful polymetastatic bone metastases.

Materials/Methods:

A retrospective operational analysis, spanning all clinic visits from 1/2025 to 9/2025 in the multidisciplinary MD Anderson Rapid Access Bone Metastasis Clinic (BMC) was conducted. Median referral to consult, consult to simulation, and simulation to RT start intervals were calculated by electronic referral and scheduling times. Median and IQR were computed for continuous variables. Treatment modality was defined as 3D conformal (3DRT) vs stereotactic body RT (SBRT) for biologically effective dose (BED) = 48Gy.

Results:

83 patients completed BMC consultation and proceeded to RT and were included in the analysis. Median referral-to-consult interval was 4.6 days (IQR 1.8–7.7 days). Median consult-to-simulation interval was 0 days (IQR 0-1.6 days). Median simulation-to-RT start interval was 5 days (IQR 3-10 days). Total referral-to-RT start interval was 10 days (IQR 5-21 days). 3DRT was used in 75% of patients, while 25% of patients received SBRT. The most common dose and fractionation was 20Gy in 5 fractions (40%) followed by 30Gy in 10 fractions (25%). Median simulation to RT time was 3.8 days for 3DRT compared to 11 days for SBRT.

Conclusion:

Majority of patients treated in the BMC achieved same day simulation and the time from referral to RT initiation was less than 2 weeks sustaining the BMC mission of rapid palliation. Longer planning times were required for SBRT patients compared to 3DRT highlighting a need for improved RT planning workflows for rapid palliation.