Presenter(s)
K. M. Banson1, P. S. Sy2, D. Serrano3, D. M. Obciana4, M. J. Calaguas5, N. A. Cupino6, T. Yoder7, K. Nicholson8, C. Hardy Abeloos9, N. K. Gerber10, M. P. Dykstra11, B. Li12, L. C. Bett1, A. Shah8, J. Gurewitz8, J. M. O. Fernandez13, and K. S. Hu14; 1Department of Radiation Oncology, NYU Grossman School of Medicine, New York, NY, 2Division of Radiation Oncology, Philippine General Hospital, Manila, Philippines, 3Department of Radiation Oncology, St. Luke's Medical Center, Manila, Philippines, 4Jose R. Reyes Memorial Medical Center, Manila, Philippines, 5Department of Radiation Oncology, St. Luke's Medical Center, Quezon City, Philippines, 6St. Luke's Medical Center, Quezon City, Philippines, 7Department of Radiation Oncology, NYU Langone Health and Perlmutter Cancer Center, New York, NY, 8Department of Radiation Oncology, NYU Langone Health, New York, NY, 9NYU Grossman School of Medicine, New York, NY, 10New York University Grossman School of Medicine, Department of Radiation Oncology, New York, NY, 11Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, 12Department of Radiation Oncology, University of Washington/ Fred Hutch Cancer Center, Seattle, WA, 13Asian Hospital and Medical Center, Manila, Philippines, 14NYU Langone Health, New York, NY
Purpose/Objective(s): Radiotherapy treatment plan evaluation is a universal core competency. We partnered with radiation oncology residents in the Philippines to develop a structured, interactive chart rounds workshop series. We sought to evaluate a pilot training initiative on breast cancer to gain feedback and inform future planned initiatives.
Materials/Methods: To understand local practice, we conducted site visits at three radiation oncology departments in the Philippines (one private, two public) to review workflow, technology, clinical cases, and resident responsibilities. With input from US- and Philippines-based radiation oncologists, physicists, and dosimetrists, we designed a 1-hour hybrid (in-person/virtual) pilot workshop on breast plan evaluation with pre- and post-workshop surveys. Residents were guided through four anonymized breast plans using the acronym FCB-CHOPS framework (fusion, contours, beam, coverage, heterogeneity, organs at risk, prescription and dose summation): (1) whole breast 3D-CRT with inadequate inferior flash; (2) whole breast 3D-CRT with inadequate medial coverage; (3) whole breast 3D-CRT with sequential boost, emphasizing hotspot evaluation on primary, boost, and composite plans; and (4) VMAT versus 4-field 3D-CRT for postmastectomy radiation. Attending physicians and physicists were invited to participate, with emphasis on resident participation.
Results: Twenty-seven residents, five attendings, and two physicists participated in the pilot workshop; 20 residents completed the pre-workshop survey and 19 completed the post-workshop survey. Residents reported learning treatment planning through informal instruction from peer residents (95%), independent learning (80%), and attendings (65%), with fewer reporting learning from structured didactics (25%). All trainees reported using a systematic mnemonic (CB-CHOP or FCB-CHOPS). Self-reported comfort in plan evaluation was highest for 3D-CRT, followed by IMRT, brachytherapy, and lowest for SRS/SBRT. For breast plans, most (80%) correctly identified the rationale for including flash, but only 20% knew how physicists technically implement flash. All respondents used at least axial CT slices when evaluating breast plans; fewer used beams-eye-view (45%) or skin/surface rendering (14%). Mean comfort in evaluating breast plans was 3.50/5 beforehand vs. 3.32/5 afterwards (p = 0.51). After the workshop, 95% reported having a defined strategy for breast plan evaluation, 95% found the workshop very helpful, and 100% expressed wanting to participate in future sessions.
Conclusion: A pilot workshop identified and helped address gaps in plan evaluation skills. Although not statistically significant, shifts in comfort level could reflect increased awareness of the complexity and rigor required for high-quality breast plan assessment. Given high interest in future workshops, this model supports collaborative global radiation oncology education and demonstrates space for growth.