PQA 06 - Genitourinary Cancer, Gynecological Cancer, and Health Care Access and Engagement
Presenter(s)
H. Taha1, Z. Mulla1, Z. Jastaniah2,3, R. Hashem4, O. F. Iskanderani5, W. Ghandourah6, H. A. Hijazi5, A. Weber1, G. Abdulmoula1, A. AlMohamad1, H. Almerdhemah1, B. Algaedi1, M. Attar5, T. Boubakra1, and R. Ujaimi5; 1King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia, 2Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Rabigh, Rabigh, Saudi Arabia, 3Radiotherapy Unit, Department of Radiology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia, 4Department of Radiology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia, 5Department of Radiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia, 6Department of Health Care Management, Umm Al-Qura University, Makkah, Saudi Arabia
Purpose/Objective(s):
Structured bowel preparation is essential in pelvic radiotherapy (PCa and GyneCa) to reduce organ motion and improve target reproducibility. This study assessed the impact of structured education on daily online setup errors and offline organ motion, aiming to improve treatment quality and reduce repeat cone beam CT (CBCT) imaging.
Materials/Methods:
An ambispective study was conducted on 100 adult patients diagnosed with either prostate or gynecological cancer who underwent treatment using Volumetric Modulated Arc Therapy (VMAT).
Patients were assigned to a standard-care group (Jan–May 2024) and an education-intervention group (Jun–Dec 2024). The intervention group received bowel-preparation and diet counseling prior to CT simulation and treatment. All patients followed an anti-flatulence diet and received enemas or tailored laxatives as needed. Rectal distension was evaluated at CT simulation and before each treatment using CBCT; patients with persistent rectal filling underwent repeat imaging or rescheduling. A validated questionnaire (Walker et al., 2021) assessed education type, patient comprehension, and compliance. The number of repeat CBCT acquisitions per patient was recorded.
Results:
One hundred patients (50 intervention, 50 control) contributed 746 treatment fractions (376 intervention; 370 control). CBCT acceptance was significantly higher in the education group (89.2% vs 30.3%). Generalized estimating equations demonstrated that structured bowel-preparation education strongly increased CBCT acceptance (OR 18.54, 95% CI 10.14–33.91; p<0.001), remaining significant after adjustment for age and diagnosis (adjusted OR 20.02, 95% CI 10.95–36.61; p<0.001). Adjusted predicted probabilities confirmed a markedly higher likelihood of acceptable imaging in the education group (0.887 vs 0.306).
Conclusion:
Structured bowel-preparation education dramatically improved CBCT acceptance and treatment workflow in pelvic radiotherapy. These findings support routine integration of formalized education protocols to enhance treatment reproducibility, efficiency, and overall quality of care.
