TOPLINE:

Only 31% of patients with prostate cancer receiving radiation therapy had a successful CT simulation on the first attempt, while more than half required multiple scans on the same day and nearly 17% had to be rescheduled for another day. Receiving both written and verbal instructions and written instructions only was associated with a higher first-attempt CT simulation success rate than verbal instructions alone.

METHODOLOGY:

• Patients with prostate cancer receiving CT planning before pelvic radiation need to undergo careful bowel and bladder preparation to ensure the accuracy of a CT simulation scan. Without adequate prep, patients may require repeat scans or need to be rescheduled, which can delay the start of treatment.
• To better understand the success rate of a first-attempt CT simulation, researchers conducted a prospective cohort study of 247 patients with prostate cancer (mean age, 69.5 years) who underwent CT simulation for pelvic radiation at a tertiary cancer center.
• Patients received education about bladder and bowel preparation at an initial consultation as well as during the CT simulation appointment. Instructions were provided verbally only (15.4%), in writing only (31.6%), or both (39.7%); 13.4% received no instruction.
• The primary outcome was a successful CT scan on the first table attempt; if the first attempt was unsuccessful, researchers tracked the number of rescans as well as how often patients were rescheduled for another day.
• Researchers assessed a range of factors associated with the success of first-attempt CT simulation. Participants also completed surveys on preparation experiences, demographics, and patient-reported outcomes.

TAKEAWAY:

• Overall, 31.2% of patients had a successful CT simulation on the first attempt, 52.2% required multiple attempts on the same day, and 16.6% needed rescheduling.
• Bladder issues contributed to 30.8% of failed first attempts while bowel issues contributed to 22.7% of failed first attempts.
• Compared with having only verbal instructions, receiving written instructions only (odds ratio [OR], 1.78) or both verbal and written instructions (OR, 1.82) was associated with significantly higher likelihood of first-attempt CT simulation success.
• A qualitative analysis of nearly 120 comments from patients revealed that unclear preparation instructions (23.7%), uncertainty about following the instructions correctly (14.4%), and difficulty timing bowel movements (10.2%) were common issues highlighted in the bowel and bladder preparation process.

IN PRACTICE:

“This study underscores the critical role of effective patient education and preparation in achieving successful prostate cancer CT simulations,” the authors wrote emphasizing that “addressing gaps in communication, improving clarity and consistency in instructions, and exploring innovative educational approaches” can enhance the success rate of simulations.

SOURCE:

This study, led by Karishma George, Tom Baker Cancer Centre in Calgary, Alberta, Canada, was published online in Advances in Radiation Oncology.

LIMITATIONS:

Limitations included the modest sample size and single-center design, which limited generalizability of the findings, a poor capture rate of the bladder fullness score and lower than planned statistical power.

DISCLOSURES:

This study received funding support from the PROSE program. Two authors reported receiving financial support from the PROSE program. Full disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.