Hostname: page-component-848d4c4894-2xdlg Total loading time: 0 Render date: 2024-06-23T06:29:23.107Z Has data issue: false hasContentIssue false
  • English
  • Français

Training needs of radiographers for implementing Tomotherapy in NHS practice

Published online by Cambridge University Press:  15 September 2010

June C. Dean  and
Donna S. Routsis
June C. Dean*
Affiliation:
Addenbrooke’s Hospital, Hills Road, Cambridge, UK
Donna S. Routsis
Affiliation:
Addenbrooke’s Hospital, Hills Road, Cambridge, UK
*
Correspondence to: June C. Dean, Addenbrooke’s Hospital, Hills Road, Cambridge, UK. Email: june.dean@addenbrookes.nhs.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Addenbrooke’s was awarded Department of Health funding for Tomotherapy in 2006, to evaluate the functionality and application of the image guidance element of Tomotherapy. No Tomotherapy unit had been implemented into a National Health Service (NHS) working environment before, so there was no model to follow. An education and training program needed to be created to ensure accurate and efficient delivery of radiotherapy using Tomotherapy.

Method: The educational needs of radiographers had to be derived from first principles. An assessment of Tomotherapy treatment delivery process was made, identifying the tasks within the process and then the skills and knowledge required to achieve each task. The process was derived from site visits to non-NHS centres using Tomotherapy, nationally and internationally. This was supplemented by educational courses for specific aspects of Tomotherapy Intensity Modulated Radiotherapy (IMRT) and Image Guided Radiotherapy (IGRT).

Results: The core skills and knowledge required were identified and an in-house educational programme created. Competencies for Tomotherapy delivery were assessed against image matching accuracy and speed. All radiographers were able to meet these standards so that Tomotherapy IGRT on the treatment unit required no input from clinical oncologists, making effective and efficient use of staff resources.

Conclusion: The educational and training needs of radiographer staff were identified and a Tomotherapy training program was devised to enable image registration to be radiographer driven.

Keywords

EducationIGRTradiographer ledTomotherapytraining
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 9 , Issue 3 , September 2010 , pp. 175 - 183
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Department of Health. The NHS Cancer plan: a plan for investment, a plan for reform. Department of Health, 27 September 2000. Report No. 22293.Google Scholar
2.NRAG. Report to Ministers from National Radiotherapy Advisory Group; 2007.Google Scholar
3.Veldeman, L, Madani, I, Hulstaert, F, De Meerleer, G, Mareel, M, De Neve, W. Evidence behind use of intensity-modulated radiotherapy: a systematic review of comparative clinical studies. Lancet Oncol 2008; 9(4): 367–375.CrossRefGoogle ScholarPubMed
4.Chen, G, Riboldi, M, Gierga, D et al. Clinical implementation of IGRT techniques. Radiother Oncol 2005; 76(S2): S10.CrossRefGoogle Scholar
5.NRAG. National Radiotherapy Advisory Group: Radiotherapy Technical Development Sub-group Report. 2006.Google Scholar
6.Mackie, TR. History of tomotherapy. Phys Med Biol 2006; 51(13):R427–R453.CrossRefGoogle ScholarPubMed
7.BIR. Geometric Uncertainties in Radiotherapy, 2003.Google Scholar
8.Staffurth, J. Clinical evidence for IMRT (a report on behalf of the Radiotherapy Development Board). Clinical Oncol 2010, in press.Google Scholar
9.Forrest, LJ, Mackie, TR, Ruchala, K et al. The utility of megavoltage computed tomography images from a helical Tomotherapy system for setup verification purposes. Int J Radiat Oncol Biol Phys 2004; 60(5): 1639–1644.CrossRefGoogle ScholarPubMed
10.Kupelian, PA, Langen, KM, Willoughby, TR, Zeidan, OA, Meeks, SL. Image-guided radiotherapy for localized prostate cancer: treating a moving target. Semin Radiat Oncol 2008; 18(1): 58–66.CrossRefGoogle ScholarPubMed
11.SCoR, IPEM, RCR. On-Target: Implementing Geometric Verification in Radiotherapy. London, UK, 2008.Google Scholar
12.Suter, B, Shoulders, B, MacClean, M, Balyckyi, J. Machine verification radiographs: an opportunity for role extension? Radiography 2000; 6: 245–251.CrossRefGoogle Scholar
13.McNair, HA, Francis, G, Balyckyi, J. Clinical implementation of dynamic intensity-modulated radiotherapy: radiographers’ perspectives. Br J Radiol 2004; 77(918): 493–498.CrossRefGoogle ScholarPubMed
14.Williams, MV, Summer, ET, Drinkwater, KJ, Barrett, A. Radiotherapy dose fractionation, access and waiting times in the countries of the UK in 2005. Clin Oncol (R Coll) 2007; 19: 273–286.CrossRefGoogle ScholarPubMed
15.Williams, MV, Drinkwater, KJ. Geographical variation in radiotherapy services across the UK in 2007 and the effect of deprivation. Clin Oncol (R Coll) 2009; 21: 431–440.CrossRefGoogle ScholarPubMed
16.Head, J. Redefining roles and responsibilities in a new department. In: ESTRO 25 (European Society for Therapeutic Radiology and Oncology); 8–12 October 2006, Leipzig, Germany. Radiother Oncol 2006.Google Scholar
17.Department of Health. The Ionising Radiation (Medical Exposure) Regulations. In: No. 1059, 2000.Google Scholar
18.Dische, S. Clinical radiobiology. In: Price, Sikora (ed). Treatment of Cancer. 3rd edition. London: Chapman & Hall Medical, 1995.Google Scholar
19.Barker, JL Jr., Ang KK, GA et al. Quantification of volumetric and geometric changes occurring during fractionated radiotherapy for head-and-neck cancer using an integrated CT/linear accelerator system. Int J Radiat Oncol Biol Phys 2004; 59: 960–970.CrossRefGoogle ScholarPubMed
20.Royal College of Radiologists, University of Cambridge, Trust AsN. Fundamentals of Radiotherapy Planning. 2009.Google Scholar
21.The Society and College of Radiographers. Radiographer Staffing in Radiotherapy Departments. London, 1979.Google Scholar
22.Routsis, D, Thomas, S, Head, J. Are extended working days sustainable in radiotherapy? J Radiother Practice 2006; 5: 77–85.CrossRefGoogle Scholar
23.Li, XA, Qi, XS, Pitterle, M et al. Interfractional variations in patient setup and anatomic change assessed by daily computed tomography. Int J Radiat Oncol Biol Phys 2007; 68(2): 581–591.CrossRefGoogle ScholarPubMed
24.Kitamura, K, Shirato, H, Seppenwoolde, Y, Onimaru, R, Oda, M, Fujita, K et al. Three-dimensional intrafractional movement of prostate measured during real-time tumor-tracking radiotherapy in supine and prone treatment positions. Int J Radiat Oncol Biol Phys 2002; 53(5): 1117–1123.CrossRefGoogle ScholarPubMed
25.Bortfeld, T, van Herk, M, Jiang, SB. When should systematic patient positioning errors in radiotherapy be corrected? Phys Med Biol 2002; 47(23):N297–N302.CrossRefGoogle ScholarPubMed
26.Engels, B, Soete, G, Verellen, D, Storme, G. Conformal arc radiotherapy for prostate cancer: increased biochemical failure in patients with distended rectum on the planning computed tomogram despite image guidance by implanted markers. Int J Radiat Oncol Biol Phys 2009; 74(2): 388–391.CrossRefGoogle ScholarPubMed
27.ICRU. Prescribing, Recording, and Reporting Photon Beam Therapy. International Commission on Radiation Units and Measurements, 1993.Google Scholar
28.ICRU. Prescribing, Recording and Reporting Photon Beam Therapy (Supplement to ICRU Report 50). International Commission on Radiation Units and Measurements, 1999. Report No. 62.Google Scholar