Underpinning the safety and standards of advanced radiotherapy techniques
Currently more than 50% of cancer patients would benefit from radiotherapy (external and brachytherapy) being included in their treatment. The portfolio of radiotherapy research in England is expected to continue to grow over the next decade, leading the world in the development of the evidence base for new innovations. The Cancer Strategy for England highlights the need for further investment from research funders, with associated support from the NHS. It is part of Cancer Research UK’s strategy to increase research into radiotherapy recognising that recent advances have opened up exciting new avenues.
The UK has a deserved reputation for creativity and excellence in the design and development of radiotherapy, in particular in clinical trials which have the potential to deliver significant improvements in outcomes. Radiotherapy is a highly technical therapeutic approach and developments are constantly being made. This means that clinics are under pressure to update, commission and implement the techniques whilst still maintaining a safe and effective routine service.
NPL has supported the safe provision of radiotherapy for several decades through the provision of primary standards and the dissemination of traceable dosimetry through collaboration with IPEM to providing codes of practice. New modalities are being installed, such as protons, and in future other ion beams, as well as modalities such as electronic brachytherapy. These have differences in their dosimetry as well as how they need to be planned and expertise is needed to train the centres in how best to assess their capabilities and set up these new services.
The accuracy with which radiotherapy can be delivered is ever-increasing and this means that the treatment can be given to smaller and more mobile targets. New systems are needed to identify and track the target using multi-modality imaging as well as using smaller beams to pinpoint the treatment to the target only. External verification is needed to ensure that the techniques have been set up in the optimal way and the most has been achieved with the system. End-to-end verification looks at every aspect of the patient pathway and ensures that all the steps from imaging, through planning to treatment delivery, are assessed and link to the best outcomes for patients.
Training medical physicists to use the codes of practice, as well as being able to accurately measure the dose, is crucial in maintaining standards which are both high and uniform across the country.