Radiotherapy Planning

Treatment Planning is one of the essential components of the radiotherapy treatment process. The whole Oncology team has a part in it, including Therapeutic Radiographers, Clinical Oncologists, Clinical Scientists and Clinical Technologists. The aim is to create a clinically acceptable plan, targeting the radiation dose to a specific – desirable area, with as much healthy organ sparing as possible. Highly complex planning software is used to create a treatment plan according to the requirements from the Clinical Oncologist, adhering to national legislation (IRMER) and our local quality system protocols. Once the plan is ready, numbers of checks are performed, by other Technologists, Oncologists and an independent treatment planning software, to ensure the plan is optimal and safe to be delivered.

The pathway and requirements for treatment planning:

• Radiographers perform a CT scan that is used by the Oncologist to define a treatment volume
• Oncologist outlines on the CT image, defining target volume and organs at risk according to IRMER guidelines and department protocols
• Clinical Technologists, Clinical Scientists or Radiographers create a high quality treatment plan that can involve ongoing discussions and reviews to ensure plan is optimal
• The final plan is checked by another qualified member of the team and is reviewed and accepted by the Oncologist

The accepted plan is ready to be treated and is sent to the Therapeutic Radiographers for further checks and treatment delivery.

The following categories of External Beam Radiotherapy are currently delivered by the Department:

• 3D simple calculations (VSim)
• 3D conformal radiotherapy
• Intensity-modulated radiation therapy (IMRT)
• Volumetric modulated arc therapy (VMAT)
• Respiratory phase monitored and gated radiotherapy
• Stereotactic radiotherapy treatments (SRT)
• Stereotactic ablative body radiosurgery (SABR)

In Radiotherapy, we are constantly looking for ways to improve and develop the service. We are often involved in implementing new techniques to make sure our patients have access to the most up to date and safest high quality radiotherapy treatment.

For example, in 2023 our department is going to develop a paper light workflow which will make the treatment planning process more efficient and will be developing our oligometastatic SABR service to include a wider range of anatomical sites.

The ECC is heavily involved in participation in clinical trials for a number of treatment sites and have developed our own in-house clinical trial for prostate SABR. The treatment planning team is a key component for implementing and maintaining participation in clinical trials.