RADIOTHERAPY

’Radiotherapy is estimated to contribute to 40% of cases where a cancer is cured’

(Prof Mike Richards, UK National Cancer Director, 2007)


Radiation Physics supports radiotherapy provided by Hull & East Yorkshire Hospitals to a population of around 1.2 million living in East Yorkshire, northern Lincolnshire and parts of North Yorkshire.

For patient information please refer to the Hull and East Yorkshire NHS Trust Website.

WHO ARE WE?

The Radiotherapy Physics group within Radiation Physics are scientific and technical staff who apply the principles of physics to optimise and develop radiotherapy treatments, usually to treat cancer.

We are a team of Physicists (registered with the Health and Care Professions Council (HCPC)), Dosimetrists and Technicians; all of whom undergo extensive training. Dosimetrists are primarily involved in generating bespoke and optimal patient treatment plans and immobilisation devices. Technicians ensure our highly sophisticated equipment is functional and operating safely. Physicists are involved in routine checks as well as service development. We also have a group of Oncology Information System specialists who write software and look after our extensive databases.

With this team of scientific and dedicated support staff we are able to ensure that radiotherapy is one of the safest and most tightly controlled areas of medicine.

More information on the Roles of the Scientist and Technologist in Radiotherapy Physics is available from the Institure of Physics & Engineering in Medicine (IPEM).

RADIOTHERAPY EQUIPMENT

STATE-OF-THE-ART TREATMENTS

  • First interstitial brachytherapy patient treated, improving target coverage whilst reducing toxicity in difficult gynaecological cancers (November 2017)
  • Introduced Flattening Filter Free treatments for lung SABR patients to reduce treatment times (June 2017)
  • Deep Inspiration Breath Hold for breast patients to reduce heart irradiation (March 2016)
  • Stereotactic ablative radiotherapy (SABR) for lung tumours (July 2014)
  • Implementation of an EPID based In vivo and pre-treatment dosimetry system (2014)
  • On-site PET/CT - Siemens Biograph mCT Flow (April 2014)
  • 4DCT treatment planning (February 2014)
  • Inverse planned IMRT Breast treatments
  • RapidArc volumetric modulated arc therapy (VMAT) prostate treatments (February 2013)
  • RapidArc VMAT Head and Neck treatments (August 2013)
  • Contact radiotherapy treatments (we were one of only five centres in the world who could offer this treatment) (August 2011)
  • On-site wider-bore GE Optima MR450W MRI scanner (April 2011)
  • 3D Image Guided Brachytherapy (IGBT) using MRI & CT (June 2009)
  • Intensity modulated radiotherapy treatment (IMRT) treatments (January 2002)

WHAT WE DO

Radiotherapy is a fast moving, technologically advanced area. Our job is to ensure that all radiation exposures are optimal, safe and legal, and that we use the most up to date techniques. With our help radiotherapy is delivered with complete confidence so that the dose intended is the dose delivered to the patient. Healthcare Professionals provide a range of services from checking equipment, preparing radiotherapy plans and treatments to high level research and development.

TREATMENT PLANNING

The Eclipse™ Treatment Planning System is used by dosimetrists and physicists to create individualised radiotherapy treatments. Patients are CT scanned in the position they will be in for daily treatment and we use the scan to create an optimal plan specifically for them. This involves ensuring that the Planning Target Volume (the area that needs treating which is drawn by the Clinician) receives the required prescription radiation dose without overdosing surrounding organs at risk, aiming to reduce short and long term side effects.

We plan using different treatment techniques including 3D Conformal, VMAT, Sliding Window IMRT and SABR.

QUALITY CONTROL

It is essential that all equipment used in radiotherapy is functioning at the highest level of accuracy and safety. Physicists ensure that our equipment is compared regularly with National Physics Laboratory reference doses. We frequently test our systems and even design new methods to detect potential problems long before they have any clinical impact.

RESEARCH AND CLINICAL IMPLEMENTATION

As a team of scientists, we frequently engage in research and implement technologies and techniques from the literature into our own practice.

Flattening Filter Free (FFF) beam

We are in the process of implementing FFF beam for treating stereotactic ablative radiotherapy (SABR) lung cancer patients. This will allow to deliver treatments at a faster rate (approximately 2.5 to 4 times faster) compared to the current flattened beam treatments, reducing the time patients are required to stay in the treatment position making the treatments more tolerable.

4DCT and VMAT for Oesophagus Cancer Patients

Thoracic tumours move with breathing leading to a number of issues. 4D CT scanning plays an important role to generate personalised target volumes. The VMAT technique provides highly conformal plans helping to minimise organs at risk doses (OAR) and hence reduce side effects and toxicities. This was implemented for lower third and gastro-oesophageal junction (GOJ) patients recently in 2016.

Deep Inspiration Breath-Hold Technique for Left Breast Patients

Deep inspiration breath-hold (DIBH) is an effective method of limiting radiation exposure to the heart and lungs. In addition, it eliminates movement caused by breathing. It was implemented locally for treating patients with left-sided breast cancer in 2016.

Clinical Trials

Radiotherapy Clinical Trials are complex because data is recorded from multiple centres and has to be correctly interpreted to give high quality results. As a team we adopt new planning methods and provide large portfolios of evidence and audits in order for our patients to be allowed to participate in radiotherapy clinical trials. This also includes performing test plans and measuring radiation doses on our equipment.

Other current projects include;

  • Increasing the use of the Eclipse Scripting Application Program Interface within the department, adding additional functionality and data mining utilities to aid clinical decision making and improve efficiency:
    • CBCT moves data mining
    • Knowledge Based Planning tools for common sites such as prostate.
    • SABR plan objectives plugin to easily compare to the SABR consortium clinical objectives.
    • Plan complexity data mining tool for Rapidarc delivery.
  • Work to improve treatment verification by implementing Varian’s advanced imaging features, allowing greater imaging of moving targets and improved confidence on treatment.
  • Implementation of an advanced high accuracy treatment planning algorithm (Acuros XB)
  • Further integration/implementation of 4DCT and 4D planning into clinical treatment
  • Expansion of the use of RapidArc to additional anatomical sites
  • Monitoring response to radiation using early markers of apoptosis and proliferation in head and neck squamous cell carcinoma biopsies, utilising a microfluidic approach (Collaboration with HYMS)
  • Investigating the potential uses of deformable registration in treatment planning and adaptive radiotherapy
  • Investigation of PET/CT imaging into clinical pathways
  • Implementation of Flattening Filter Free (FFF) linac beams for routine clinical treatment

MEDICAL PHYSICS EXPERTS

The MPE’s under regulation 14 of the Ionising Radiation (Medical Exposure) Regulations 2017 for radiotherapeutic practices other than standardised therapeutic nuclear medicine practices for Hull & East Yorkshire Hospitals are:

  • Professor Andy Beavis (Head of Department)
  • Mr Peter Colley (Consultant Physicist)
  • Mr Nick Harding (Principal Physicist)
  • Ms Jenny Marsden (Principal Physicist)
  • Mr John Saunderson (Consultant Physicist)
  • Mr Mark Wilson (Principal Physicist)


VISIT THE HULL & EAST YORKSHIRE HOSPITALS NHS TRUST WEBSITE

For patient information please refer to the Hull and East Yorkshire NHS Trust Website.

ADDRESS
Radiation Physics Department
Queen's Centre for Oncology & Haematology
Castle Hill Hospital
Cottingham
East Yorkshire
HU16 5JQ
U.K.

CONTACTS

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