We put forward the concept of the radiotherapy physics team as a community of practice (COP). Radiotherapy physicists are required to continuously develop their scientific, computational and management competencies. Much of this knowledge is gained through peer-to-peer interaction in a structured environment, enabling the individual to increase their tacit knowledge. Such interaction among peers will allow issues to be framed within their context, information to be shared, decisions to be made and protocols to be developed. The structure that allows physicists to create, share and manage knowledge conforms to the accepted definition of a COP. By implementing the methods of literature review and peer group survey, we have investigated the applicability of the concept of a radiotherapy physics COP. The results of the survey have shown a generally positive medical physicist training outlook in the UK and Germany, but highlighted certain areas where improvement is needed. Our surveys have shown that while most trainees are adequately supported, there are two areas where improvements can easily be made. Spatial factors, such as departmental geography, may not always be conducive to knowledge sharing but can readily be altered in most cases. The paucity of departmental seminars and journal club meetings has been highlighted as a problem at some training centres.

The essential need for postoperative irradiation in people with carcinoma of the upper aerodigestive tract and limited metastatic nodal spread is controversial. An experience with postoperative radiotherapy in head and neck cancer (HNC) patients with one histologically positive cervical node is presented. Between 1976 and 2000, 37 individuals with confirmed metastatic disease in a single neck node underwent postoperative radiotherapy. The median follow-up period was 24 months. Among the 35 evaluable patients, the observed failure rates at the primary site, neck and distant location were 11%, 15% and 6%, respectively. The overall 5-year relapse-free survival rate was 60%. The relapse-free survival rate at 5 years was 86% in individuals who did not have additional histopathological risk factors and 55% in those patients who did (p = 0.46). The precise role of postoperative radiotherapy in people with HNC and documented metastasis in a single cervical lymph node remains to be defined including the identification of select individuals who may truly benefit from the combined therapy program.

Purpose: To look for the therapeutic benefit of radiotherapy after surgery in patients with T1–T2 breast tumour.

Methodology: From 1990 to 2000, 915 patients with T1–T2 breast tumour who underwent mastectomy or conservative breast surgery (CBS) with or without radiotherapy were analysed retrospectively for age, disease stage, radiation therapy technique, dose, the use of chemotherapy or hormonal therapy and other clinical and/or pathologic characteristics. The Kaplan–Meier method was used to estimate locoregional recurrence-free survival (LRRFS) and overall survival (OS). The Cox proportional hazard regression model was used to determine significant prognostic factors affecting LRRFS and OS.

Results: At a median follow up of 74 months, LRR rate was 5.3% and distant metastases rate was 19%. Disease-free survival (DFS) and OS at 10 year was 72% and 76%, respectively. LRR in patients with CBS followed with radiation was 3% as compared to 33% without radiation. LRR in patients with post-mastectomy radiation was 3% as compared to 19% without radiation. In patients with N0 nodes, LRR was 4% with radiation and 20% without radiation. Worst case was in patients with CBS-N0 who were not given radiation. LRR in such patients was 32% as compared to 5% in those who were given radiation post-CBS. In patients with mastectomy with N0 status, LRR was 3% with radiation as compared to 18% with out radiation. On univariate analysis factors affecting LRRFS were type of surgery, nodal involvement, radiotherapy and hormonal therapy. Factors affecting OS were nodal involvement, grade, lymphovascular invasion (LVI), ductal carcinoma in situ (DCIS), extracapsular extension (ECE), chemotherapy and radiotherapy. On multivariate analysis factors affecting LRRFS were type of surgery, nodal involvement, radiotherapy and hormonal therapy. Factors affecting OS were nodal involvement, LVI, DCIS, ECE, chemotherapy and radiotherapy.

Conclusion: Radiation use offered a therapeutic advantage for all patients with T1–T2 breast cancer.

Purpose: Conformal radiotherapy of the prostate is an increasingly common technique in the treatment of prostate cancer. When using 3D conformal radiotherapy (CFRT) methods, it is desirable to protect the vital structures such as bladder, rectum, and femur. In this study, our aim was to compare the femur head doses resulting from co-planar beam arrangements in four-field (4F), five-field (5F), six-field (6F) and seven-field (7F) treatment plans, in a dose-escalated CFRT schedule.

Materials and Methods: From January 2005 to December 2006, at Istanbul University Medical Faculty of Radiation Oncology Clinic, a total of 22 patients with carcinoma of the prostate had been scanned using computed tomography (CT) (0.50 mm) in the supine position. During the CT scanning which used the Sim Pro (CMD–USA) programme, planned target volume (PTV), clinical target volume (CTV), and dose volumes received by the bladder, rectum and femur heads were recorded and dose–volume histogram (DVH) were created. The dose volume relating to prostate and seminal vesicles was termed CTV 1, and the dose volume relating to prostate alone was termed CTV 2. During the formation of PTV, into CTV 1, from the anterior-superior-inferior 8 mm, and from posterior 5 mm tolerance were taken into account. After volume determination is calculated using XiO (CMS-USA) 3D treatment planning computer, each patient 4F (45° – 25%, 135° – 25%, 225° – 25%, 315° – 25%), 5F (0° – 20%, 45° – 20%, 90° – 20%, 270° – 20%, 315° – 20%), 6F (45° – 20%, 90° – 10%, 135° 20%, 315° – 20%, 270° – 10%, 225° – 20%) and 7F (0° – 4%, 45° – 12.9%, 90° – 22.2%, 135° – 12.9%, 315° – 12.9%, 270° – 22.2%, 225° – 12.9%) was entered; 70 – 76 Gy was calculated to be given to prostate lodge. With the use of Siemes Oncor, 18 MV photons CFRT was applied. In DVH analysis, following were observed: V50, minimum and maximum doses for head of left femur and right femur total doses.

Results: Our statistical evaluation was made using SPSS software, and we found femur doses following; 4F V50 1030 cGy (minimum 58, maximum 1390), 5F V50 2425 cGy (minimum 540, maximum 3631), 6F V50 1769 cGy (minimum 1234, maximum 3912) and 7F V50 3230 cGy (minimum 2150, maximum 4137). In comparing different techniques, the greatest rectal sparing was achieved by the 5F plan. (Rectal: 5F V%25 = 59.90 ± 6.8 Gy, 4F V%25 = 62.30 ± 10.3 Gy, 6F V%25 = 69.36 ± 5.7 Gy, 7F V%25 = 61.32 ± 7.3 Gy). The greatest femoral head sparing was achieved by the 4F techniques. When paired samples t-test was made, we found considerable lower femur doses for 4F techniques (p = 0.05).

Conclusion: We concluded that, during radiotherapy to treat carcinoma of the prostate, the dose received by the rectum is the most important factor to consider, given the potential for late toxicity in this organ. However, while using lateral fields (90–270°) so as to protect the rectum, the doses received by the femur heads were observed to be higher. Especially in older patients, the critical doses of 52 Gy for TD5/5 and 65 Gy for TD 50/5 were observed to be not reached late toxicity for 4F, 5F, 6F and 7F.

The aims of conservative treatment in patients with ocular melanoma are globe retention, good visual acuity (VA) and local control. Two well-established radiation conservative treatment options are proton beam radiotherapy and episcleral plaque brachytherapy (EPB). Patients who receive treatment with either of these options will experience some degree of radiation-related ocular complications and poor VA. The purpose of this review of the literature is to establish whether there is a significant clinical difference in normal tissue morbidity and local tumour control between proton therapy and EPB, and whether this difference can justify the purchase and implementation of additional proton therapy facilities. Based on this review, evidence suggested that both treatment options are comparable, and that neither proton therapy nor EPB is clinically superior than the other regarding normal tissue morbidity and local tumour control. This review highlighted the need for further research on a larger scale in order to bridge the gap that is apparent within the literature.

Introduction: Health professionals have a duty of care to radiotherapy patients in providing them with adequate information before treatment. There is a lack of research that describes the roles of radiation therapists and radiation oncology nurses in providing information to patients. This study aimed to: (1) explore how radiation therapists communicate with breast cancer patients during a radiotherapy planning appointment; (2) determine what information is provided during this appointment and (3) explore radiation therapists’ perspectives on their role in providing patient information and support.

Methods: The following methodologies were used: self-report questionnaires; simulated radiotherapy planning sessions and joint interpretive forums. Statistical analysis was used to analyse the questionnaires and the simulated planning sessions and forums were analysed qualitatively.

Results: A total of 110 radiation therapists participated in the survey. We simulated two radiotherapy planning appointments and held two forums. Four themes emerged: role definitions, reducing patient anxiety and distress, barriers and strategies for effective communication and confidence in patient communication.

Conclusion: Radiation therapists play an important role in communicating with patients and providing information, particularly if patients exhibit anxiety and distress. Further research is required to determine whether patients’ information needs can be met with additional information provided by radiation therapists.