Purpose: To identify the challenges and opportunities that prevent Radiation Therapist (RT) led research at our clinic. Insight gained from this process may lead to strategies which can encourage and support RT research. In this way we can ensure evidence-based practises are promoted by RTs as well as enhancing the professional profile of RTs in the research domain.

Methods: A qualitative approach was chosen for this study. Five focus group sessions were conducted to discuss issues related to research participation within our department. Sessions were audio-recorded and transcribed. Thematic analysis occurred whereby overarching themes were identified, content categories were developed, and summaries were written from these categories. Pre-dominant themes were later presented to the entire radiation therapy department for member checking. Answers to a series of questions were obtained anonymously through the use of iClickersTM (MacMillan MPS, Gordonsville, VA). Further, an open group discussion followed focusing on three key areas (departmental, personal and professional). Initiatives or opportunities that could be implemented to increase research activities were discussed and recorded by a designated note-taker.

Results: Nineteen RTs participated in five focus group sessions. The over-arching themes identified were definition of research, involvement in research and the barriers to conducting research. Member checking confirmed these major themes.

Conclusion: We identified the challenges faced by RTs in the areas of research and development at our centre. This information has given us a greater understanding of the culture of our department and the attitudes to research activities from all groups within it. We aim to use these insights to set-up a framework of support to facilitate increased initiatives. Alongside this support RTs will have a clear understanding of their responsibilities to the organisation that facilitates their research. We anticipate these developments will lead to greater job satisfaction for RTs, increased staff morale and most importantly, the improvement of the overall quality of services we deliver to our patients.

Purpose: Several isotopes are available for low dose-rate prostate brachytherapy. Currently most implants use a single isotope. However, the use of dual-isotope implants may yield an advantageous combination of characteristics such as half-life and relative biological effectiveness. However, the use of dual-isotope implants complicates treatment planning and quality assurance. Do the benefits of dual-isotope implants outweigh the added difficulty? The goal of this work was to use a linear-quadratic model to compare single and dual-isotope implants.

Materials & Methods: Ten patients were evaluated. For each patient, six treatment plans were created with single or dual-isotope combinations of 125I, 103Pd and 131Cs. For each plan the prostate, urethra, rectum and bladder were contoured by a physician. The biologically effective dose was used to determine the tumor control probability and normal tissue complication probabilities for each plan. Each plan was evaluated using favorable, intermediate and unfavorable radiobiological parameters. The results of the radiobiological analysis were used to compare the single and dual-isotope treatment plans.

Results: Iodine-125 only implants were seen to be most affected by changes in tumor parameters. Significant differences in organ response probabilities were seen at common dose levels. However, after adjusting the initial seed strength the differences between isotope combinations were minimal.

Conclusions: The objective of this work was to perform a radiobiologically based comparison of single and dual-isotope prostate seed implant plans. For all isotope combinations, the plans were improved by varying the initial seed strength. For the optimized treatment plans, no substantial differences in predicted treatment outcomes were seen among the different isotope combinations.

A research study was conducted at the radiation oncology department of a large teaching hospital in Ghana, to determine whether the use of a pain questionnaire would facilitate a contribution by the radiation therapists (RTs) to the management of pain in the patients undergoing external beam radiotherapy. The rationale for the study was to test the pain questionnaire as a tool for routine use by RTs and to increase the knowledge and skill of the RTs with regard to pain assessment in order that they could have an effective role in the multidisciplinary approach to pain management.

The pain questionnaire for administration by RTs was adapted as a tool for assessing pain. The tool and the process were tested in a prospective study of 90 participants who willingly consented to participate. The data was analysed as a means of evaluating the questionnaire and learning about pain in this group of cancer patients. The results of this analysis were integrated with the findings from textual data published in a previous paper.

Findings revealed that RTs could administer a limited pain questionnaire and use this for clinical assessment of patients with pain, refer patients who need urgent medical attention to the doctors, monitor the patients receiving radiotherapy and adjuvant chemotherapy as well as provide meaningful suggestions to the multidisciplinary team on the management of pain.

Through this reflective process it is recommended that because RTs have daily contact with patients during external beam radiotherapy treatment and because the majority of cancer patients in the study population experience pain, the RTs should enhance their knowledge of pain and participate in routine pain assessment. Through engagement in this role development the quality of care to the patient population in Ghana will be improved.