Research in radiation therapy is developing as radiation therapists recognise the need for improved evidence-based practice and patient care. However, many radiation therapists have a limited background in the area of research practices and the methodology that may be utilised to answer specific research questions. The purpose of this paper is to describe the development of a research question and the steps involved in determining an appropriate methodology that can be used to answer that research question. To demonstrate application of the approaches and methodologies that are described, an example research question that focuses on the experience of treatment decision-making for early stage breast cancer is considered and referred to throughout the paper. Initially, quantitative and qualitative research paradigms are considered and described to demonstrate the approaches that can be used, the type of data that can be collected and the results that can be analysed and utilised to answer the research question. As a phenomenological approach was found to be appropriate to investigate the question, this approach is explored in greater detail.

It is believed that health care workers are particularly susceptible to developing stress-related illness because of the nature of their work. The purpose of this research was to identify occupational stresses that may or may not be unique to therapy radiographers, identify the coping mechanisms that are used to combat work-related stress and gain insight into the lived experiences of this group of therapy radiographers. A phenomenological (qualitative) approach was used to identify the radiographers' perception of occupational stresses and coping mechanisms. Data collection was through in-depth interviews that were transcribed and analysed using Colaizzi methodology. The results identified stresses within the following categories: personal performance, patient contact, working environment, communication, management, professional behaviour and departmental working. These results support the stresses identified through other research studies on health care workers. Coping mechanisms identified include Social Support, Confrontive Coping, Escape-Avoidance, Self-Controlling, Distancing and Positive Reappraisal. The most frequently used coping mechanisms were social support, confrontive coping and escape-avoidance. This research has also identified a new stress; the stress associated with the ‘potential to make errors’ i.e. the acute awareness of the damaging effects of high energy X-rays if a mistake is made.

This research has attempted to provide insight into the working world of the therapy radiographer and to discover the meaning and information specific to their ‘lived experience’. It is hoped that this research provides the reader with a deeper understanding of the nature and meaning of the experience.

Hadron therapy uses sub-atomic particles to deliver radiotherapy and has the capability of delivering to an increased depth compared to photons. This offers the potential of conformal therapy without the increased integral dose associated with intensity-modulated radiotherapy (IMRT). In addition, there is the possibility of hadron therapy having increased relative biological effectiveness (RBE) when compared to photons. There is increasing interest in this topic currently with the possibility of a second UK hadron therapy facility being under discussion.

This paper introduces the concept of hadron therapy and presents an evaluation of the potential benefits associated with it. Planning studies and clinical trials are reviewed in order to assess the impact that hadron therapy would have on patient management. Costs and other factors affecting the implementation of a hadron therapy facility are presented.

The proven benefits of hadron therapy are easily demonstrated by the planning studies with increased conformity and reduced integral dose over a range of tumour sites. Simple hadron plans consistently out-perform complicated IMRT plans. The costs associated with hadron facilities are higher than for photons, but they offer simplified planning due to the inherent conformality achievable with simple hadron beams. As costs decrease and technology improves, the benefits of hadron therapy may result in the replacement of the photon for radiotherapy.

Acute skin reactions are expected in patients receiving radical radiotherapy to the breast. Side effects of other adjuvant treatments such as chemotherapy and hormonal therapy can further impact upon patients' well being. As a result these patients are routinely monitored throughout their radiotherapy treatment at a review clinic. Previously the domain of doctors, radiographers are expanding their existing role and becoming more involved in review clinics.

This paper highlights the key side effects reported by actual patients from their adjuvant treatment and strategies to alleviate these side effects. It also reflects upon the experience, both positive and negative, of undertaking clinical review and role expansion in general.

The management of intracerebral tumours has always provided us with a challenge when deciding upon the best treatment approach. However, when such tumours are benign and located in close proximity to critical structures, tumour management becomes all the more challenging.

The treatment of vestibular schwannomas has always posed such problems because of their anatomical proximity to critical structures such as the brainstem and several cranial nerves. Through a comprehensive literature appraisal, this article evaluates the problems associated with conventional treatment options and discusses how technical advances over the past decades have affected disease management and therefore impacted on the range and type of treatment modalities employed. In addition, it highlights the role of alternative contemporary approaches in the management of vestibular schwannomas.

Background: Oro-pharyngeal mucositis is a common complication of radical radiotherapy for head and neck cancer and may be the major treatment dose-limiting factor. Symptomatic treatment, however, appears variable and often ineffective.

Aim: To assess current UK practice, review published literature to assess the evidence base for current mucositis interventions and develop an evidence-based protocol for local use based on this knowledge.

Methods: An open-ended, qualitative questionnaire was sent to twenty UK Radiotherapy Departments to provide a sample of the current use of symptomatic treatments, including analgesia. A literature search was conducted using Medline and Cochrane databases to provide an evidence-based recommendation for the development of an effective local management protocol.

Results: Sixteen departments returned completed questionnaires (80% response rate). Eleven different pharmaceutical preparations were being used for symptomatic relief, with benzydamine (Difflam Oral Rinse) and Mucaine being the most commonly prescribed (in five departments each). Eleven different analgesics were being prescribed ranging from soluble aspirin to continuous infusion of diamorphine. The conclusion of a Cochrane Collaboration systematic review of the literature found weak or no evidence for the use of current interventions as effective agents for the relief or eradication of treatment-related mucositis.

Conclusions: For such a common and important treatment toxicity, there is no consistent symptomatic management and there is no good evidence-base for the use of any of the presently prescribed medications. Clinical trials have involved small samples and little replication of studies. Evidence does exist for the importance of good oral hygiene before, during and after treatment, and this has formed the basis of our new departmental protocol with discontinuation of the use of commercial mouthwashes.