Results of a National Survey of Radiotherapy Planning and Delivery in the UK in 2007

Aims: Technical developments in radiotherapy have increased very rapidly over recent years, resulting in the processes of radiotherapy planning and delivery changing significantly. It is essential that alongside these developments, optimal methods for accurate target volume definition become a priority. The Radiotherapy Imaging for Delivery of Radiotherapy Working Party was formed to create a framework for imaging for radiotherapy planning and delivery: the areas of interest were interpretation of imaging for planning, optimum acquisition of imaging for radiotherapy planning and training and assessment across all staff groups involved with radiotherapy planning. A detailed assessment of the current situation in the UK was needed to prepare for this document. A national survey was undertaken and the results are reported in this paper. Materials and methods: A questionnaire was sent to all NHS radiotherapy departments in the UK on 3 occasions in 2007. A total of 48 replies were received from 58 centres giving a response rate of 83%. Results: Approximately half of centres (46%) in the UK use IMRT. Thirteen centres are using IMRT in the routine management of patients. Nine centres indicated that they use IMRT routinely within the research setting. Twenty-six centres are not using IMRT but 10 centres are planning to implement the technology within 12 months. Only 4 centres in the UK routinely use IGRT and 6 centres report use of image guidance in the research setting. Twelve centres are planning to implement this over 12 months. Few oncologists have dedicated radiology input for planning. Twenty-seven centres had help from radiologists on an ad hoc basis only and 10 centres had no input at all. Only 2 centres have formal radiology training for trainees and 9 centres report ad hoc time with diagnostic radiologists or cite the FRCR course as the main sources of training. Twelve centres have structured training for radiographers and 4 centres for medical physicists. Conclusions: This survey assessed radiotherapy planning and delivery within the UK in 2007. The most significant findings were the lack of implementation of IMRT and IGRT which appeared to mainly to be due to lack of available staff, such as medical physicists, insufficient access to existing equipment, lack of time for more complex radiotherapy planning and insufficient funding. A further concern is the lack of formal training in tumour and normal tissue outlining across several staff groups. Jefferies, S. et al. (2009). Clinical Oncology 21, 204-217 (C) 2008 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.