ESTRO 2024 - Abstract Book

S5767

RTT - Education, training, advanced practice and role developments

ESTRO 2024

oncologists was that the guide structures were very helpful and that there would be support for an expedited “CT to Treat” pathway for palliative VMAT.

Conclusion:

With time savings for the clinical oncologist, there is a greater saving for the planning department due to no requirement to wait for the clinical oncologist’s availability. In practice, this would often add a working day to pathways.

This pathway is viable for the safe delivery of expedited VMAT for palliative radiotherapy for bone metastases, however a number of pre-requisites are recommended:

• Consideration of further trial cases before moving to a fully radiographer-led planning pathway. • The radiographer should have diagnostic imaging available prior to planning CT to review the disease burden and determine whether it falls within their scope of practice. • The radiographer should correlate the diagnostic information with patient-reported symptoms to ensure accurate localisation to symptomatic areas. • Final plan sign off should remain with the clinical oncologist in the event that any changes are required prior to safe delivery of palliative treatments. This could be reviewed if more work is completed to audit the incidence of adjustments being required.

Although presently the fastest VMAT treatment may not be prepared in the same time as the fastest single field or MPD treatment due to additional plan checking requirements, it is viable to deliver a next-day CT to treatment service.

Further work could look at the role of radiographer-led contouring in the treatment of oligometastic bone disease with stereotactic ablative radiotherapy (SABR).

Keywords: Palliative VMAT, Rapid Access

References:

Fog L S, Schut D, Sjogren P, Aznar M C (2015). The potential role of modern radiotherapy techniques in the treatment of malignant spinal cord compression: a dose planning study. Cambridge University Press.

Job M, Holt T, Bernanrd A (2019). An evaluation of an advanced practice role in palliative radiation therapy. J Med Radiat Sci 66(2): 96-102

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