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Probst H.,Sheffield Hallam University | McNair H.A.,Institute of Cancer Research | Baker A.,The Clatterbridge Cancer Center Foundation Trust | Miles E.A.,Mount Vernon Cancer Center
Radiography | Year: 2015

Research from Allied Health Professionals (AHPs) is anecdotally known to lag behind that of other professions. The developing research landscape within other therapies and internationally led us to question how UK practice in therapeutic radiography was developing. The aim of the survey was to audit research capacity across therapy radiography in the UK. Method: An electronic survey was sent to Radiotherapy Service Managers (RSM) and research leads in each of the radiotherapy centres in the UK. An adapted version of the 'Auditing Research Capacity' tool (ARC© tool) was used as the basis of the questionnaire. Results: A total of 45 RSM responded to the survey (67% response rate) and 30 Research radiographers (RR) (45% response rate). A total of 51 RR were in post equating to 40.3 whole time equivalents and averaging 1 RR per centre. Variation was evident in the commitment to the development of a research culture identified by practices such as linking research to the business planning cycle, inclusion of research in recruitment and advertising materials, or having a nominated therapeutic radiographer lead on research for the department. Over a third of responding centres did not have a research strategy and training for RRs was limited; specifically in areas such as writing funding bids, writing for publication and the research and governance process. Conclusion: A number of short and long-term strategies are proposed that should enhance a positive research culture and improve research capacity for therapeutic radiography led research. These include utilisation of the existing infrastructure provided by the National Institute for Health Research, a lead or co-ordinator for research activity with a remit to motivate others. Development of links and networks, and the development of a research strategy linked to wider Trust research priorities. The research strategy should include mentoring or developing appropriate research skills for those engaged in research (including higher degree qualifications). RSMs should also encourage peer-reviewed publications, and conference presentations from all staff to ensure research results are disseminated to the wider profession. © 2014 The College of Radiographers.

Schmidt-Hansen M.,National Collaborating Center for Cancer | Hoskin P.,Mount Vernon Cancer Center | Kirkbride P.,The Clatterbridge Cancer Center Foundation Trust | Hasler E.,National Collaborating Center for Cancer | Bromham N.,National Collaborating Center for Cancer
Clinical Oncology | Year: 2014

Aims: Radiotherapy is standard treatment for localised prostate cancer and is often combined with hormone treatment to prevent androgen stimulation of prostate cancer. Hormone therapy carries significant morbidity and can only be justified in the radical treatment of localised disease if it can be balanced against a significant gain in disease control and survival. Materials and methods: We searched Medline, Premedline, Embase, Cochrane Library, Web of Science (SCI & SSCI) and Biomed Central for randomised controlled trials published in English comparing radiotherapy or hormone therapy alone with radiotherapy and hormone therapy in combination as first-line treatment in patients with non-metastatic prostate cancer reporting overall survival, disease-free survival, distant metastases-free survival, biochemical survival, adverse events (including cardiovascular) and/or health-related quality of life. Results: Fourteen trials were included and showed that combination therapy was associated with better or similar survival and disease-free outcomes compared with single-modality treatment, and that this may particularly be the case for patients with higher risk disease. The results also suggested that combination therapy is associated with more and worse adverse events and quality of life, although this was not always the case. Some of the results are at risk of reporting bias. Conclusion: The published data support the use of combined treatment with androgen deprivation and radiotherapy for intermediate- and high-risk localised and locally advanced prostate cancer. Optimal timing, duration, formulation and the management of side-effects remain important questions for further research. © 2014 The Royal College of Radiologists.

Taylor J.T.,University of Liverpool | Waltham C.,University of Lincoln | Price T.,University of Birmingham | Allinson N.M.,University of Lincoln | And 6 more authors.
Nuclear Instruments and Methods in Physics Research, Section A: Accelerators, Spectrometers, Detectors and Associated Equipment | Year: 2016

For many years, silicon micro-strip detectors have been successfully used as tracking detectors for particle and nuclear physics experiments. A new application of this technology is to the field of particle therapy where radiotherapy is carried out by use of charged particles such as protons or carbon ions. Such a treatment has been shown to have advantages over standard x-ray radiotherapy and as a result of this, many new centres offering particle therapy are currently under construction around the world today. The Proton Radiotherapy, Verification and Dosimetry Applications (PRaVDA) consortium are developing instrumentation for particle therapy based upon technology from high-energy physics.The characteristics of a new silicon micro-strip tracker for particle therapy will be presented. The array uses specifically designed, large area sensors with technology choices that follow closely those taken for the ATLAS experiment at the HL-LHC. These detectors will be arranged into four units each with three layers in an x- u- v configuration to be suitable for fast proton tracking with minimal ambiguities.The sensors will form a tracker capable of tracing the path of ~200. MeV protons entering and exiting a patient allowing a new mode of imaging known as proton computed tomography (pCT). This will aid the accurate delivery of treatment doses and in addition, the tracker will also be used to monitor the beam profile and total dose delivered during the high fluences used for treatment.We present here details of the design, construction and assembly of one of the four units that will make up the complete tracker along with its characterisation using radiation tests carried out using a 90Sr source in the laboratory and a 60MeV proton beam at the Clatterbridge Cancer Centre. © 2016 The Authors.

Appleton L.,The Clatterbridge Cancer Center Foundation Trust | Flynn M.,University of Liverpool
European Journal of Oncology Nursing | Year: 2014

Purpose: This qualitative exploratory study was grounded in local patient and service user experiences and was designed to investigate how the language and metaphors of cancer influence personal and social adjustment after completion of a course of treatment. Methods: The study employed a focus group design, in which eighteen people, recruited through regional networks and support groups, participated. Meetings elicited participants' stories and focused discussion on key words and common phrases in the cancer lexicon. Data from transcribed focus group recordings were analysed thematically and organised into descriptive categories concerned with the interpretations of common terms and how these influenced the management of identity and emotions. Results: The thematic categories emphasised the importance of language in the way participants managed their illness and sought to control their feelings and their interactions with others. Interpretation of findings revealed a strong central idea linking participants' accounts, which was that language, metaphor and euphemism are central to adjustment and the forging of an altered identity as a survivor of cancer diagnosis and treatment. Conclusions: The findings are consistent with what is already known about the language and metaphors of cancer, with language being an important mechanism for managing uncertainty. From participants' accounts it also appears that there may be subtle but important differences in professional and lay understandings of cancer language and metaphor. This suggests a need for oncology nurses to elaborate their broad understanding of communication skills and move toward a more detailed understanding of the language used during interactions with patients. © 2014 Elsevier Ltd.

Armoogum K.S.,Royal Derby Hospital | Thorp N.,The Clatterbridge Cancer Center Foundation Trust
Cancers | Year: 2015

Background: We compare clinical outcomes of paediatric patients with CNS tumours treated with protons or IMRT. CNS tumours form the second most common group of cancers in children. Radiotherapy plays a major role in the treatment of many of these patients but also contributes to late side effects in long term survivors. Radiation dose inevitably deposited in healthy tissues outside the clinical target has been linked to detrimental late effects such as neurocognitive, behavioural and vascular effects in addition to endocrine abnormalities and second tumours. Methods: A literature search was performed using keywords: protons, IMRT, CNS and paediatric. Of 189 papers retrieved, 10 were deemed relevant based on title and abstract screening. All papers directly compared outcomes from protons with photons, five papers included medulloblastoma, four papers each included craniopharyngioma and low grade gliomas and three papers included ependymoma. Results: This review found that while proton beam therapy offered similar clinical target coverage, there was a demonstrable reduction in integral dose to normal structures. Conclusions: This in turn suggests the potential for superior long term outcomes for paediatric patients with CNS tumours both in terms of radiogenic second cancers and out-of-field adverse effects. © 2015 by the authors; licensee MDPI, Basel, Switzerland.

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