Our radiotherapy centres are always looking for ways to improve experiences for our patients, whether that's with new treatments or techniques through clinical trials, or with new equipment and technology.
We want to improve access across the network to modern, advanced and innovative radiotherapy techniques and ensure more of our patients can benefit from cutting-edge technology.
Our Radiotherapy Centres are some of the best in the country and already offer a range of advanced treatments, such as Stereotactic Radiosurgery for patients with brain tumours and Stereotactic Ablative Radiotherapy (SABR) for primary lung cancer or cancer that has spread to another part of the body.
We work closely with our radiotherapy centres in the network, along with commissioners and the National Programme of Care for Cancer, to ensure new advanced and innovative treatments are available to all patients in the network.
An exciting and innovative programme is underway across Newcastle and Carlisle to develop advanced adaptive radiotherapy workflows that have the potential to transform patient care. Adaptive radiotherapy enables plans to be modified during a course of treatment in response to changes in a patient anatomy, helping maintain optimal tumour coverage while further reducing radiation exposure to surrounding healthy organs and tissues.
Most adaptive radiotherapy solutions currently in use around the world rely on specialist equipment and dedicated software designed specifically for this purpose. The ambition of the team at The Northern Centre for Cancer Care is to demonstrate that these techniques are achievable with the technology available in most radiotherapy departments, and can therefore be of benefit to a much greater number of patients.
A key part of the project will be the collection and analysis of patient outcome and toxicity data. This evidence will help the team to evaluate the clinical benefits of adaptive radiotherapy and build a stronger case for its wider adoption, ensuring that future developments remain focused on improving patient outcomes and quality of life.
The first phase of the programme is focused on establishing a rapid offline replanning, or offline adaptive service. This approach is designed for patients who experience gradual anatomical changes during treatment, such as weight loss. New streamlined pathways will enable adapted treatment plans to be created and approved for use the next day. This represents a significant improvement over traditional replanning processes, which can often take several days from the point a change is identified to the delivery of an updated treatment plan.
The knowledge, expertise and infrastructure developed through this work will then form the foundation for the next stage of the programme: online adaptive radiotherapy. This approach will benefit patients whose anatomy changes from day to day, such as those receiving radiotherapy to the bladder. In these cases, patients will attend for treatment as usual, but their treatment plan will be adjusted in near real time to reflect the anatomy of that specific day. By tailoring treatment immediately before delivery, online adaptive radiotherapy has the potential to provide even greater precision; ensuring that the tumour receives the intended dose while healthy tissues are protected as effectively as possible.
This project is partly facilitated by the improved quality of daily pre-treatment images resulting from recent Hypersight installations on our Varian linacs, and new functionality in the recently upgraded RayStation planning system. Bringing together a multidisciplinary team of clinical oncologists, radiographers, dosimetrists and medical physicists, the project is focused on transforming the way radiotherapy is planned and delivered. By streamlining and automating key treatment planning processes the team are creating workflows that are faster, safer and more efficient; paving the way for a new generation of adaptive radiotherapy that can respond to each patient's needs throughout their treatment journey.
Together, these developments represent an important step towards a future where radiotherapy can adapt to each patient throughout their treatment journey, delivering more personalised, precise and effective cancer care.
Surface guided radiotherapy (SGRT) is a technique that involves tracking the patient's surface anatomy in real-time to ensure a faster, more streamlined treatment setup.
The James Cook Cancer Institute, Middlesbrough, was the first centre in the country to install the C-Rad SGRT system, Catalyst, in January 2015. The equipment has now been generously funded by the Newcastle Hospitals Charity and is being rolled out across both sites at Newcastle and Carlisle, so all our patients in the network can benefit.
The benefits of this technique for patients are;
- Improved accuracy which reduces the risk of radiation affecting surrounding healthy tissue.
- Faster, more efficient treatment set up times.
- Less patient moving and handling which is both much better for the patients, and also far better from a staff health and safety perspective.
- Real-time monitoring and automatic corrections, particularly beneficial for treatments where even slight movements such as breathing, can impact the accuracy of the treatment.
- Minimises the need for repeated X-ray imaging before each treatment.
Over the past couple of months, the radiotherapy teams at Newcastle have been training staff on the new systems and preparing to treat their first patient at the beginning of October.
Over the next few months, all new patients coming to NCCC for radiotherapy for breast cancer will benefit from SGRT. At present, current practice of using permanent tattoos remains. The technology is also being rolled out into clinical use for patients at Carlisle.
The Radiographers at both sites have enjoyed being part of such a big project and the successful implementation of SGRT - well done everyone!