The Academic Clinical Oncology and Radiobiology Research Network (ACORRN) was launched in 2005 by the National Cancer Research Institute (NCRI) to revitalise radiotherapy (RTX) and radiobiology (RB) research in the UK [Price P. Clin Oncol 2005; 17:299–304]. The network was established in response to the sharp decline over the past 10 years in the number of clinical academics and radiation biologists. The decline had left the UK's radiotherapy and RB communities with insufficient infrastructure and capacity, despite radiotherapy experiencing one of the most rapid advances in technology and computerisation of any field in medicine.

In 2005, against a background of expanding radiotherapy services and increasing demands on therapy radiographers, the UK radiotherapy managers group were concerned about vacancies and low establishments impacting on service delivery, and lack of guidance on staffing establishments. They undertook a survey and work to develop a staffing framework, also to highlight the criticality of adequate radiographer staffing to radiotherapy, both in service delivery and treatment safety. The survey, of 2004 services and staffing, aimed to see if commonality existed in establishment size related to services delivered, and whether staffing levels correlated with activity levels.

Reasonable parity in the total number of funded WTE establishment for “core” services, per centre, per planned daily Linear Accelerator (linac) hour of service was shown. The resultant staffing formula for core services is 1.33 WTE per linac hour. This includes radiographers, assistants, helpers and others contributing to the core activities. The average linac day length was 8h. The average fraction time was 11min with a range of 1.7–5.7 fractions per hour, the variations in activity rate correlating with actual staffing levels. The formula was tested in three departments and example staffing models constructed to help in operationalising the four-tier career structure.

There are several clinically useful techniques for delivering radical radiotherapy to the prostate. One such beam arrangement is a conformal four-field box technique. Patients who have undergone a total hip replacement have in place a metallic prosthesis, which presents challenges in achieving a homogenous dose distribution. This is due to the increased density of the metal in comparison to bone and soft tissue. The resultant effect is additional attenuation of the X-ray beam as it passes through the prosthesis. The interaction of the photons with the metal also causes increased scatter. Thus, the dose delivered to the tumour is reduced if it is not corrected for. Due to the uncertainty in the amount of attenuation, it is recommended to avoid irradiating through the hip concerned. This means that the four-field box technique cannot be used. Instead, different field arrangements are used such as three or four oblique fields. This is a retrospective investigation into which field arrangement would be the most appropriate for early stage prostate cancer patients. Ten previously treated prostate patients were planned with different beam arrangements avoiding the prosthesis. The results were analysed and are presented with reference to the doses to the organs at risk and the planning target volume. The results indicate that the beam arrangement of choice should be three fields (anterior, posterior and lateral) or a three-field oblique beam arrangement. It has been proved that these plans are acceptable as a solution in this scenario.

A patient arriving for their first Radiotherapy appointment can exhibit an array of behaviours, such as anxiety or aggression, which are generated by intense emotions. Each patient will have their own individual concerns and their needs should be addressed, to make their first experience in the Radiotherapy Department as smooth and stress free as possible.

The radiographer's role at this point is undoubtedly to provide patients with information, whilst demonstrating a compassionate and genuine nature. This can make all the difference to the way a patient reacts and copes with the entire course of radiotherapy.

The skills that will allow a radiographer to handle these situations are, in the first instance; good communication skills, but in addition to this the development of some basic counselling skills could further enhance patient care.

The aim of this article is to discuss the benefits of utilising basic counselling skills to create the best environment possible for the patient, and possibly answer some questions about their legitimate nature.

Purpose: To identify subgroups in glioblastoma multiforme (GBM) with different susceptibilities to radio-chemotherapy by p53 protein and Ki-67 expression.

Patients and Methods: Thirty-one patients with primary GBM underwent a combined radio-chemotherapy with topotecan. Percentage of cells expressing p53 protein and Ki-67 antigen was determined immunohistochemically. Additionally, the cell density within the tumour tissue was measured.

Results: Median percentages of p53 and Ki-67 expressing cells were 4.3% (range = 0–28%) and 12.0% (range = 0–28%), respectively. Dividing the cases into two groups by high or low p53 protein 1-year disease-free survival rates were 13.3% and 23.6%. High or low Ki-67 expression showed one-year disease-free survival rates of 18.8% and 17.1%. Neither p53 nor Ki-67 expression showed a significant correlation with disease-free survival or overall survival. Median cell density was 252 cells/field (range = 42–595). 1-year disease-free survival rates were 14.5% and 21.7% in high and low cell density group, respectively. A significant correlation with progression-free survival was observed, whereas the stratification into two groups revealed no significance. Cell density showed a significant inverse correlation with p53 and Ki-67 immunopositivity.

Conclusion:p53 protein and Ki-67 expression seem to be inappropriate for the estimation of prognosis in patients receiving a combined radio-chemotherapy with topotecan.

The proximity of abdominal tumors to non-target organs has motivated exploration of intensity modulated radiation therapy (IMRT), with its demonstrated capability to create conformal dose gradients, in abdominal tumors. However, substantial extra-target dose may be observed to radiosensitive organs remote from the treatment field.

We present dosimetric data from two patients receiving abdominal IMRT using a sequential tomotherapy technique, demonstrating substantial dose to extra-target organs.