Shane E. Dempsey

A retrospective planning analysis comparing intensity modulated radiation therapy (IMRT) to volumetric modulated arc therapy (VMAT) using two optimization algorithms for the treatment of early‐stage prostate cancer

The primary aim of this study is to compare intensity modulated radiation therapy (IMRT) to volumetric modulated arc therapy (VMAT) for the radical treatment of prostate cancer using version 10.0 (v10.0) of Varian Medical Systems, RapidArc radiation oncology system. Particular focus was placed on plan quality and the implications on departmental resources. The secondary objective was to compare the results in v10.0 to the preceding version 8.6 (v8.6).

Validation and use of the Newcastle Reflective Analysis Tool: a three‐year longitudinal study of RT students’ reflective journals

Freeform written personal development journals are used within the Radiation Therapy (RT) program at the University of Newcastle to promote reflection on practice. The journals are developed by students on completion of each semester based professional placement (clinical placement). To evaluate the level of reflection within journals the Newcastle Reflective Analysis Tool (NRAT) was developed. The NRAT allows for both narrow and broad classification of reflective writing, useful for formal and informal reflective writing assessments. This paper provides validation of the NRAT in the assessment of freeform reflective writing and its use in the assessment of reflection in RT student journals. The results also indicate the need to introduce interventions to foster students’ reflective writing ability within the RT program. As a result of these findings the Newcastle Reflective Inventories (NRI) have been developed. The NRIs are short form guided inventories aimed at assisting students with their reflective writing development.

Practice patterns of radiation therapy technology in Australia: results of a national audit

This article presents the results of a single‐day census of radiation therapy (RT) treatment and technology use in Australia. The primary aim of the study was to ascertain patterns of RT practice and technology in use across Australia. These data were primarily collated to inform curriculum development of academic programs, thereby ensuring that training is matched to workforce patterns of practice.

The quality assurance of volumetric modulated arc therapy (VMAT) plans for early stage prostate cancer: a technical note

As radiation therapy transitions from intensity modulated radiation therapy (IMRT) to volumetric modulated arc therapy (VMAT) it is important to consider the quality assurance (QA) of VMAT plans in light of what has previously been learned and developed in IMRT QA. This technical note assesses if IMRT based plan QA software, which has reduced the need in IMRT for phantom dose measurements on the linear accelerator, can be incorporated into VMAT QA processes. Twenty prostate cases were retrospectively planned using VMAT with one arc to deliver a prescription of 74 Gy in 37 fractions. A plan QA was performed using both IMSure (version 3.3), a software‐based IMRT QA program, and ArcCHECK (version 6.2.3.5713), a phantom‐based VMAT QA tool. Outcomes assessed included the time needed to perform the QA of both the IMSure and ArcCHECK QA methods, and agreement between planned dose and QA measured dose. On average per case, the ArcCHECK technique needed 31.5 min to perform the VMAT plan QA, while IMSure required 3.5 min to perform the same QA. All 20 cases passed dosimetric QA using ArcCHECK. However, using IMSure, three cases failed dosimetric QA using the departments existing IMRT QA criteria. This research has demonstrated that the IMRT QA software IMSure may be incorporated into the QA of VMAT plans, however the criteria to assess the dosimetry of the VMAT plans may need to be different to that for IMRT cases. The implication of this research for radiation therapists is to be critically aware of the differences between the plan QA requirements and methods for IMRT and those required for VMAT.

Development and validation of reflective inventories: assisting radiation therapists with reflective practice

Objective: Freeform reflective writing is one way that radiation therapists can document their development. Barriers to this form of writing include the fact that some radiation therapists do not know what to write or how to begin this writing process. This paper outlines the development and validation of guided inventories called the Newcastle Reflective Inventories and the validation of the Newcastle Reflective Analysis Tool as an effective tool for assessing short-form guided reflective writing. Method: The Newcastle Reflective Inventories consist of a series of questions that guides the user through the reflective writing process. Validation of the Newcastle Reflective Inventories involved comparing the evidence of reflection in 14 freeform journals to that of 14 inventories completed on the same topic. Validation of the Newcastle Reflective Analysis Tool included the assessment of 30 Newcastle Reflective Inventories. Results: There was a highly statistically significant difference ( p Discussion: These results show that the Newcastle Reflective Inventories are effective tools in promoting reflective writing when compared with freeform journaling.

Increasing nutritional support for patients undergoing radiation therapy: the radiation therapist perspective

Purpose: The aim of this study was to determine radiation therapists’ knowledge on the nutritional management of side effects for patients receiving treatment to the gastrointestinal tract and genitourinary system and to determine the willingness of radiation therapists’ to participate in nutritional training. Method: A cross-sectional survey at a Radiation Oncology Treatment Centre was performed coupled with a semi-structured interview to explore radiation therapists’ knowledge and experiences related to patient nutritional care. Results: Eighty-one percent of participants agreed that they were often asked by patients for advice on eating. The majority of participants recognised that providing adequate nutrition support would be beneficial in terms of patient outcomes (91%) and ongoing patient compliance with nutrition advice (81%). However, participants demonstrated low confidence in providing nutrition support. Eighty-six percent of radiation therapists had not received any training on nutritional interventions and 100% of radiation therapists were interested in receiving more training. Conclusion: This research indicates that radiations therapists are often asked for nutritional advice by patients and recognise the associated benefits but are not confident in providing advice. Our findings reveal an opportunity for radiation therapists to provide scripted nutrition advice to patients to reinforce recommendations made by dietitian.

Comparing four volumetric modulated arc therapy beam arrangements for the treatment of early-stage prostate cancer

This study compared four different volumetric modulated arc therapy (VMAT) beam arrangements for the treatment of early‐stage prostate cancer examining plan quality and the impact on a radiotherapy departments resources.

High Reliability Organisation (HRO) Principles of Collective Mindfulness: An Opportunity to Improve Construction Safety Management

The construction industry remains a high-risk industry, because of high fatality rates worldwide. Most construction accidents result from interaction between the work team, workplace, equipment and materials which lead to about 70% of injuries and fatalities. A wide range of safety management approaches have been implemented to manage construction risks, and they have been successful in reducing lost time injuries and incidents. However, a number of safety management approaches currently used in the industry have not kept pace with emerging theory on accident causation, prevention and safety management. To minimise accidents more advanced approaches and methods are required, and one of such methods is High Reliability Organisation (HRO) principles of collective mindfulness. This paper presents a systematic review of HRO research published in construction from 1990–2017. This review aims to identify the possibilities and barriers associated with transferring HRO principles to construction activities. Key findings from seven articles are discussed, research gaps identified and primary outcomes from the data will be presented descriptively.

A comparison of the acute toxicities using moderate hypo-fractionated intensity-modulated radiation therapy or volumetric modulated arc therapy for the treatment of early-stage prostate cancer

Aim This study compared the acute toxicities reported during radiotherapy treatment using either intensity-modulated radiation therapy (IMRT) or volumetric-modulated arc therapy (VMAT) to deliver a moderate hypo-fractionated treatment for early-stage prostate cancer. Material and methods Acute toxicities are routinely reported at the clinical site for all patients using the Common Terminology Criteria for Adverse Events. Toxicity assessment is performed on day 1 of treatment, then once weekly thereafter. The recorded toxicities of 40 cases treated with five-field IMRT, and 32 cases treated using VMAT were retrospectively compared. All cases were prescribed 73·68 Gy in 28 fractions. Eight symptoms were assessed; diarrhoea, proctitis, fatigue, pain, dermatitis, urinary frequency, urinary retention and urinary tract pain. Results In terms of the overall toxicity recorded, VMAT was shown to reduce the toxicities of dermatitis, fatigue, pain and urinary frequency ( p Findings The research reported here is one of the first publications to demonstrate that VMAT is associated with decreased toxicities compared with IMRT for the treatment of early-stage prostate cancer.

A qualitative analysis of radiation therapy students' professional placement journals

Purpose Student experience on clinical placement is not well captured with traditional program evaluation tools. This study aims to complete a qualitative analysis of the reflective clinical journals completed during professional placement by radiation therapy (RT) students in order to uncover the issues that affect students on placement and how these change as the students progress through the program. Materials and methods A qualitative descriptive analysis (QDA) was undertaken on the descriptive content of student journals completed by 97 students over 3 consecutive years while undertaking professional placement in Radiation Oncology Treatment Centres within Australia. Two coders used a QDA sourcebook specifically designed for the research to independently analyse the descriptive content of the reflective journals for four main categories and 18 subcategories. Results The result revealed a statistically significant increased tendency to discuss clinical environment and a decreased tendency to discuss the patient, 92·9–12·5% (coder 1) and 85·7–18·8% (coder 2), as they progressed through the program. Conclusions The results of this study showed some similarities with studies completed in other health professions; however, the breadth of issues explored within the content of these RT student journals demonstrates the true diversity of the RT student experience on professional placement.