New Technologies & Radiotherapeutic Advances in TROG Trials (October 2007)
Progress in radiation therapy is heavily dependent on technological advances particularly in relation to computerised equipment for treatment planning and delivery. Radiotherapeutic advances are also critical for enhancing the radiobiological effect of treatment. Ensuring that clinical research involves new technologies and radiotherapeutic developments is a priority to ensure these are implemented and evaluated in a structured environment with rigorous quality assurance.
Technological trials require strong collaboration between medical physicists, radiation therapists, and radiation oncologists. TROG trials have previously incorporated technology-based objectives including the introduction of site-specific 3-D conformal radiotherapy; accelerated partial breast irradiation (TROG 06.02: APBI); prostate brachytherapy and dose escalation (TROG 03.04: RADAR) and split field techniques (TROG 03.02: Gastric Phase II). Trials involving radiotherapeutic developments have included fractionation (TROG 07.01: DCIS); use of a novel radiosensitiser (TROG 02.02: Headstart) and treatment sequencing (TROG 01.04: Rectal).
New trials are focusing on the implementation of IMRT and hypofractionation (PROFIT: TROG in collaboration with OCOG); further development of a new treatment technique (Gastric Phase III: TROG in collaboration with AGITG) and humidifier device testing (TROG 07.03: RadioHum in collaboration with Fisher and Paykel Healthcare).
QA resources must be developed to meet the demands of trials involving new technologies and radiobiological advances. Radiotherapy QA reviews as standard include assessment of target and organ definition in conjunction with the evaluation of compliance with dose constraints. The SWAN radiotherapy treatment plan review software will greatly enhance the RT QA review process by enabling volumetric 3-D reviews to be routinely undertaken. Multi-disciplinary working parties established for the development of new trials and new QA resources continue to demonstrate the strong collaborative networks within TROG’s membership and demonstrate the benefits for clinical research in Australia and New Zealand. TROG’s IMRT clinical trial QA resources are currently under development and will include IGRT and other credentialing requirements.
TROG Technical Reseach Workshop (April 2007)
The TROG Technical Research Workshop was held on 11th April 2007 at Rotorua, New Zealand with 44 multi-disciplinary delegates in attendance. The workshop provided an opportunity to increase the clinical research knowledge of participants and highlighted potential opportunities for how to get involved in radiotherapy clinical trials. The sponsorship provided by Varian Medical Systems was greatly appreciated.
A new initiative trialled during the 2007 Annual Meeting was a session for RTs and Physicists to feedback thoughts, comments and suggestions on new trial proposals to the RT and Physicist members of the TROG Scientific Committee. This proved to be a great success with trial Chairs receiving valuable feedback from affiliate members on any technical issues that may need further attention. The RT and Physics new trial proposal feedback session will now be a standing feature of future TROG Annual Meetings.