Radiotherapy

Equipment
This year has seen significant progress in addressing the deficiencies in radiotherapy equipment, identified by the Royal College of Radiologists' Report (1998.)

A new Linear Accelerator (with a multi-leaf collimator and portal imaging system to allow more accurate targeting of radiotherapy) and Simulator were commissioned during the year. Funding for a further three Linear Accelerators from the New Opportunities Fund was announced and towards the end of the year, work began on two new bunkers required to house the machines. This is, however, only the start and the establishment of a funded, rolling replacement programme will be needed if the deficiencies of the past are not to be re-created in the future.

Staffing
Staffing continues to be a cause of major concern for CCO, as for most other Radiotherapy Departments in the UK.

While we were successful in recruiting Radiographers during the summer of 1999, the anticipated staff losses during the winter and spring (to the new North Wales Cancer Treatment Centre) could not be replaced, leading to unfilled vacancies by the end of the year. This reflects a shortage of Therapy Radiographers at local, national and international level, exacerbated by the on-going provision of additional radiotherapy facilities in the UK.

Waiting times
Waiting for cancer treatment always engenders anxiety in patients and their relatives and we continue to seek ways of reducing the waiting time for treatment as far as possible.

The waiting time fell during the autumn as the result of waiting list initiatives, but rose again by the end of the year because of unfilled radiographer vacancies. Though waiting times should fall during the autumn of 2000, following the opening of the North Wales Cancer Treatment Centre, this will be dependent on our ability to maintain and improve on present staffing levels.

Developments
Radiotherapy is rapidly developing in many ways and we continue to seek to make new developments available to our patients, where appropriate, as soon as possible.

Conformal Radiotherapy for carcinoma of the prostate is under investigation in the MRC RT01 study, to which we are the single largest contributor (100 patients.) We are now entering patients into the START trial, which is designed to evaluate the optimal duration of radiotherapy for breast cancer. We are testing planning facilities for Intensity Modulated Radiotherapy (a new, more accurate method of localising radiotherapy) and expect to be able to deliver Intensity Modulated Radiotherapy towards the end of 2000. Facilities to allow the use of Magnetic Resonance Imaging (MRI) for treatment planning for brain tumours have been developed and should be extended to other tumour sites in the near future. Development of Stereotactic Radiotherapy continues and Stereotactic Conformal Radiotherapy (for skull base tumours) has been introduced during the year.

The next few years will see exciting advances in radiotherapy and the latest developments at CCO will ensure that we will be able to make these available to the people of Merseyside and Cheshire.