a b s t r a c tIt is widely accepted that health professionals might sometimes underestimate cancer patients' needs for information on the complex process of radiotherapy (RT) planning and delivery. Furthermore, relatives might also feel excluded from the treatment of their loved ones. This pilot study was carried out in order to assess whether both patients and their relatives would welcome further information on RT planning and delivery using the virtual reality (VR) system VERT. One hundred and fifty patients with different types of cancer receiving radical RT were included in the study. Patients and relatives were shown using VERT on a one-to-one basis with an oncologist or a radiographer, a standard room where RT is given, a linear accelerator, and how RT is planned and delivered using their own planning CT Scans. Patients welcomed this information as it helped them to reduce their fears about RT. Relatives felt also more involved in the treatment of their loved one. The results obtained in this pilot study show that VR aids could become an important tool for delivering information on RT to both patients and relatives.© 2015 The College of Radiographers. Published by Elsevier Ltd. All rights reserved. IntroductionThere is clear evidence suggesting there is often a gap between the information provided to patients regarding their disease and management, and the amount of information patients wish to receive.1 Furthermore, it is not uncommon for clinicians to underestimate cancer patients' needs for information, 2 especially when the vast majority of cancer patients want to be thoroughly informed about their illness. 3 Despite this, there are still problems with respect to the provision of information which could satisfy most patients. 4 The importance of the provision of information to patients has been stressed by the Department of Health 5 stating that is a key requirement in current cancer services standards in the UK. However, it cannot be assumed that all patients want substantial information regarding their treatment as some might prefer to fully trust their doctor rather than being involved in taking any decisions that could affect their management. While several studies have addressed these issues, 6,7 further work is still required to improve the understanding of patients' needs. Furthermore, relatives might feel sometimes disengaged in the management of their loved ones and might consider themselves being excluded from several areas within the management process. The negative psychological impact upon partners and other relatives of cancer patients is well documented, 8 and such negative effect is (amongst many other factors) widely associated with lack of medical information given to them. It has long been argued that providing tailored information to relatives as well as patients in general cancer care is a positive aspect of the treatment process 9 and there is little doubt that such inclusionary practice should be encouraged in cancer care.A clear example where provision of information to patien...
The BVAM or CHOD/BVAM regimens can be delivered despite neutropenia without significant treatment delay or dose reduction in patients less than 70 years of age. Further intensification of this type of chemotherapy is probably not possible with patients of this age, many of whom have a poor performance status.
A performance assessment was made of the Gulmay D3300 kilovoltage (combined superficial and orthovoltage) X-ray therapy unit. Results are presented for the key dosimetric beam parameters required for routine patient treatment. This unit is relatively new to the UK market and displayed similar properties to other existing equipment. Beam half-value layers were different from comparable published data, but were consistent with the actual values of external tube filtration employed. The applicator, system interlocks and dose monitor performance were satisfactory and the tube leakage was below the UK recommended maximum (air kerma rate 300 mGy h(-1) at 5 cm from the tube head). The variation of absorbed dose with stand-off distance from the applicator base followed the inverse-square law for all tested combinations of beam tube potential (kVp) and applicator, and the measured focus-to-surface distances were in acceptable agreement with the nominal values. A significant beam profile asymmetry was seen for field sizes greater than 10 cm at the upper tube potential (kVp) range (maximum ionization quotient 1.08), but this was an inherent property of the X-ray tube. The difficulties of obtaining percentage depth dose measurements are discussed, and it was concluded that the use of published data (appropriately verified) was acceptable. The methodology followed could form the basis of an acceptance and commissioning protocol. To address the relative lack of agreed standards for this type of equipment, performance test tolerances are proposed that are recommended for new installations.
LiF:Mg:Cu:P thermoluminescent dosemeters (TLD) can be used for the same X-ray dosimetry applications as LiF:Mg:Ti, with each type having the disadvantage of a response dependent on energy, particularly at low energies. Measurements were made of the response per unit air kerma of LiF:Mg:Cu:P and LiF:Mg:Ti to nine quasi-monoenergetic X-ray beams with mean energies from 12 keV to 208 keV. Each measurement was normalized to the value produced by 6 MV X-rays. LiF:Mg:Cu:P was found to under-respond to a majority of these radiations whereas LiF:Mg:Ti over-responded to a majority. Their smallest relative measured response was produced by the lowest energy beam, and the maximum measured relative response of 1.15+/-0.07 and 1.21+/-0.07 for LiF:Mg:Cu:P and LiF:Mg:Ti, respectively, occurred at 33 keV. Energy response coefficients were derived from these measurements to estimate the error introduced by using either type of TLD to measure the dose from an X-ray spectrum different to that used for its absolute response calibration. It was calculated that if the response of either type of TLD was calibrated at 100 kVp, then an error of no more than +/-2% would be introduced into measurements of tube output at potentials of 50-130 kVp. LiF:Mg:Cu:P was found to introduce a larger error (up to 30%) into the measurement of body exit dose than LiF:Mg:Ti at tube potentials of 40-150 kVp, if its absolute response was calibrated using the corresponding body entrance beam. The method should allow this type of error to be estimated in other dosimetry applications for either type of TLD.
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