Module information
Module details
- Title
- Brachytherapy and other Specialised Radiotherapy Techniques
- Type
- Specialist
- Module code
- S-RP-S2
- Credits
- 10
- Phase
- 3
- Requirement
- Compulsory
Aim of this module
The aim of this module is to introduce the trainee to specialised radiotherapy treatment techniques and modalities including brachytherapy, kV, electrons and SABR.
Work-based content
Training activities
| # | Learning outcome | Training activity | Type | Action |
|---|---|---|---|---|
| # 1 | Learning outcome 1,4,8 |
Training activities
Perform HDR post source change quality assurance |
Type DTA | Action View |
| # 2 | Learning outcome 1,4 |
Training activities
Undertake quality assurance and dosimetry of equipment/systems associated with brachytherapy |
Type DTA | Action View |
| # 3 | Learning outcome 2,8 |
Training activities
Produce and evaluate an HDR gynaecological plan for patient treatment |
Type DTA | Action View |
| # 4 | Learning outcome 2,8 |
Training activities
Produce and evaluate brachytherapy treatment plans for one site other than gynaecological cancers |
Type DTA | Action View |
| # 5 | Learning outcome 4,8 |
Training activities
Review departmental risk assessment for the safe handling of radioactive sources and make recommendations |
Type DTA | Action View |
| # 6 | Learning outcome 4,8 |
Training activities
Give appropriate radiation protection advice to a patient and/or their family/carer and/or other health professionals |
Type DTA | Action View |
| # 7 | Learning outcome 5 |
Training activities
Perform radiobiology calculations for patients receiving brachytherapy treatment combined with external beam |
Type DTA | Action View |
| # 8 | Learning outcome 3,6,7,8 |
Training activities
Perform planning and/or quality assurance activities on a specialist treatment modality. Reflect on the role and the cost/benefit considerations to the department and its patients for that modality |
Type DTA | Action View |
| # 9 | Learning outcome 3,8 |
Training activities
Create a clinically suitable plan for a patient using a SABR technique and perform associated patient specific quality assurance |
Type DTA | Action View |
| # 10 | Learning outcome 6,7,8 |
Training activities
Advise on kV treatments for patients covering a range of anatomical sites including suitable treatment delivery parameters and perform patient dose calculations |
Type DTA | Action View |
| # 11 | Learning outcome 6,7,8 |
Training activities
Advise on electron treatments for patients covering a range of anatomical sites including suitable treatment delivery parameters and perform patient dose calculations |
Type DTA | Action View |
Assessments
Complete 2 Case-Based Discussions
Complete 2 DOPS or OCEs
Direct Observation of Practical Skills Titles
- Perform HDR quality assurance.
- Produce an HDR gynae plan.
- Perform U/S quality assurance.
- Perform brachytherapy TPS quality assurance.
- Create a clinically acceptable SABR plan.
- Handle sealed radioactive sources safely.
Observed Clinical Event Titles
- Discuss a brachytherapy treatment plan with a healthcare professional.
- Discuss and provide radiation protection advice in brachytherapy with a non-specialist (patient, family member, member of staff etc).
- Attend a kV or electron patient clinical markup/treatment session and provide appropriate physics advice.
Learning outcomes
| # | Learning outcome |
|---|---|
| 1 | Perform required measurements to establish brachytherapy and specialist treatment machines are suitable for clinical use, interpret results and instigate corrective action where required. |
| 2 | Generate and evaluate brachytherapy treatment plans. |
| 3 | Generate and evaluate SABR treatment plans taking into account the patient suitability for the treatment and alternative options available. |
| 4 | Interpret and apply the regulatory framework on the safe use of radioactive sources in a clinical environment. |
| 5 | Perform radiobiology calculations for patients receiving treatment. |
| 6 | Describe the use of specialist techniques in radiotherapy. |
| 7 | Appraise the suitability of plans for superficial treatments and advise other health care professionals on their application. |
| 8 | Practice effectively as part of a multidisciplinary team to provide safe, patient centred radiotherapy treatments. |
Clinical experiences
Clinical experiences help you to develop insight into your practice and a greater understanding of your specialty's impact on patient care. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. Reflections and observations from your experiences may help you to advance your practice and can be used to develop evidence to demonstrate your awareness and appreciation of your specialty.
Activities
- Observe brachytherapy on a non-gynaecological treatment site.
- Attend theatre session for brachytherapy.
- Attend a brachytherapy multidisciplinary team meeting and follow the patient pathway to appreciate the options for treatment and patient experience undergoing treatment.
- Attend a SABR multidisciplinary team meeting and follow the patient pathway to appreciate the options for treatment and patient experience undergoing treatment.
- Observe a brachytherapy source change considering logistics and application of legislation around receipt and storage of radioactive sources.
Academic content (MSc in Clinical Science)
Important information
The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.
Learning outcomes
On successful completion of this module the trainee will be able to:
- Critically appraise brachytherapy delivery techniques and treatment planning and explain the associated dosimetry systems.
- Compare and contrast alternative superficial treatment modalities, their clinical uses, treatment planning approaches, and dosimetry.
- Explain the principles of, and requirements for, stereotactic treatments, critically evaluating the risks and safety requirements.
- Critically evaluate a range of specialised and novel radiotherapy treatment techniques and treatment planning modalities.
Indicative content
| Brachytherapy | |
| Brachytherapy | Types of brachytherapy, clinical uses, sealed sources |
| Brachytherapy equipment | HDR construction, operation and quality assurance, well counters, code of practice for calibration |
| Brachytherapy dosimetry | Sealed source strength measurement, TG43 formalism, line and point dose calcs, conventional dosimetry systems |
| Gynae brachytherapy | Historical basis, vaginal vaults, cervix, interstitial needles |
| Other clinical uses | Prostate LDR/HDR, oesophagus, skin techniques, eye plaques, non-malignant disease |
| Superficial Radiotherapy | |
| Choice of modality | Electrons v kV vs. brachytherapy, clinical rationale |
| Clinical use of kV | Generation of kV beams, Clinical indications, beam modifications, dose calculations, treatment time calculations |
| Clinical use of electrons | Clinical indications, electron planning, small fields, obliquity, inhomogeneity, beam modifiers, VSD calcs, ICRU71, TPS algorithms |
| SABR | |
| SABR | Aims. Patient eligibility. Characteristics of SABR, Dose fractionation and constraints, evidence, imaging and volume delineation, motion management, planning and delivery techniques |
| Lung SABR | SABR consortium guidelines, patient selection, dose fractionation, evidence, motion management, IGRT |
| SABR for other sites | Oligomets, other treatment sites, trials, evidence |
| Specialist treatment modalities | |
| TBI | Techniques, clinical indications, dosimetry |
| Intracranial SRS | Aims, Platforms for SRS, small field dosimetry (including Codes of Practice) and quality assurance, clinical indications, planning techniques, treating multiple metastases, IGRT |
| Protons | Rationale for proton therapy, evidence and clinical indications. Physics of proton beams, proton beam generation and beam transport system, proton beam delivery systems, dosimetry and codes of practice, proton-specific issues in treatment planning and robust proton planning, UK proton provision |
| TSEI | |
| MR-linacs | Equipment, MR-only planning, on-treatment verification, application to adaptive planning |
| Other specialist and novel modalities | As relevant at time of delivery e.g. Halcyon, Cyberknife, Gammaknife, TomoTherapy, Zap-X |