Dr Tom Roques, Norfolk & Norwich University Hospital

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09/01/2013 Two main problem areas • Patient selection for treatment • Volume definition How do we choose the right treatment for the patient? Selection criteria for radiotherapy relatively vague Clinical trial selection criteria not applied in real life Rely on staging (at MDT), PS and intuition Poor at assessing functional reserve – esp in elderly 8
09/01/2013 Huge variation in the UK Geographical Variation in Radiotherapy Services Across the UK in 2007 and the Effect of Deprivation M.V. Williams and K.J. <strong>Dr</strong>inkwater Clinical Oncology August 2009 The problem with MDTs Over-stretched - all becoming longer and there are more of them Perhaps one doctor will have met the patient The treating oncologist will almost certainly not have met the patient So decisions i based on imaging i and path, not patient t characterstics and preferences Little/no evidence to support quality of MDT decision making 9
Page 1 and 2: 09/01/2013 What can doctors do to p
Page 3 and 4: 09/01/2013 How to improve? Awarenes
Page 5 and 6: 09/01/2013 Radiotherapy risk profil
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Page 11 and 12: 09/01/2013 Volume definition 11
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Page 15 and 16: 09/01/2013 QA review of all plans w
Page 17 and 18: 09/01/2013 Imaging for Oncologists
Page 19 and 20: 09/01/2013 19
Page 21: 09/01/2013 Conclusions • Take lea

Dr Tom Roques, Norfolk & Norwich University Hospital

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