Radiology: GIRFT Programme National Specialty Report

Radiology: GIRFT Programme National Specialty Report
GIRFT 10 November 2020

• This report, a companion to Sir Mike Richards’ recent review of diagnostic services Diagnostics: Recovery and Renewal, examines ways of meeting the ever-increasing demand on radiology units in England at the same time as shaping a better service for those who use it.

Strategic investment in MRI Simulators for radiotherapy services in Scotland

Strategic investment in MRI Simulators for radiotherapy services in Scotland
Scottish Heath Technology Group 7 May 2020

• Analytic support as part of a strategic proposal to introduce magnetic resonance imaging (MRI) Simulators onto the radiotherapy capital equipment replacement programme.

November 2019 prioritisation decisions

November 2019 Specialised Services prioritisation decisions
NHS England 11 February 2020

• Decisions on which new specialised treatments should be routinely commissioned:
• NHS England has agreed to continue funding two stereotactic ablative radiotherapy (SABR) policies for patients with metachronous extracranial oligometastatic cancer (all ages), and for hepatocellular carcinoma (adults)
• Temozolomide as adjuvant treatment for people with newly diagnosed anaplastic astrocytoma without 1p/19q codeletion following surgery and radiotherapy (adults)
• Dexrazoxane for preventing cardiotoxicity in children and young people (under 25 years) receiving high-dose anthracyclines or related drugs for the treatment of cancer
• Human coagulation factor X for hereditary factor X deficiency (all ages)
• Canakinumab for treating periodic fever syndromes: TRAPS, HIDS/MKD and FMF (ages 2 years and older)
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Establishment Compact: Learning Health Care System for Radiotherapy Services in England

Establishment Compact: Learning Health Care System for Radiotherapy Services in England

NHS England 13 December 2019

• This document describes a collective commitment made to establish a new, vibrant learning healthcare system (LHCS) for radiotherapy in England. It gives details of the new Radiotherapy Networks in England (from April 2019).

Provision of Interventional Radiology Services, 2 ed

Provision of Interventional Radiology Services, 2 ed
Royal College of Radiologists September 2019

• This document demonstrates the range of services offered by interventional radiologists and sets out the core requirements for the provision of an IR service both in district general hospitals and tertiary or teaching hospitals, advising on how services may be set up collaboratively within regions to offer the highest quality of care to patients.

PET-CT imaging in patients with anal cancer

PET-CT imaging in patients with anal cancer
SHTG Advice Statement and Evidence Note, April 2019

Advice for NHS Scotland

Service specification Radiotherapy Operational Delivery Networks

Service specifications for radiotherapy services across England.
NHS England January 2019

• Service specifications include a new specification to establish 11 Radiotherapy Operational Delivery Networks across England which will be responsible for driving improvements in treatment and care through the adoption of best practice standards, improving access for patients to the most advanced and innovative techniques and reducing the variation in quality of services.

CQC Radiology review

Radiology review: A national review of radiology reporting within the NHS in England 

CQC 19 July 2018

• A CQC review of NHS radiology services in England 2016-17 found
• The timescales for reporting on radiology examinations, and arrangements for monitoring and managing backlogs, vary widely between trusts.
• There are few national standards that trusts can benchmark themselves against. 
• Even trusts that were monitoring their performance did not always report on time.
• Issues with staffing, including an average vacancy rate of 14% across trusts that responded. This supports existing evidence about the national difficulties in recruiting and retaining radiologists.

Chemotherapy and radiotherapy for advanced pancreatic cancer

Chemotherapy and radiotherapy for advanced pancreatic cancer
Cochrane Database of Systematic Reviews 20 March 2018, Issue 3. Art. No.: CD011044

• The review identified studies (n=42) in people with pancreatic cancer that could not be operated on (locally advanced) or that had already spread beyond the pancreas (metastatic). The studies involved 9463 participants who were receiving their first therapy for pancreatic cancer.
• This review has shown that in advanced disease, combination chemotherapy with FOLFIRINOX (5-fluorouracil, irinotecan, oxaliplatin combination); GEMOXEL (gemcitabine, oxaliplatin and capecitabine); cisplatin/epirubicin/5FU/gemcitabine; gemcitabine plus nab-paclitaxel; and gemcitabine plus a fluoropyrimidine agent, provide a survival advantage over gemcitabine alone. These combinations do increase side effects. Gemcitabine given slowly using a fixed rate of infusion may be more effective than giving it in the standard way, which is quickly over 30 minutes.

Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases

Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases
Tsao MN et al
Cochrane Database of Systematic Reviews 2018, Issue 1. Art. No.: CD003869.

• A review of the effectiveness and adverse effects of whole brain radiotherapy (WBRT) given alone or in combination with other treatments to adults with multiple brain metastases (54 trials, n=11,898).
• Findings:
• Altered higher biological WBRT dose-fractionation schemes did not confer benefit for overall survival, neurological function, or symptom control compared with standard treatment. However, overall survival and neurological function were worse for lower biological WBRT dose-fractionation schemes than for standard dose schedules.
• The addition of WBRT to radiosurgery improved local and distant brain control (i.e. absence of new intracranial lesions at the site or outside of treated lesions after treatment) among selected people with brain metastases, but investigators reported worse cognitive outcomes and no differences in overall survival.
• Selected people with multiple brain metastases from non-small-cell lung cancer may show no difference in overall survival when optimal supportive care is given and WBRT is omitted.
• Use of other treatments (radiosensitisers, chemotherapy, or molecular targeted agents) in conjunction with WBRT remains experimental.