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This conference proved to be an important landmark in the development of multidisciplinary collaboration in UK radiotherapy and there are already plans for a further conference at The University of Bath (6-9 April 2003), the theme of the meeting being "Optimisation in radiotherapy". There were many lessons for UK radiotherapy and some important caveats. Some new developments, such as IMRT, appear to involve substantial resources for safe and effective application: the risk management considerations are considerable, particularly owing to the many assumptions within the processes involved. Enhanced quality assurance levels are clearly indicated in the more sophisticated forms of radiotherapy. Perhaps such advances will only be achieved at large centres that have adequate academic units of physics, clinical oncology and radiography with sufficient charitable and targeted NHS research and development funding. Alternatively, more progress may be made in departments with smaller workloads, where staff can concentrate on developmental issues. There is clearly a danger that many departments will independently attempt to define practical ways to deliver IMRT; national guidelines and trials including quality assurance are urgently required. The use of mathematical modelling of the various processes in radiotherapy also appears to be of increasing importance in guiding clinical decisions and clinical trial design, and within audit of the overall process of radiotherapy, including workload considerations. Mathematical simulations of the entire process may allow optimal use of resources: techniques such as linear programming and operational research have been successfully used in industry for many decades. Within radiotherapy, such work usually depends on the goodwill and enthusiasm of the contributors and is not funded formally. Adequate resource support is essential. The definition of target volumes should include the contributions of histopathologists and radiologists. This may be a suitable topic for a future UKRO meetings, involving colleagues from the relevant disciplines. The professions involved in radiotherapy need to be aware of developments in related fields: the molecular pathology of cancer; advances in diagnostic imaging; and the potential interaction between radiation and novel approaches to drug treatment of cancer. The conference confirmed that the next decade will be crucial for the development of clinical oncology. There is a wide and increasing opportunity for more research to improve accuracy where necessary and to reduce uncertainty where possible.

Original publication

DOI

10.1259/bjr.75.892.750297

Type

Conference paper

Publication Date

01/01/2002

Volume

75

Pages

297 - 306