Evaluate the multiple phases involved in the accurate delivery of external beam radiation
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The patient pathway towards the delivery of external beam radiation (EBR) is an intricate system of phases. Each reliant consecutively with accuracy being the principal objective. Diagnosis, localization, immobilization, treatment planning, verification and treatment delivery are the main phases of the pathway. Each co-dependent and essential in the delivery of accurate EBR and yet also potentially equally inhibiting.
A recent study by Cancer Research UK (2013) as cited by O'Hara (2014) suggests that on average 25 individuals are diagnosed per day in Northern Ireland. Hence a vast number of patients are being introduced to this pathway.
As stated by Eyre, Smith et al. (2000) early detection truly is the solution to the survival of patients enabling increased treatment success. Hence diagnosis, the initial phase in delivery of EBR, begins prior to contact with a Radiotherapy centre. This phase cannot be assessed or evaluated with a time frame, a prominent struggle faced. And hence a quality restraining the ability to deliver EBR accurately.
Public Health England (2014) have proposed that the diagnosis phase may commence via; a managed route (GP referrals) or an emergency presentation route (emergency GP referrals or A&E admittance). GP referrals result mainly from a patient's presentation of looming symptoms whilst emergency presentation usually are late, unobserved symptoms. Thus illustrating how this "initial" phase can commence at any given stage of disease, therefore effecting the outcome considerably.
Diagnosis from these routes are enabled by various investigations and tests. Via blood tests, prescribed diagnostic scans and x-rays or the referral to a specialist consultant. Their complete reliability somewhat questionabl...
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...y of EBR. For example, the imaging of patients for their first three daily treatments. This employs the principles of verification yet throughout the "final" stage.
Patient review during treatment is another aspect employed to monitor the accurate delivery. Monitoring patients bloods and electrolytes help examine the patients response to treatment and thus signify any signs of inaccurate treatment.
The close compliance of these phases enabling the continuous creditability of external beam radiation as one of the most successful modalities in the treatment of cancer, as suggested by Watson, Barrett et al. (2001). Arguably the delivery of the treatment can be seen to be the most important phase in the accurate delivery of EBR as the radiation is being administered. However without the previous phases, or links in the EBR chain, the accuracy would not be achievable.