Rapid Access Radiotherapy For Palliative Treatment

Our Rapid Access Palliative Radiotherapy Pathway is designed to provide fast access for patients needing palliative radiotherapy for symptomatic relief quickly.

Rapid access palliative radiotherapy at GenesisCare offers significant benefits, including:

•  A non-invasive, outpatient treatment
•  Faster access to treatment focused on patient care for symptomatic relief 
•  Radiotherapy prescriptions delivered faster, over a shorter time following strict adherence to protocol 
•  Shorter treatment time on the bed for patients – sometimes less than 15 minutes
•  Complimentary transport to and from the patient’s treatment centre

Our aim is to improve our patient’s quality of life, by being able to offer this service quickly and efficiently, patients can trust they’re receiving the best care and often increase their life expectancy.

Patients receive a full package of care to meet their complex needs. They’ll be supported by our specialist trained radiotherapy teams, who are experts in palliative treatment. We understand palliative treatment can be a concerning time for patients, that’s why all our patients have access to wellbeing therapies through our partnership with the Penny Brohn UK charity. Patients can also request transport to and from their treatment centre, at no extra cost.

Our aim is to see, plan and treat patients within 24 to 72 hours.

Our expert multi-disciplinary teams, including leading dosimetrists are available to provide fast support for the patient’s treatment planning.

The referring oncologist will retain full management of the patient’s treatments, including the planning sign off, ensuring we maintain the highest standard of continuation of care.

For retreatment cases, we aim to treat the patient within 48 to 72 hours. We’ll request the patient’s previous treatment details and work closely with our multidisciplinary teams to ensure the patient is on treatment as quickly as possible. 

1. Referrer emails RT booking form and consent to pall@genesiscare.co.uk
2. Previous radiotherapy details requested for retreatment cases
3. Patient planning scan appointment booked and complimentary transport arranged
4. Patient has CT scan and physics planning and checking is completed
5. Referrer takes ownership and approves plan
6. Treatment delivered
7. Treatment summary provided to referrer. Referrer to prescribe medications if needed

Eligible patients will be required to:

• Have good performance status (ECOG status 0-2)
• Be able to walk or safely transfer from a chair to a treatment couch

This pathway excludes complex palliative patients who require SABR treatment and patients with spinal cord compressions with a high ECOG score. These patients can still be referred following our standard referral process.

To submit a patient referral for our Rapid Access Palliative Radiotherapy using our Horizon online referral portal, select ‘emergency’ in the priority section. Or for submitting a written referral, you should include a CAT3 and document ‘Rapid Access’ or ‘emergency’ and send directly to your local centre team.

All patient referrals should include the patient’s mobility status and any pre/post medication required.

For more information, get in touch

0808 2536 932
enquiries@genesiscare.co.uk

The patient: A 63-year-old male with advanced prostate cancer required palliative radiotherapy to the prostate, partial bladder and external iliac nodes which were impacting his quality of life through increasing pain, urinary obstruction, and pending nerve compression.

The treatment plan: Urgent radiotherapy to the pelvis including prostate, bladder, and nodal volumes. 20 Gy in five consecutive fractions to be delivered without any delays.

The planning and treatment pathway:

• 12.00pm: Patient presents with symptoms impacting his quality of life and is triaged into an oncology consultation for assessment and discussion on proposed management plan. Transport is arranged to take the patient to their centre.
• 12.30pm: Patient agrees to radiotherapy and signs informed consent form
• 1.00pm: A CT simulation is completed, and data sets exported to Pinnacle Treatment Planning System
• 1.30pm: The referring Oncologist completes target and normal tissue contours
• 1.45pm: A GenesisCare Dosimetrist reviews the contours and suggests a VMAT plan would be preferential to the initially proposed 2D approach. The Oncologist is unsure of the benefit and again stresses the importance of starting treatment urgently. The Dosimetrist explains that GenesisCare has the infrastructure and processes to complete a VMAT plan in the required timeline and suggests to the Oncologist they return in 30 minutes to review the potential of a VMAT plan
• 2.15pm: The Oncologist returns and reviews the initial VMAT plan. They’re impressed with both the quality of the plan and the speed in which the plan was developed. The Oncologist altered their request from 2D to VMAT for the patient, on the understanding that treatment commences within 24hrs
• 2:45pm: The Oncologist reviews the VMAT plan and agrees the approach is preferable, the plan is highly conformal and reduces dose to normal tissues, such as the small bowel, which would otherwise be in the 2D approach
• 3.00pm: The plan and approvals for treatment are completed. Quality Assurance is also completed with automated Mobius software – the plan passes all criteria
• 3.30pm: Patient starts 1 of 5 consecutive treatments. 

The VMAT treatment was planned and commenced in under 4 hours, this pathway is made possible by efficient teamworking between our patient administration team, centre leaders, dosimetrists, and physicists.