The European core curriculum for radiotherapy technologists.

BACKGROUND: The Radiotherapy Technologist is the third member of the team responsible for the accurate delivery of radiotherapy to the cancer patient. Educational standards have been established for both radiotherapists and medical physicists and our group recognised the need to also standardise the education of radiotherapy technologists. MATERIALS AND METHODS: The project commenced in 1990 and was completed by 1994 when an agreed core curriculum was presented at a consensus conference. All aspects of curriculum development and education delivery were reviewed during this four year period. RESULTS: Core topics were identified. educational entry standards described and a duration of three years, consistent with European Union mobility regulations, agreed. CONCLUSIONS: The core curriculum describes the standard necessary to be achieved for entry into the profession to ensure the optimum treatment is offered to all patients throughout the European Union. Regular review of the core curriculum should be carried out to ensure the defined standards are maintained.

Comparison of plastic and Orfit masks for patient head fixation during radiotherapy: precision and costs.

PURPOSE: Two widely used immobilization systems for head fixation during radiotherapy treatment for ear-nose-throat (ENT) tumors are evaluated. METHODS AND MATERIALS: Masks made of poly vinyl-chloride (plastic) are compared to thermoplastic masks (Orfit) with respect to the accuracy of the treatment setup and the costs. For both types of material, a cut-out (windows corresponding to treatment fields) and a full mask (not cut out) are considered. Forty-three patients treated for ENT tumors were randomized into four groups, to be fixed by one of the following modalities: cut-out plastic mask (12 patients), full plastic mask (11 patients), cut-out Orfit mask (10 patients), and full Orfit mask (10 patients). RESULTS: Reproducibility of the treatment setup was assessed by calculating the deviations from the mean value for each individual patient and was demonstrated to be identical for all subgroups: no differences were demonstrated between the plastic (s = 2.1 mm) and the Orfit (s = 2.1 mm) group nor between the cut-out (s = 2.0 mm) and not cut-out (s = 2.1 mm) group. The transfer chain from similar to treatment unit was checked by comparing portal images to their respective simulation image, and no differences between the four subgroups (s = +/- 3.5 mm) could be detected. A methodology was described to compare the costs of both types of masks, and illustrated with the data for a department. It was found that Orfit masks are a cheaper alternative than plastic masks; they require much less investment expenses and the workload and material cost of the first mask for each patient is also lower. Cut-out masks are more expensive than full masks, because of the higher workload and the additional material required for second and third masks that are required in case of field modifications. CONCLUSIONS: No substantial difference in patient setup accuracy between both types of masks was detected, and cutting out the masks had no impact on the fixing capabilities. A first Orfit mask will typically be a cheaper alternative than a plastic mask for most departments (lower fixed and variable costs). The higher material cost of the subsequent Orfit masks, compared to the plastic masks, offset the lower investment expenses.

Severe congenital cutis laxa with pulmonary emphysema: a family with three affected sibs.

Clinical and morphologic findings in 3 sibs with congenital cutis laxa are presented. A severe urinary malformation in one affected infant is reported in detail. Elevated serum copper concentrations were observed in 2 of the sibs and in the healthy mother. However, the 64Cu uptake of fibroblast cells from tissue culture was not increased. Ultrastructural pathologic findings from skin biopsies have been studied and compared at birth and at age 2 years. The lack of junction between the 2 elastic fiber components was similar. Further evidence for clinical heterogeneity of this disease is stressed.