This report discusses a 28-year-old male patient diagnosed with an intermediate-grade vascular neoplasm in the distal diaphysis of the right femur. The tumour was excised, irradiated extracorporeally and re-implanted, demonstrating the procedure’s feasibility and effectiveness of this approach.

A 28-year-old male patient presented with complaints of claudication. Magnetic resonance imaging revealed a lytic lesion measuring 65 × 40 × 91 mm in the distal diaphysis of the right femur. Positron emission tomography-computed tomography evaluation identified a malignant lytic lesion in the right femur without evidence of distant metastasis. Preoperative imaging suggested malignancy. The bone segment was excised, irradiated with 50 Gy in a single fraction and re-implanted. The patient underwent open reduction, internal fixation and deep soft tissue tumour excision. Histopathology confirmed intermediate-grade vascular neoplasm without angio invasion or perineural invasion. Immunohistochemistry was positive for Pansitokeratin, Vimentin, Cytokeratin-7, D2-40 and CD31 and negative for CD34.

Postoperatively, the bone segment was successfully re-implanted and fixed with metal hardware. Follow-up imaging over thirty months showed successful integration with no local recurrence or metastasis. The patient recovered well without significant complications.

Extracorporeal radiotherapy is a viable technique for treating intermediate-grade vascular bone neoplasms, providing effective tumour control and preserving limb function. This approach could be considered for broader clinical application.

Before COVID-19, breast cancer patients in the UK typically received 15 radiotherapy (RT) fractions over three weeks. During the pandemic, adoption of a 5-fraction treatment prescription and more advanced treatment techniques like surface-guided RT, meant a change in the duration and number of hospital visits for patients accessing treatment. This work sought to understand how breast cancer patients’ time in the RT department has changed, between 2018 and 2023.

Appointments for CT simulation, mould room, and RT, from January 2018 to December 2023, were extracted from the Mosaiq® Oncology Management System. Appointments lasting between 5 minutes and 5 hours were analysed. Total visit time was calculated from check-in to completion on the quality checklist.

In total, 29,523 attendances were analysed over 6 years. Average time spent in the department decreased during the pandemic but has since increased 12·4% above pre-COVID-19 levels. Early morning and late afternoon appointments resulted in the shortest visits, with early afternoon appointments leading to the longest visits. On average, patients spend the longest in the department on a Monday, and the least amount of time on a Friday. Friday was the least common day to start a 15-fraction treatment, whereas Tuesday and Friday were equally uncommon for the 5-fraction regime.

During the COVID-19 pandemic, the number of visits a patient makes for breast cancer RT and related services dropped, and remained lower post-COVID-19, due to fewer treatment fractions being prescribed. Average time spent in the department initially decreased but has since increased beyond pre-COVID-19 levels.

Dental management is critical prior to radiotherapy (RT) for head and neck cancer (HNC) but cumbersome and time intensive. This qualitative study investigates dentists’ evaluative processes to identify areas for improvement.

Semi-structured interviews were conducted with dentists involved in the care of HNC patients. The interviews were guided by the Consolidated Framework for Implementation Research and the Theoretical Domains Framework to identify factors influencing pre-RT dental management.

Five dentists were participated in the interviews. Key themes were identified through qualitative and quantitative evaluation and are as follows: Coordination among care providers, knowledge of the RT plan, visual depictions of dose distribution and understanding of the patient’s dental history.

This study demonstrates the complexity of pre-RT management and identifies key elements. Knowledge of the RT plan and improved interdisciplinary coordination represents opportunities for improvement. Visual dose prediction methods may expedite and improve pre-RT management.

Oral mucositis (OM) emerged in the late 1980s to describe the adverse effects of radiation therapy (RT) on the oral mucosa. OM is the most common and clinically significant acute adverse effect of radiotherapy for head and neck cancer. Symptoms of OM vary from pain and discomfort to an inability to tolerate food or fluids, and it may affect the quality of life, breaks in treatment, hospitalisation, and therefore cancer treatment and outcome. This study aimed to evaluate the pomegranate flower’s efficacy in preventing and treating radiation-induced mucositis due to antioxidant, anti-inflammatory and anti-cancer effects.

This phase II clinical trial was conducted on 50 patients (case and control) with head and neck malignancy. Patients in the case groups were instructed to rinse their mouths with 5 mg Pomegranate powder with 15 cc of sterile water three times a day. The patients in the control group rinsed their mouths with normal saline mouthwash, which is the most relatively accepted preventive and supportive care in this setting. The onset and degree of radiation-induced mucositis were graded during treatment, with ‘WHO mucositis grading’ and the ‘quality of life questionnaire’ (QLQ-OES18).

Forty-eight patients were analysed. There was a significant difference between the two groups on onset and severity of mucositis in the two groups. There were longer intervals for the incidence of different grades of mucositis in the case group, in comparison with the control groups (P value < 0·05). Also, Complaints of dysphagia in the case groups were lower than in the control.

Pomegranate flower seems to be effective at the time of onset, and the severity of oral mucositis during head and neck radiation. It could be a simple, potent, and inexpensive agent, which is easily available.

Valid and informed consent in healthcare is an ethical and legal requirement. This evaluation reports the practices within UK radiotherapy departments surrounding consent processes and therapeutic radiographer (TR) education. This article focuses on those patients who are considered to lack the capacity to consent.

This service evaluation adopted a qualitative research design. Seventy-six radiotherapy department managers were sent the online survey: containing a combination of open, closed and free text questions relating to consent practices. Descriptive analysis using Microsoft Excel was performed; additional correlation analysis was attempted with Fisher’s exact test using Statistical Package for the Social Sciences.

TRs from 39 radiotherapy departments (51%) completed the survey. Analysis of results demonstrated obtaining written consent before radiotherapy treatment was completed in all departments. Assessment methods used to determine capacity to consent varied across the departments. Responses identified 37 departments employ a different consent form for those considered to lack capacity. Thirty-eight departments have a policy surrounding consent; 16 departments reported no formal TR education in consent. Of the remaining 22 departments, 13 departments included lack of capacity within their education package.

To ensure best practice throughout the UK, is it recommended that radiotherapy departments review their consent processes to ensure they are in the best interests of the patient. It is recommended that TRs are familiar with their regulatory body standards and the ethical and legal issues surrounding consent; all departments should consider capacity and those considered to lack capacity within their education and training framework.

A 53-year-old female presented with a large (945 cc) unresectable leiomyosarcoma of the uterus, with metastasis in the lungs, significant abdominal/pelvic pain and evidence of hydronephrosis secondary to obstruction caused by the mass. In an effort to palliate symptoms, radiation was recommended.

Given the size of the lesion, the patient was treated with crossfire GRID, a type of spatially fractionated radiotherapy (18 Gy × 1), followed four weeks later by a short course of external beam radiation (4 Gy × 5).

The patient experienced significant symptom relief. Her abdominal/pelvic pain resolved, and a stent was placed to relieve her hydronephrosis. The tumour volume had decreased significantly (5·5 months post-treatment 276 cc, 8·5 months post-treatment 17 cc). Unfortunately, at 9 months post-treatment, the patient died from progression of her metastatic disease in the lungs.

The use of GRID radiotherapy resulted in effective and sustained palliation of a large uterine leiomyosarcoma in this patient’s case.

This study aimed to assess the perception of radiographers on the difficulties encountered during the delineation of organs at risk (OARs) for radiotherapy planning and the methods that could be used to facilitate this process.

A self-designed questionnaire was distributed to all radiographers (n = 29) employed at the radiotherapy department in Malta. The survey assessed the challenges faced by the radiographers during the delineation of various OARs and inquired about the perceived effectiveness of specific measures that could be used to facilitate the delineation process using a Likert scale ranging from 1 (not difficult/effective) to 5 (very difficult/effective).

The response rate was 79%. Overall, the delineation of OARs was rated as slightly difficult (mean score 1.95 ± 0.33). Nevertheless, some OARs, such as the parotid, stomach and brain stem, were deemed more difficult to contour with a mean score of 3 or higher. The implementation of peer review was perceived as the most influential factor in reducing delineation difficulty (mean score 4.59 ± 0.58), followed by contouring training (mean score 4.48 ± 0.58) and training on artificial intelligence (AI) (mean score 4.35 ± 0.48).

The introduction of peer review, training and AI could facilitate the delineation of OARs.