Page 207 - HA Convention 2015

Corporate Scholarship Presentations

CS3.5 Cancer Services 13:15 Room 228

Overseas Practice of Hospice — Observation and Application in Allied Health of Hospital Authority Tuesday, 19 May
Chan EWH
Medical Social Work Department, Haven of Hope Hospital, Hong Kong

From 19th to 30th May 2014, a team of four allied health professionals including two physiotherapists, one occupational
therapist and one medical social worker attended a five-day programme named “Multi-professional Plus in St. Christopher’s
Hospice (SCH)” on the first week upon arrival and a four-day clinical attachment on the second week.

SCH is the first hospice that provides expert pain and symptom control, compassionate care, education and clinical
research. Its mission is to promote and provide skilled and compassionate palliative care of the highest quality.

During clinical attachment, the team members were assigned to respective allied health professions to have a better
understanding of their facilities and work. This presentation provides an overview of the services offered by SCH to help
explore the feasibility of adopting the service model in medical social service, and to identify the training needs for service
development. Through collaboration with multidisciplinary team, innovative programmes were launched to bring hospice
users and local community together, and to respond to the needs of patient, family and the bereaved. Discussion of death
is no longer a taboo but a reality recognised in the community. The emotional and social needs of the patients, families and
the bereaved are recognised. Social workers and counsellors have a significant role in bereavement service. The application
of advance care planning is essential in laying out a care plan for patients approaching their end of life. The medical social
workers in HA can participate in this subject to facilitate patients’ decision by considering their social and emotional
aspects. We are facing a challenging world which requires ongoing health and social care. As a result, a training pathway
to the allied health professional is in imminent need to enhance the service quality and strengthen the collaboration of the
multidisciplinary team.

CS3.6 Cancer Services 13:15 Room 228

Enhanced Role and Practice of Radiation Therapists in Imaging in Radiation Therapy — Impact on the Treatment HOSPITAL AUTHORITY CONVENTION 2015
Quality
Tang PPK
Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong

The Overseas Corporate Scholarship Programme regarding Imaging for Radiation Therapy is for radiation therapists (RTs) to
enhance competence in RT imaging. Through the clinical attachment in Peter MacCallum Cancer Centre (East Melbourne,
Australia), we have received training for interpretation of images from different imaging modalities, and focused on
radiotherapy planning and treatment respectively.

The new imaging modalities have made remarkable changes in the practice of treatment planning, radiation delivery and
verification in radiotherapy. The co-registration of Magnetic Resonance Imaging (MRI) and Positron Emission Tomography
(PET) with the planning Computed Tomography (CT) provides more detail and precision in target volume and normal
anatomical structure delineation. A more conformal dose distribution plan to the target volume can limit the dose to normal
tissues. However, errors induced from target delineation, organ movements during treatment and patient positioning, which
may result in local failure or over-dosage to the normal tissues.

The introduction of Image-guided Radiotherapy (IGRT) has improved accuracy of radiation delivery. The modern treatment
machines are equipped with On-Board Imaging (OBI) and Cone Beam CT (CBCT). Making a comparison between these
images and treatment plan, image-guided adjustments can be applied to the patient position or radiation beam position;
therefore, ensuring increase precision of treatment delivery.

These new technologies have greatly impacted the role and responsibility of RTs. They have substantially extended the
responsibilities of RTs in treatment planning, especially in normal tissue delineation and computer planning. RTs require
detailed knowledge of imaging modality limitation, image interpretation, normal tissue constraints and their toxicities to
develop a proper plan. Prior to delivering radiation therapy, RTs perform online image-guided corrections to reduce setup
errors via orthogonal KV imaging or CBCT, ensuring that the radiation beam positions are accurate. Bony anatomy matching
between portal images and Digitally Reconstructed Radiograph (DRR) or using CBCT to verify the target and normal organs
positions become a daily routine. Thorough understanding of the roles as well as inter-professional collaboration between
radiation oncologists and other specialties to ensure safety are important. All these changes in practice of RTs improve the
treatment quality.

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