Image-guided radiotherapy for prostate cancer in the United Kingdom: a national survey

Objective: To survey the technology and practice of image-guided radiotherapy (IGRT) for prostate cancer in the UK. Methods: A pre-tested semi-structured online questionnaire was sent to National Health Service (NHS) and private radiotherapy providers in the UK between March and April 2014. The survey was carried out on the Opinio c online platform. Results: There was a high survey response rate of 83%. There is widespread use of intensity-modulated radiotherapy and advanced verification imaging modalities. Cone-beam CT (CBCT) is the main verification imaging modality in radical prostate radiotherapy, used in 66% of UK centres. Fiducial markers in combination with imaging were used in 30% of centres. Over half the centres used a daily imaging schedule, with a Day 1-3 frequency followed by weekly frequency used less commonly. 26% of centres used daily CBCT. Conclusion: There is widespread use of volumetric verification imaging with CBCT for prostate radiotherapy in the UK. There is no consensus on the optimal verification imaging schedule. Advances in knowledge: This survey provides an insight into contemporary UK practice of IGRT for prostate cancer, both in the NHS and private sector. It demonstrates the widespread use of CBCT imaging and highlights the need for further research to optimize the practice.