Royal North Shore Hospital’s data-driven approach to radiation oncology
Fifteen years ago, when Professor Tom Eade began working at Royal North Shore Hospital (RNSH) as a radiation oncologist, he was eager to set up a solid system to collect patient data for research.
He’d been inspired by the approach to cancer research he’d seen during his fellowship in the United States. “There was a lot of interest in collecting clinical trial data and evidence-based practice,” he says. Today, the department boasts a sophisticated system that helps doctors and many other highly-skilled staff run a range of pioneering studies, which help improve cancer treatment and patient outcomes. A focused approach to collecting patient data means doctors and staff can run real-time audits of the approximately 1,000 patients treated at the centre each year. “We use the data to help understand where we need to do better for our patients, which educates us in future trial design, and which studies we should recruit to.” Aside from running data-driven studies, Tom says the department also has a long history of being strong in the technical aspects of cancer treatments due to ongoing basic scientific research. “We’re getting better imaging of the cancer, and we’ve got better technology for delivering and planning the radiation.” Impact of radiation treatment The data collected at RNSH encompasses not just cancer outcomes but also the side effects of radiation treatment, an area that is of particular interest to the radiation therapy community.
“It’s quite hard for most clinicians to report because if you cure a patient, they don’t tend to turn up after five years and obviously, if you haven’t cured them, then it’s sometimes hard to work out what was the cancer and what was the radiation treatment,” says Tom. But the department is in a unique position because they have well-established communication with patients, which in some cases stretches over 15 years, so they can keep asking questions about side effects. “Having our infrastructure in place also allows us to have a really good feeling about our patient cohort – the risk group, the stage of their cancer, and what types [of cancer].” Trials unique to NSLHD With a strong database, the department can more easily enrol patients in multicenter studies and run their own in-house research. Over the past few years, Tom and the team have been able to design and complete randomised phase III clinical trials that are specific to the patient cohort in the district. Recent successes include completing a 500-patient prostate cancer study comparing treatment durations, and a breast cancer study focused on shorter fractionation periods for radiation therapy.
The department is also researching palliative radiation.
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