McLeod Radiation Oncology – Ensuring Quality and Safety in Patient-Centered Care


by Tobin Hyman, MS, DABR

For 57 years, McLeod Regional Medical Center has provided radiation therapy to cancer patients in the region. Building on the 115 years McLeod has cared for patients and families, the McLeod Center for Cancer Treatment and Research has continued to grow and evolve to meet the cancer needs of the community at large.

Since the opening of its dedicated cancer facility in 2013, McLeod has invested more than $14 million dollars in the technology of three Varian TrueBeam linear accelerators to deliver radiation to our cancer patients while minimizing harm to healthy tissue and bones such as the spinal cord or lungs. These accelerators also allow us to perform stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) — two advanced forms of treatment that deliver precisely-targeted radiation with sub-millimeter accuracy in a fewer number of treatments offering patients more convenience and a better quality of life.

Stereotactic radiosurgery, a non-surgical radiation therapy, treats cancerous tumors in the brain and spine. The radiation is focused onto the area of disease to completely cover it with the dose necessary to overwhelm all of the abilities of a cancer cell to defend itself. This non-invasive, painless treatment utilizes a set of multiple beams that intersect at a single point on the tumor. The beams remain focused on the area as the linear accelerator rotates around the patient’s head. When performing SRS to the brain, the team ensures extreme precision and accuracy with the TrueBeam STx linear accelerator. This linear accelerator features stereoscopic X-rays and frameless technology, which means the McLeod team delivers highly accurate single fraction treatment without the conventional, invasive frame applied to the patient’s head.

Featuring advanced imaging capabilities such as cone-beam CT, these linear accelerators also allow the team to verify the tumor’s location or make adjustments during treatment. This drastically decreases the treatment time which increases patient comfort without compromising the quality of the treatment delivered.

Advantages of SRS and SBRT for patients include the ability to receive treatment close to home. Understanding that a cancer diagnosis is a life changing event for all of our patients, the decision by McLeod to invest in the technology to plan and accurately deliver this type of cancer treatment means patients do not have to leave home to receive the highest level of care. Some of these patients are also living with advanced disease. At this point in their cancer journey, patients often want to reach certain milestones. They wish to spend quality time with their family and friends. We make that possible by offering these cutting-edge cancer treatment options.

With a fewer number of treatments, SRS and SBRT also benefit patients by saving them time. For example, compared to conventional whole brain radiation therapy which involves smaller daily doses of radiation in 10 treatments, SRS delivers five to ten times the daily dose of radiation in one to five treatments. The increased dose improves the effectiveness of this form of treatment and the side effects are significantly less by treating smaller volumes. Additionally, in the treatment of lung cancer, SBRT can be performed in as few as three to five sessions as opposed to four to eight weeks of conventional radiation.

Of primary emphasis to the members of the team in Radiation Oncology is the pursuit of quality. The Agency for Healthcare Research and Quality defined quality as “doing the right thing, at the right time, in the right way, for the right person – and having the best possible results” (AHRQ 2001). The process of preparing a patient for radiation therapy is complex, involving many different practitioners (physician, medical physicists, simulation therapists, dosimetrists, nurses) before reaching the accelerator or other treatment machine for the delivery of the daily treatment by the radiation therapists. As a result, it is imperative that operational procedures are standardized, and, where possible, error-proofed as much as possible to maintain the overall quality of the treatment. This is where accreditation comes into play.

The Radiation Oncology department at McLeod Regional Medical Center has the distinction of being the only accredited radiation oncology department within 60 miles of Florence. The department is accredited by the American College of Radiology – Radiation Oncology Practice Accreditation (ACR-ROPA and is currently pursuing its’ fourth three-year accreditation cycle. Of the 2,300 radiation oncology facilities in the United States, only 776 are accredited by ACR-ROPA. Our department is one of the 33.7% facilities to choose accreditation through the ACR-ROPA program, and one of approximately 50% of centers to voluntarily submit to accreditation of any kind. Additionally, the department has also achieved international recognition as a Novalis Certified Radiosurgery Center. McLeod is one of only 11 centers in the USA to receive this distinction, and one of only 50 in the world.

We believe that we have a great responsibility to patients and their families to commit our staff and equipment to a 360-degree review of our radiation oncology program. In today’s healthcare environment, specialized treatment techniques such as SRS and SBRT should undergo a comprehensive external review at regular intervals to ensure the safest care possible is being delivered when treating patients with cancer. Our dedication to quality serves as a daily reminder of how far we have come as an organization in our efforts to provide patient-centered cancer care.

Tobin Hyman, MS, DABR, is a board certified medical physicist who returned to the Department of Radiation Oncology in 2007 to serve as the Chief Medical Physicist for McLeod Regional Medical Center. Originally from Pamplico, SC, Hyman considers it an honor to care for the people in this region. He also serves as a surveyor for the American College of Radiology – Radiation Oncology Practice Accreditation (ROPA) program, is a member of the ROPA committee, and is active in product/technology development within radiation oncology. He is also currently serving as a member of the North Carolina Medical Accelerator Working Group.