The ANZ ROMP plaque SIG, and the recent Ocular Oncology Planning and Research Days
Lotte S Fog
Ocular plaque brachytherapy is a niche treatment, delivered in only 6 ANZ clinics. It is an unusually multi-disciplinary field, with ophthalmology, physics, medical and radiation oncology, pathology and more professionals involved through patient diagnosis, treatments and outcomes. This is challenging since these professionals typically work in physically separate clinics, meet rarely, know little of each others fields and read very different journals – not many physicists regularly peruse Ocular Oncology and Pathology, and few ophthalmologists regularly sit down with a coffee and the latest edition of The Contemporary Journal of Brachytherapy!
In early 2024, ANZ physicists working with plaques formed an informal SIG and started meeting regularly to share knowledge, experience and interesting cases. This SIG currently has 23 members and has had 14 meetings. These meetings have helped us form a vibrant and useful network which has, in my opinion, strengthened our knowledge and enthusiasm, and has increased physics leadership in the plaque space.
Recently, we had a very successful Planning Afternoon - on Thursday November 13th 2025 - with invited speaker Emeritus Professor Melvin Astrahan, and in-person attendance from plaque clinics in Perth, Adelaide, Melbourne, Sydney and Brisbane. We all became more familiar with the only available image-based planning TPS, Plaque Simulator™, written by Prof Astrahan. On Friday November 14th, we held a Multidisciplinary Research Day, where the 45 attendees included physicists, ophthalmologists, medical and radiaiton oncologists, pathologists, orthoptists, scientists and industry representatives, who spent 8 hours discussing Ocular Oncology Research. This was crucial, as – even with excellent physics input - it is in this multi-disciplinary space that the magic happens.
From my personal perspective, both these days were wonderful, and more successful than I had dared hope for. On the Planning Day, I believe that all the ROMPs learnt very much from Prof Astrahan – several of us are now keen to play an instrumental role in improving practice. On the Research Day, the talks were very varied, and covered dosimetry, genetics, systemic therapy, data registries and more. What made me particularly delighted was interactions between the attendees interacted, in the sessions and the breaks – even attendees from the same city typically work in hospitals that are physically separate – there were many bridges to cross, and many were. The buzz of the break-time conversations will stay with me for a long time. In my opinion, these conversations are where the magic happens.
Ocular oncology is a rapidly changing field. Opthalmologists manage the patients, and are keen to learn from patient outcomes. Systemic therapy provided through medical oncology has recently become available, and this can be used to shrink tumours pre-brachytherapy and reduce toxicity – it may even reduce the likelihood of metastasis – crucial since about half of the patients currently develop liver metastasis. Pathology plays a crucial part as analysis of biopsy results can inform patient follow-up, since genetic make-up means that some patients are more likely to have better clinical outcomes than others. The implementation of image-based planning is likely to improve patient outcomes, and radiation oncology should be included in this process. In this multi-disciplinary space, physics can play a leading role – as has been demonstrated in several recent publications:
https://www.sciencedirect.com/science/article/abs/pii/S0167814024000355
https://www.sciencedirect.com/science/article/pii/S0008418224000747
https://discovery.ucl.ac.uk/id/eprint/10195596/1/FTB final.pdf
https://www.sciencedirect.com/science/article/abs/pii/S2468653023005018?casa_token=oyUbkpc27HkAAAAA:uUZi-9ZHB6uMoH7lsf2PAsbKSysdjuoHVaejrBtVzcnly9LDa7DwizvDAbiz258_bvDGOuDSJg
It is in this multi-disciplinary space that our magic happens, and I look forward to the ANZ plaque ROMPs being instrumental in this space.
Please find the agenda for the Research Day here.
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