ESTRO 2020 Abstract book

S390 ESTRO 2020

outcomes and enhance the therapeutic index.

To reduce daily sedation of children during teletherapy, the University Hospital for Radiotherapy at the General Hospital of Vienna (UKSTR) started a pilot scheme that took place between July 2017 and May 2018. To ensure that the children maintain their position during the radiation, they are being cognitive distracted with the help of tablets showing short movies. This approach could reduce or even eliminate anxiety and stress Furthermore, the number of daily radio- oncological treatments of children and youths should increase at the UKSTR. An optimal use of available resources leads to a reduction of costs, which means the economical aspect would met. Method Based on medical guidelines all patients (aged 0-18) were given the video-assisted immobilisation utilisation as an avenue by the radiologic technologists (RTs). After a standardised evaluation, the personal needs were implemented in the VAR sequence. To achieve optimal results in the VAR method it is crucial to start the cognitive distraction of children and youths already during the preparation of the radiation therapy (planning CT scan, simulation). The adequate preparation is vital in this pilot scheme. Results During the specified period (July 2017- May 2018) 38 children and youths (24 male, 14 female) were treated, all younger than 18 years. 52% of the treated children and youths were cognitive distracted by movies during the radiation therapy. 34 % of the patients did not want to watch a movie. The other 13% had to be sedated during teletherapy. The selective increase observed at the UKSTR was 50%. Conclusion The VAR method was successfully implemented in the clinical routine. All the aims of the project were met. For this method to be successful, an accurate briefing of the child, the family and all other professionals (RTs, nurses, doctors) involved is an essential requirement. The reduction of costs is another significant aspect: Per child and treatment cycle this means a possible cost reduction of 2800 Euros, not to forget the efficient usage of existing resources (personnel expenses, occupied medical devices) due to the clinical use of the VAR method at the UKSTR. SP-0642 How to become a department head – a medical physicist’s perspective P. Keall 1 1 University of Sydney, ACRF Image X Institute, University of Sydney- NSW, Australia Abstract text Careers in science and medicine have a paradox. Success in the discipline we have been trained in for many years results in attaining leadership and management positions, in which we generally have very little training. In this presentation I will discuss the very non-linear journey I had to become firstly a radiation physics division director and currently a research institute director. I will outline some of the challenges and lessons learned along the way, and review the question of why we want – or shouldn’t want – leadership positions. Symposium: How to become a department head

SP-0640 Challenges in Treating Older Adults with Cancer A. O'donovan 1 1 Trinity College Dublin, Discipline Of Radiation Therapy, Dublin, Ireland Abstract text In the years to come, the incidence cancer in older people in Europe, and throughout the world, will rapidly increase, particularly in those aged 80 and older i.e. the “oldest old”. It is very timely to consider the impact of this projected change, not only on the oncology infrastructure required to effectively manage additional patients, but also the demands of an ageing population and the health service planning changes that may be required to respond to their needs. Clinically, patients will present with variable performance status. It is known that chronological age is a poor representative of physiologic age, and that frailty more accurately captures a patient’s reserve capacity. Characterising the heterogeneity of the older cancer patient cohort, and their ability to tolerate oncologic treatment, is the main rationale for the incorporation of geriatric medicine principles into radiation oncology. Frailty forms the basis for the practice of geriatric medicine, but remains poorly appreciated in other aspects of medicine, such as oncology. It has been defined in the gerontology literature as a consequence of age-related decline in many physiological systems, resulting in a reduced reserve capacity and increased vulnerability to stressors. This vulnerability is related to an inability to maintain homeostasis in the face of a physiological threat e.g. cancer and its treatment. The important thing to note in relation to the clinical presentation of frailty, is that compared to disability, frailty is potentially reversible, when managed effectively and appropriate interventions put in place to deal with deficits identified. This has the potential to prevent falls, hospitalisation, nursing home placement and other important quality of life indicators. Various interventions are recommended in order to prevent or slow the onset of frailty in this patient population. There are also a number of age appropriate considerations that we need to consider in clinical practice. The daily nature of radiation therapy over the course of a few weeks, depending on treatment site, is a significant undertaking for older patients in particular. Increasingly hypofractionated regimes have been used in the older patient population in particular, especially for those with known social frailty. This is one potential way to widen access to radiation therapy in this patient population. This symposium aims to illustrate the challenges for treating older patients with cancer in Europe, by considering their age-related changes or underlying frailty, how it may be assessed in radiation oncology, appropriate interventions, the current evidence base and some site specific indications. SP-0641 Video-assisted Immobilisation (VAR) of Children and Youths during external beam radiotherapy N. Ritt Universitätsklinik für Strahlentherapie, Brachytherapie, Wien, Austria.

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