ESTRO 36 Abstract Book

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S1018 ESTRO 36
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Conclusion
Alerts are an issue in the radiotherapy. This research
shows that for each patient treatment the user must deal
with 1 to 5 alerts depending on the supplier. This indicates
that bad alerts management will not lead to false
radiation. On the other hand an overkill from alerts will
lead to alerts tiredness.A linear accelerator can make over
more than one thousand alerts. For the user is unthinkable
to deal with all these alerts. But act on a random basic is
also not conceivable.
EP-1863 Risk analysis for image guided lung SBRT
A. Perez-Rozos1, I. Jerez-Sainz1, A. Roman1, A. Otero1, M.
Lobato 1, Y. Lupiañez1, J. Medina1
1 Hospital Virgen de la Victoria, Radiation Oncology.
Medical Physics., Malaga, Spain
Purpose or Objective
Stereotactic Body Radiotherapy (SBRT) is a complex
technique that reduce number of sessions and increase
fraction dose, with higher accuracy requirements. In this
work we carry out a risk analysis of our lung SBRT
simulation, planning and treatment process using Failure
Modes and Effects methodology (FMEA).
Material and Methods
FMEA analysis was performed by a multidisciplinary team
integrated by radiographers, nurses, medical physicists,
and radiation oncologists. Main steps were: identify flux
diagram of whole process, assign risk and probability for
every steps, and specific analisys of higher RPN number
steps to reduce global risk uncertainty.
Results
Main analyzed steps include: a. Simulation, b. Prescription
and treatment planning c. Preparation and treatment
verification d. Treatment delivery. Every step was then
described with higher detail. The detail degree has to be
enough to allow for clarity, but not too high to loose in
small unimportant steps.
In every substep we identifyed failures modes and effects
and risk piority numbers (RPN) were assigned, using a
score for severity, ocurrence and detection probabilities
(scores from 1 to 10). RPN numbers were promediated
between team members. Failure modes with the higher
scores were given the maximum priority to subsequent
study to apply specific QA or to take measurements to
reduce RPN number. We have identifyed 32 events, the 5
with higher scores were selected in a first stage to reduce
risk numbers. Critical steps involved isocenter transfer
and integrity between image and treatment system,
prescription errors between oncologist prescription and
electronic one, and mistakes in treatment delivery.
Conclusion
Risk analysis in radiotheapy process must be a priority to
identify weakness and reduce uncertainty.
Multidisciplinary teams help to make flux diagrams,
identify critical steps and increase global safety.
EP-1864 Control of patients with
pacemaker/implantable cardioverter defibrillator
undergo radiotherapy.
M. Puertas Valiño1, A. Mendez Villamon1, M. Gascon
Ferrer1, C. Vazquez Sanchez1, P. Sanagustin Pedrafita1, J.
Castillo Lueña1, M. Tejedor Gutierrez 1
1hospital universitario miguel servet, radiotherapy,
zaragoza, spain
Purpose or Objective
To establish a few basic criterias of control of the device,
in patients submitted to irradiation, without generating an
excessive load of work for the involved services and a
stress to the patient.
Material and Methods
There has been created a patient registration sheet, with
the clinical information of these and with those
parameters relating to the treatment, as well as symptoms
suffered by the patient and the information it brings over
of the functioning of the device. A protocol of action has
been established, so that when a patient of these
characteristics is considered to be subsidiary of treatment
by ionizing radiation, some procedures are carried out:
1. Consultation to the Service of Cardiology of our center,
for the first valuation.
2. Preparation of the treatment , bearing in mind, the
distance of the field of irradiation to the device. Make sure
that the device does not receive a direct, unshielded
irradiation.
3. Schedule of treatment for these patients, making easier
the control for the cardiologist of our institution.
Once the treatment sessions have finished, the final
review is realized and the opportune controls are ruled.
Results
From the beginning of the project in March 1, 2016, there
have been radiated in our department, 16 patients with
cardiac implantable devices .
- 5 women and 11 men.
- The middle ages are 76,8 years (66 years to 86 years).
- All of them were non-pacemaker-dependent
- The tumour pathology origin of the need of irradiation
has been:
- Carcinoma of lung 8 patients.
-Carcinoma of breast 5 patients.
-Brain Metastasis 1patient.
-Cancer of rectum patient 1.
Cancer of larynx patient 1.
-The dose of radiation the patients has been variable:
between 30 Gy (300cGy/sesión) in case of cerebral
metastases, to 69.3 Gy (210 cGy/sesión) in case of the
carcinoma of larynx or an extreme hipofraccionamiento in
the SBRT of lung, with dose of 60 Gy, in meetings of
1200cGy. In two cases, the patients received concomitant
chemotherapy. - The used energies have been, in the
majority of the patients, photons of 6, 10 and 15 MV. Only
in a case of cancer of breast, the irradiation of photons
was followed by 3 meetings electrons.
The review of the device, it has not showed alterations of
this one in any case. There have been checked the
medication, syncopes, IC, as well as all the parameters of
the programming of the pacemaker or defibrillator,
without some alteration be observing.
Conclusion
In our patients some alteration has not been targeted in
the device after the irradiation, independently of the
dose. On balance, RT may be delivered safely in carefully
selected patients without the need to remove the PM/ICD
from the vicinity of the RT field.
EP-1865 The utilization of retrospective registry for
patient information of access to care
M. Siekkinen 1, M. Stepanov2, A. Hammais3, P. Rautava4
1Turku University Hospital, Cancer Centre, Turku,