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SP-0027 Evaluation of time, attendance of medical
staff,and resources during stereotactic
radiotherapy/radiosurgery:QUIRO-DEGRO trial
A. Zabel-du Bois
1
, S. Milker-Zabel
1
, W. Popp
2
, J. Debus
1
,
H. Sack
3
, R. Engenhart-Cabillic
4
1
University Hospital Heidelberg, Radiooncology and
Radiotherapy, Heidelberg, Germany
2
Prime Networks AG, Prime Networks AG, Basel,
Switzerland
3
University of Essen, Department of Radiation Oncology,
Essen, Germany
4
Philipps-University Marburg, Department of
Radiotherapy and Radiation Oncology, Marburg,
Germany
Purpose:
The German Society of Radiation Oncology
(DEGRO) initiated a multicenter trial to develop and
evaluate adequate modules to assert core processes and
subprocesses in radiotherapy. Aim of this prospective
evaluation was to methodical assess the required
resources (technical equipment and medical staff) for
stereotactic radiotherapy/ radiosurgery.
Methods and Materials:
At two radiotherapy centers of
excellence (University Hospitals of Heidelberg and
Marburg/ Giessen) the manpower and time required for
the implementation of intra- and extracranial stereotactic
radiotherapy was prospectively collected consistently
over a 3 months period. The data were collected using
specific developed process acquisition tools and standard
forms and were evaluated using specific process analysis
tools.
Results:
For intracranial (extracranial) fractionated
stereotactic radiotherapy (FSRT) and radiosurgery (RS), a
total of 1925 (270) and 199 (36) records could be
evaluated, respectively. The approx. time needed to
customize the immobilization device was median 37 min
(89 min) for FRST and 31 min (26 min) for RS, for the
contrast enhanced planning studies 22 and 27 min (25 and
28 min), for physical treatment planning 122 and 59 min
(187 and 27 min), for the first and routine radiotherapy
sessions for FSRT 40 and 13 min (58 and 31 min),
respectively. The median time needed for the RS session
was 58 min (45 min). The corresponding minimal
manpower needed was two technicians for customization
of the immobilization device, 2½ technicians and one
consultant for the contrast-enhanced planning studies,
one consultant, ½ resident and
⅔
physicist for physical
treatment planning, as well as one consultant, ½ resident
and 2½ technicians for the first radiotherapy treatment
and 2
⅓
technicians for routine radiotherapy sessions.
Conclusion:
For the first time, the resource requirements
for a radiotherapy department for the maintenance,
protection and optimization of operational readiness for
the application of intra-and extracranial stereotactic
radiotherapy was determined methodically.
Published in: Strahlenther Onkol. 2012 Sep;188(9):769-76
Symposium with Proffered Papers: Novel approaches in
heart / lung matters
SP-0028 State of the art in heart effects
M.C. Vozenin
1
1
Centre Hospitalier Universitaire Vaudois, Department of
Radiation Oncology, Lausanne Vaud, Switzerland
The therapeutic management of cancer has improved
during the past decade and is today characterized by a
significant increase in survival rates. Although effective on
cure rates, both locoregional and systemic treatments
present some concerns related to the development of
chronic toxicities. The social impact of both acute and
chronic toxicities of treatments is fully recognized and a
specific attention is today paid to the toxicities induced
by anti-cancer treatments as they impact on patients’
quality of life. About fifty percent of cancer patients are
treated with radiotherapy (RT) which is, after surgery, the
most important technique involved in curing cancer. Based
on major technical advances in physics, imaging and
ballistics, a high precision RT dose delivery safely reduces
the volume of irradiated normal tissue and significantly
decrease
complications.
These
technological
improvements make it possible to avoid organs at risk,
such as the heart. This means that today radiation-induced
cardiac toxicity is decreasing but in the mean time the
evolution of treatment’s standards towards combined
therapies suggests that heart toxicity will remain a major
concern within the next years. More specifically, cardiac
toxicity is known to occur in patients treated with
combination of RT with anthracycline or taxanes and
targeted therapies; but appropriate biological evaluation
of acute and chronic toxicities induced by these bi- or tri-
therapies are lacking. Our previous work, suggest
differential activation of 2 members of the small GTPase
pathway
, i.e.
Epac-1 and RhoB, in the pathogenesis of
radiation-induced cardiac toxicity. These targets are
currently investigated in mice treated with
RT+Paclitaxel+Heceptine.
In
addition,
several
inflammatory mediators are release by dying cancer cells
in the course of anti-cancer treatments and the
contribution of such factors to cardiac toxicity is currently
under investigation, models and first results will be
presented.
SP-0029 Pharmacological modulation of cardiac
radiation injury
M. Boerma
1
1
University of Arkansas for Medical Sciences, Other,
Little Rock, USA
For several decades, clinical and epidemiological studies
have identified early and late manifestations of cardiac
radiation injury in cancer patients who received a
relatively high dose of radiation to all or part of the heart.
Radiation therapy has undergone many improvements in
treatment planning and radiation delivery. Nonetheless,
in a subset of patients with thoracic cancers the heart is
still partly exposed, and with the rapid increase in the
number of long-term cancer survivors late side effects of
cancer therapy such as those in the heart are still of
concern. Current treatment of radiation-induced heart
disease is no different from heart disease due to other
causes, and there is no available pharmacological
modulation that prevents or mitigates cardiac injury from
radiation exposure. However, several potential
pharmacological interventions such as anti-oxidant
strategies, angiotensin converting enzyme inhibitors and
transforming growth factor receptor inhibitors have been
tested in pre-clinical models of cardiac radiation injury.
This presentation gives an overview of some of these
recent pre-clinical studies.
OC-0030 In vitro study of FLASH vs. conventional dose-
rate irradiation: Cell viability and DNA damage repair
A. Beddok
1
, C. Fouillade
1
, E. Quelennec
1
, V. Favaudon
1
1
Institut Curie, Inserm U 1021 - CNRS UMR 3347, Orsay,
France
Purpose or Objective
Favaudon et al. recently reported that high dose-rate (>
40Gy/s), 'FLASH” irradiation allows sparing C57BL/6J mice
from radiation-induced pulmonary fibrosis. The
mechanisms which underlie this difference are still
elusive. The purpose of this study was to assess, on the
one hand the cell viability and on the other hand the
activation of two DNA damage response proteins (γH2AX
and 53BP1) after FLASH vs. conventional dose-rate
irradiation (CONV, 0.03 Gy/s).