ESTRO 36 Abstract Book

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S1004 ESTRO 36 2017
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(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
1 hospital 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,
Finland
2Turku University Hospital, Centre for Clinical
Inrformatics, Turku, Finland
3Turku University Hospital, Centre for Clinical
Informatics, Turku, Finland
4University of Turku, Preventive Health Care, Turku,
Finland
Purpose or Objective
Access to care can have a major impact on cancer care
outcomes. Therefore hospitals should provide sufficiently
rapid access and information of the time to support
patients’ decision making of treatment unit. The follow up
data of the access to care for patients is also a criterion
of qualitative cancer care defined by Organization of
European Cancer Institute (OECI). The aim was first to
describe how a gynecological (gyn) and breast cancer (bc)
patient's access to care during their care pathway has
occurred in Turku University Hospital (Tyks) Cancer Centre
after receiving an admission note and secondly submit it
to the electronic portrayal of patient care pathway for
patients.
Material and Methods
The study was carried out VIII / 2015 - IX / 2016 in clinical
information service unit and treatment units in Turku
University Hospital (Tyks) in Finland. The target group was
gyn (N=1549) and bc (N=945) patients starting their first
cancer treatment. The data collection method was a
retrospective registry study. The dates of appointments,
phone calls, multidisciplinary meetings, treatment
decisions and periods (surgery, radiotherapy,
chemotherapy, other treatments) were carried out from
WebMarela, Oberon and Aria information system entries.
Access to care was analyzed from the admission note to
the first treatment unit and to other care contact days.
The results were analyzed by statistical methods (the
mean time and the standard deviation figures). The
accuracy of the results was verified by obtaining a review
of experts from treatment units. The recommended time
of access to cancer care of Ministry of Social Affairs and
Health in Finland were taken into consideration. Results
were presented quarterly and linked electrically internet
sites to the portrayal of patient care pathway for patients.
Results
In total, access time for gyn patients (n=331) from the first
admission note to first treatment unit (gyn surgery
outpatient clinic) contact (first appointment) was 11 days
(mean; quarterly range 10-12) and to surgery 28 days
(mean; quarterly range 24-35) or to
radiotherapy/chemotherapy 41 days (mean, quarterly
range 39-43). Access time for bc patients (n=661) from
the first admission note to first treatment unit (breast
surgery outpatient clinic) contact (phone call) was 4 days
(mean, quarterly range 2-5), to appointment 14 days
(mean; quarterly range 10-15) and to surgery 27 days
(mean; quarterly range 21-33) or to
radiotherapy/chemotherapy 20 days (mean; n=1).
Guarterly, access to care for gyn patients was highest at
second quarter 2015 and 2016, and for bc patients
increased linearly from first quarter 2015 to third quarter
2016. The increase was not depend on number of patients.