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S9

ESTRO 36 2017

_______________________________________________________________________________________________

possibilities for improvement that were not foreseen at

forehand.

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

physicist for physical

treatment planning, as well as one consultant, ½ resident

and 2½ technicians for the first radiotherapy treatment

and 2

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