259 / 1082
S246
ESTRO 36 2017
_______________________________________________________________________________________________
associated with this field of medicine, evidence-based and
rigorous systems are imperative. The implementation of
such systems facilitates the reactive enhancement of
patient safety following an event. This research study was
undertaken so as to evaluate Irish event reporting-and-
learning procedures and to propose recommendations as
to how the national standard can be improved to the
optimal standards outlined in the literature. The
methodology used to undertake this research was
developed with the aim of ensuring its applicability to
international practice, allowing for further similar studies
to be performed in other countries.
Material and Methods
An evidence-based event reporting-and-learning process
map was developed from recommendations in the
literature [see Figure 1], followed by a questionnaire to
assess a radiation therapy centre’s compliance with this
map. Radiation Therapy Service Managers of Irish radiation
therapy centres (n=12) were invited to participate in the
anonymous online questionnaire. Frequency analysis of
closed-ended questions and thematic analysis of open-
ended questions was performed to assess the data.
Results
A 91.7% response rate was achieved. The
following improvements were found to be most in need of
occurring: decreased variation in event classification and
taxonomy, expanded use of external reporting systems,
and heightened dissemination of lessons-learned to wide
audiences. A recommendations table was developed to
present methods in which required standardisation and
enhancement of practice can be achieved [see Table 1].
Conclusion
This study identified aspects of Irish event reporting-and-
learning systems wherein improvements are necessary.
The recommendations made can be utilised to optimise
the national standard of incident and near-miss
management in Ireland. Due to their evidence-based
nature, they can also be applied to the field of radiation
therapy across the globe. With such developments, a
worldwide enhancement of the safety-culture in the field
of radiation therapy can occur.
Symposium: Non-rectal GI tumours: key open questions
to be answered from (and for) the radiation oncologist!
SP-0469 Radio(chemo)therapy in oesophageal cancer:
can we do better?
M. Hulshof
1
1
Academic Medical Center, Dept Radiation Oncology,
Amsterdam, The Netherlands
The indications for radiation in esophageal cancer have
increased dramatically in the last 15 years, and the
developments of chemoradiation for esophageal cancer
can be defined as a success story: Preoperative
chemoradiation became standard since phase III trials
have shown that overall survival did increase in resectable
stage of disease and the results from studies with
definitive chemoradiation for irresectable\inoperable case
has changed the treatment intent from palliative to
curative. The indications for palliative radiotherapy
remained unchanged. Thus the vast majority of
esophageal cancer patients will get radiotherapy
somewhere in their disease tract. This recent change is
the reason that improvements in radiation accuracy for
esophageal tumors are running behind compared to longer
existing indications like prostate. Improving radiation
accuracy in esophageal tumors is challenging because of
its mobility by breathing effects, the anatomical changes
that can occur during the treatment period and the
difficulties of accurate delineation of macroscopical
tumor borders on a CT scan. This challenge becomes even
larger because the impact of all these uncertainties have
shown to differ between the different levels of the
esophagus, i.e. proximal, mid versus distal. Use of