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ESTRO 36 2017
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Conclusion
In our patients, there is a significant improvement in late
radiation toxicity after HBOT, with the best responses
being observed in gastro-intestinal and bone toxicity.
PO-1019 Mobile Oncology: Survey with Healthcare
Professionals about Telemedicine, mHealth and mobile
Apps
K. Kessel
1,2
, M. Vogel
1
, F. Schmidt-Graf
3
, S. Combs
2,3
1
Technical University Munich TUM, Department of
Radiation Oncology, München, Germany
2
Institute for Innovative Radiotherapy iRT, Department
of Radiation Sciences DRS, Neuherberg, Germany
3
Technical University Munich TUM, Department of
Neurology, München, Germany
Purpose or Objective
Mobile applications (apps) are an evolving trend in the
medical field. To date, no native mobile applications for
smartphones or tablets in an oncological setting exist,
which support patients during therapy and follow-up and
allow for data analysis and/or direct feedback about
therapy parameters. Moreover, there is an ongoing
discussion whether such apps are really valuable, and
whether healthcare professionals (HCP) will accept their
use in clinical day-to-day life. Hence, we analyzed their
attitude about telemedicine, mHealth, and mobile apps.
Material and Methods
We developed an online survey with 24 questions
evaluating HCPs’ attitude towards telemedicine and
patients using medical mobile apps in general, as well as
specified questions on functionality and possible
disadvantages of an app. A link to the survey was sent to
all HCPs of our hospital via an in-house e-mail distributor
and lasted for six weeks.
Results
A total of 108 HCPs completed the survey. Of all, 88.9%
consider telemedicine as useful, 84.3% versus 15.7%
support the idea of an oncological app complementing
classical treatment. Automatic reminders, timetables,
laboratory results, and assessing side effects as well as
quality of life during therapy were rated as the most
important functions. In contrast, uncertainty regarding
medical responsibility (88.2%) and data security (82.3%)
were reasons mostly named by critics. The wish for
personal contact between HCP and patient (41.2%),
missing technical skills (23.5%) and disbelieving in
improvements of data documentation (23.5%) are
additional reasons. Of all respondents, 77.8% (84/108)
believe in a resulting time saving if collected data by an
app are available at aftercare check-ups, while 22.2%
(24/108) are not convinced of a benefit of app-based
patient documentation. Favorable of an alert function due
to data input by patients with the need for further
clarification are 64.8% (versus 35.2%), 94.3% are willing to
contact the patient after notification. Of all, 93.5%
support the idea to use collected data for scientific
research and 75.0% believe it could be beneficial for the
providing hospital.
Conclusion
The present work shows a great approval for telemedicine,
mHealth and apps in oncology amongst HCPs. Assessing
side effects can lead to quicker response and thus lower
inconvenience of patients. Clinical data as life quality and
treatment satisfaction could be used to evaluate and
improve the therapy workflow. Regular input of patient-
reported outcome or side effects can be used to early
detect and document the disease progression. Overall,
this patient data can be used for scientific evaluations.
Eventually, a mobile app would enhance the patient
relation to his treating department as he has permanent
contact using the mobile app - a trend also evolving in the
medical field.
PO-1020 Re-irradiation of Head and Neck Sarcomas:
initial results of Protontherapy Center of Trento, Italy
I. Giacomelli
1
, D. Scartoni
1
, M. Cianchetti
1
, F. Dionisi
1
, B.
Rombi
1
, M. Amichetti
1
1
Azienda Provinciale per i Servizi Sanitari APSS Trento,
U.O. di Protonterapia, Trento, Italy
Purpose or Objective
Radiotherapy for head and neck (H&N) recurrent sarcomas
is usually limited by the dose tolerance of critical
structures mainly in the skull base. Re-irradiation of such
cases is rarely performed in clinical practice. Numerous
dosimetric studies have shown that proton therapy (PT)
can spare more healthy tissue than conventional X-ray
therapy and it can result in fewer side effects. We report
the preliminary results in terms of feasibility and
tolerance of re-irradiation with PT for recurrent previously
irradiated H&N sarcomas .
Material and Methods
Between November 2015 and September 2016 four
patients (pts) with five recurrent H&N Sarcomas were re-
irradiated with PT. Histology of the primary lesions were:
pleomorphic sarcoma (1), alveolar rhabdomyosarcoma (2),
sclerosing rhabdomyosarcoma (1), radiation-induced
spindle cell sarcoma (1). Median age at re-irradiation was
30.0 years (range, 29.0-50.0 years). Karnofsky
performance status was 90-100. Median interval time
between previous radiotherapy and PT was 55.4 months;
the median total dose received at the first radiotherapy
course was 54.7 Gy (range, 50.4 – 60.0 Gy). Target
definition was based on CT and MR imaging. Median CTV
volume was 45.36 cc (range, 10.48-132.2 cc) and median
PTV volume was 126.4 cc (range, 35.87-277.8 cc). Patients
received a median total dose of 60.0 GyRBE (range, 50.0-
60.0 GyRBE), 1.8–2.0 GyRBE per fraction; two pts received
also sequential and one concomitant chemotherapy. All
pts were treated with active beam scanning PT using 2-3
fields with single field optimization (SFO) technique.
Acute and late toxicities were registered according to
Common Terminology Criteria for Adverse Events version
4.0. Patients’ quality of life was assessed using the
EORTCEORTC QLQ-C30 questionnaire.
Results
Treatment was well tolerated: all patients completed PT
without breaks. Acute Grade 3 cutaneous erythema
occurred in four pts . Registered G2 toxicities were fatigue
(1) and soft tissue edema (1). Concerning late toxicities,
one patient had persistent G1 pain at the site of previous
irradiation and in one pt acute G3 skin erythema became
G1 chronic dyschromia. At a median follow-up of 7.4
months (range, 1.4-12.7 months), all pts are alive with
controlled local and distant disease
Conclusion
Our preliminary experience shows that PT re-irradiation of
recurrent H&N sarcoma is feasible and safe. Longer follow-
up and a larger number of patients are needed to
definitively assess efficacy and late toxicity.
Poster: RTT track: Risk management / quality
management