ESTRO 36 Abstract Book

S107 ESTRO 36 2017 _______________________________________________________________________________________________

techniques for online tumour tracking will be presented and a discussion on the required quality assurance for application in patient treatments. Many motion monitoring techniques may be utilised for online tumour tracking including various internal and external tracking techniques or combinations of the two. Online tumour tracking includes simple adaptation methods such as gating and breathhold techniques which minimise the motion present during the time that the treatment beam is on. However, the main focus in this talk will be on techniques leveraging treatment units specifically designed for intrafraction motion compensation. These include online tumour tracking with robotic (CyberKnife) and gimballed (Vero) linacs, as well as with standard linacs utilising a multi-leaf collimator (MLC) or a robotic couch. The talk will conclude with a discussion of important factors to be considered in the design of quality assurance programmes for online tumour tracking. SP-0215 RTTs skills for proton therapy – how and what to include in a learning programme A. Boejen 1 , T. Trans 1 , M. Madsen 1 , D. Mortensen 2 1 Aarhus University Hospital, Department of Oncology, 8000 Aarhus C, Denmark 2 Aarhus University Hospital, The Danish Centre for Particel Therapy, 8000 Aarhus C, Denmark Treatments with particle therapy (PT) will be common daily practice in more clinics and countries in Europe in the coming years. At Aarhus University Hospital, the Danish Centre for Particle Therapy is currently under construction, and installing and monitoring of equipment for dose delivery will start June 2017. All clinical procedures, such as CT-scanning, dose planning and immobilisation, must be ready for practice, as well as guidelines e.g. for patient pathway, correct dose delivery, image guidance, patient care and management. Interdisciplinary groups are starting to build up a new field. All professions must be qualified in their field to secure patients receive a correct treatment, and all centres are organising education and learning programmes. This presentation will share our experiences concerning development of skills, learning objects and educations programmes for experienced radiation therapists (RTTs) at a centre under establishment, which is expected to be in operation autumn 2018. The presentation will also cover experiences on establishing learning programmes in an interdisciplinary group with no clinical experience in proton therapy and no available online education programmes or documentation of the competencies for RTTs on PT. To secure an international perspective ESTROs Core Curriculums[1] were used as inspiration to build up learning levels and expected outcomes concerning knowledge, skills and attitudes using Bloom's taxonomy[2]. The taxonomy should be used in the field of clinicians, physicists and RTTs, while harmonisation was expected to be useful in the development of interdisciplinary programmes. Hiring of RTTs will start in spring 2018 and is estimated to be expanded with opening of additional gantries every six to twelve months until full employment in 2023. The final learning programme has to consider the progressive increase in employed RTTs and ensure the right competencies for RTTs within treatment preparation, dose delivery and patient care. The preliminary tasks for RTTs were described first and followed by a long list defining specific competencies regarding e.g. management of positioning, fixation, ProBeam, IGRT and side effects. There has to be a Symposium: Particle theraphy: how to start up and carry out daily clinical practice

constant focus on the differences between conventional radiotherapy and PT. The systematic plan with learning levels in all contexts has helped to visualize learning methods in each competence. A 3D virtual ProBeam (VERTUAL Ltd, UK) is being developed and will be integrated together with an IT- laboratory (Varian VMS) as part of the learning features. Interdisciplinary education, supervision and collaboration with physicists and clinicians are important. Observer ships at experienced particle centres and weekly conferences with evaluation of proton plans aimed at learning have contributed to the learning process. [1] The updated ESTRO core curricula 2011 for clinicians, medical physicists and RTTs in radiotherapy/radiation oncology. Eriksen JG et al, Radiother Oncol. 2012 Apr;103(1):103-8. doi: 10.1016/j.radonc.2012.02.007. [2] D.R. Krathwohl, A revision of Bloom’s taxonomy: an overview, Theory Pract, 41 (2002), pp. 212–218 SP-0216 How to start up a proton therapy department – the point of view of a RTT M. Furberg 1 1 Skandionkliniken, Uppsala, Sweden The Swedish proton project started in 2003 with a formation of SPTC (Swedish proton therapy center), which consisted of members of the medical profession. They advocated for a national proton clinic in Sweden, and in 2005 all 21 county politicians agreed that we should have a proton therapy clinic in Sweden. In 2006 the seven counties that have university hospitals formed a municipal federation for advanced radiotherapy and decided that they would build a proton clinic that would be located in Uppsala, in the middle of Sweden. They also decided that the clinic would be based on a distributed competence concept, which means that all expertise available in the country at university clinics will be used and that all preparation for the patient fixation, CT scanning, target delineation and treatment planning would be conducted at university clinics, while the treatment will be delivered at the proton facility. In practice, this means that the university hospitals would make a photon and a proton plan for each of the patients to see whether there is an advantage for protons for the diagnoses that had clinical proton protocols. These plans are presented on a national multidisciplinary video conference where the plans are compared and the clinicians jointly take the decision whether the patient should receive proton therapy. In this case the patient is called to the clinic while fixation devices and the proton plans are sent to the facility. The clinic uses permanent staff, including all RTT/nurses, two permanent physicians and three permanent medical physicists, as well as rotating radiation oncologists and medical physicists from the university hospitals. Process description and risk analysis . The first RTT/nurse was hired a year and a half before the start of treatments, who along with a national multi- disciplinary working group devised a process description and a risk analysis based on the proposed patient course from the university clinics to the Skandion Clinic and back. Two RTT/nurses employed one year before the start of treatments worked together in various national working groups to develop procedures, workflows, train in and configure the systems to be used in the process such as the Mosaiq OIS (oncology information system), patient information system and fixation procedures. Three RTT/nurses joined six months before the start of treatments with responsibility to work up procedures and guidelines for the coordinator, the procedures and guidelines for pediatric treatments and for nursing care at the facility. An important part was dedicated to writing all the required documents for new processes that has to be developed from scratch, so a group of RTT/nurses and Short history, organization and distributed competence .