ESTRO 2020 Abstract book

S732 ESTRO 2020

Purpose or Objective We report the first magnetic resonance image guided radioablation (MR-IGRA) in a patient with dilated cardiomyopathy and recurrent sustained ventricular tachycardia (VT) associated with several electrical storms. Material and Methods A 71-year-old male patient with non-ischemic dilated cardiomyopathy continued suffering from recurrent life- threatening VT and electrical storms with recurrent antitachycardia pacing and ICD shocks, despite optimized guideline-directed heart failure treatment, maximal antiarrhythmic medication, two endocardial radiofrequency catheter and one epicardial surgical ablation. Results Phantom measurements showed a distortion of less than 1.5 mm due to the ICD. Areas of anatomical scarring and critical substrate in the basal LV were identified to build a volumetric target using invasive three-dimensional electroanatomical mapping of the VT during previous electrophysiologic studies as well as cardiac MRI/CT. The patient was treated with a single fraction of 25 Gy @ 85% isodose. Cine tracking time was 46 minutes, beam on time 24 minutes. 24 hours post intervention the patients developed aggravation of VT and a prolonged electrical storm. VT ceased following high-dose dexamethasone administration at day 2 after MR-IGRA. In the first month of follow-up no episodes of VT and complications were detected. Left ventricular ejection fraction remained stable at 25%. Conclusion In this first MR-IGRA, real-time tracking and beam gating was successfully applied to treat a patient with dilated cardiomyopathy and recurrent therapy-refractory sustained VT with electrical storms. As of two days post treatment the patient has been without episodes of sustained tachyarrhythmia. PO-1297 Utilization of Radiation Therapy and Predictors of Noncompliance among Syrian Refugees in Turkey M. Sayan 1 , M. Eren 2 , A. Kötek 3 , S. Oskeroğlu Kaplan 4 , Ö. Duran Hoşkan 4 , F. Çukurçayır 5 , İ. Babalıoğlu 6 , Ö. Derinalp Or 7 , A. Öztürk 8 , C. Eroğlu 9 , F. Teke 10 , N. Kurtul 11 , T. Kütük 12 , B. Ceylaner Bıçakçı 13 , Ş. Şenyürek 14 , M. Aktan 15 , N. Ohri 1 , B. Haffty 1 , B. Atalar 16 1 Rutgers Cancer Institute of New Jersey, Radiation Oncology, New Brunswick, USA ; 2 Marmara University Pendik Education and Research Hospital, Radiation Oncology, Istanbul, Turkey ; 3 Gaziantep Dr. Ersin Arslan Education and Research Hospital, Radiation Oncology, Gaziantep, Turkey ; 4 Şanlıurfa Mehmet Akif İnan Education and Research Hospital, Radiation Oncology, Şanlıurfa, Turkey ; 5 Balıkesir Atatürk City Hospital, Radiation Oncology, Balıkesir, Turkey ; 6 Konya Education and Research Hospital, Radiation Oncology, Konya, Turkey ; 7 Adana City Education and Research Hospital, Radiation Oncology, Adana, Turkey ; 8 Bursa Ali Osman Sönmez Oncology Hospital, Radiation Oncology, Bursa, Turkey ; 9 Erciyes University, Radiation Oncology, Kayseri, Turkey ; 10 Dicle University, Radiation Oncology, Diyarbakır, Turkey ; 11 Kahramanmaraş Sütçü İmam University, Radiation Oncology, Kahramanmaraş, Turkey ; 12 Malatya Education and Research Hospital, Radiation Oncology, Malatya, Turkey ; 13 Dr. Lütfi Kırdar Kartal Education and Research Hospital, Radiation Oncology, Istanbul, Turkey ; 14 Kahramanmaraş Necip Fazıl City Hospital, Radiation Oncology, Kahramanmaraş, Turkey ; 15 Necmettin Erbakan University, Radiation Oncology, Konya, Turkey ; 16 Mehmet Ali Aydınlar Acıbadem University, Radiation Oncology, Istanbul, Turkey Purpose or Objective According to the United Nations Refugee Agency, 5.6 million registered Syrian refugees have fled from their

Patients could follow RAMSI's trends on a notice board in the ward, on the Department Facebook page and website (Figure 1). The results of the RAMSI system surveys contributed in our experience to the implementation of specific corrective actions.

Conclusion The RAMSI project is the first reported application of SI Terminals in clinical practice, especially in radiotherapy with the aim of collecting perception of quality of received services and assistance. The evaluation of health structures through RAMSI could led to a “patient-focused” definition of the quality of assistance. This type of evaluation should be considered as a relevant opportunity to improve health services in order to guarantee patients wellness and satisfaction. PO-1296 First MRI Guided Cardiac Radioablation of Sustained Ventricular Tachycardia M. Mayinger 1 , K. Boldizsar 2 , S. Ehrbar 3 , L. Wilke 3 , M. Chamberlain 3 , A. Moreira 3 , N. Weitkamp 3 , C. Brunckhorst 2 , F. Duru 2 , J. Steffel 2 , A. Breitenstein 2 , H. Alkadhi 4 , H. Garcia Schueler 3 , R. Manka 4 , F. Ruschitzka 2 , M. Guckenberger 3 , A. Saguner 2 , N. Andratschke 3 1 Universitätsspital Zürich, Radiation Oncology, Zürich, Switzerland ; 2 University Hospital Zurich, University Heart Center Zurich, Zurich, Switzerland ; 3 University Hospital Zurich, Radiation Oncology, Zurich, Switzerland ; 4 University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich, Switzerland