ESTRO 2023 - Abstract Book

S1042

Digital Posters

ESTRO 2023

Skin tattoos represent the standard for surface alignment and setup of breast cancer radiotherapy yet contribute to adverse cosmesis and patient dissatisfaction. With the advent of contemporary surface imaging technology, we evaluated setup accuracy, time, and dosimetry between “tattoo-less” and traditional tattoo-based setup techniques. Materials and Methods Patients receiving chest wall radiation for breast cancer underwent traditional tattoo-based setup (TTB), alternating daily with a tattoo-less setup via surface imaging using AlignRT (ART). Following initial setup, position was verified by daily kV imaging, with matching on the chest wall bony anatomy representing ground truth. Translational shifts (TS) and rotational shifts (RS) were ascertained as were setup time and total in-room time. Delivered dosimetry was calculated using the reverse isocenter shift technique. Statistical analyses used the Wilcoxon Signed Rank test and Pitman-Morgan variance test. Results A total of 39 breast cancer patients requiring chest wall and regional nodal irradiation were analyzed, For tattoo-less setup via ART, the median absolute TS in the vertical dimension was 0.28cm (range: 0.14 - 0.48), whereas for TTB it was 0.34cm (0.15 – 0.52) (p = 0.038). Analysis based on 95% CI. In the lateral dimension, ART TS was 0.24cm (0.10 - 0.40), vs 0.29 (0.13 – 0.46) for TTB (p = 0.007). In the longitudinal dimension, ART TS was 0.26cm (0.13- 0.44) vs 0.34cm (0.14 – 0.59), for TTB based setup (p<0.001). Variance testing revealed increased precision with ART in the vertical (p < 0.001) and longitudinal (p < 0.001) axes. The median absolute RS for ART was 0.80° rotation (range:0.40-1.50), 0.60° roll (0.20-1.20), 0.50° pitch (0.10-1.00). The corresponding median RS for TTB was 1.00° (0.40-1.70), 0.60° (0.20-1.20), and 0.50° (0.10-1.00). For rotational shifts, ART was statistically significantly more accurate than TTB (p = 0.023). ART setup was otherwise not statistically different from TTB in terms of roll and pitch (p=0.558, 0.929, respectively). ART showed no difference in precision versus TTB in terms of RS, pitch, and roll (p=0.181, p=0.544, p=0.858). The median total in-room time for ART was 18.77 min (range: 16.04-20.77) and 18.70 min (17.58-20.67) for TTB (p=0.38). The median setup time was 12.75 min (11.43-14.80) for ART and 13.78 min (12.42-15.09) for TTB (p=0.054). There was no significant difference between the AlignRT method and the tattoo-based method for both setup time and in-room time. Conclusion These results suggest that a tattoo-less setup approach with AlignRT (ART) may be sufficiently accurate to supplant surface tattoos for patients receiving chest wall breast radiation. Further analyses with larger cohorts will determine whether tattoo-based (TTB) approaches can be replaced by surface imaging. 1 University Medical Center Bonn, Radiation Oncology, Bonn, Germany; 2 Johanniter Hospital , Gynecology and Obstetrics, Bonn, Germany; 3 University Medical Center Bonn, Radiation Oncology , Bonn, Germany; 4 University Medical Center Bonn, Gynaecology and Gynaecological Oncology, Bonn, Germany; 5 University Medical Center Bonn, Senology and Breast Center, Bonn, Germany Purpose or Objective Breast cancer patients often participate in shared decision-making to select a treatment regimen from multiple options. However, dissatisfaction with treatment outcomes can lead to decision regret. We evaluated decision regret and physical and psychological well-being among breast cancer patients who underwent adjuvant radiotherapy and explored associations with patient, tumor, and treatment characteristics and symptoms. Materials and Methods This cross-sectional study involved retrospectively obtaining clinical data and data collected through interviews carried out within regular long-term medical aftercare. Decision regret was assessed using the Ottawa Decision Regret Scale, physical and psychological well-being were assessed using the PROMIS Global Health-10 questionnaire, and patients were also asked about their treatment outcomes and symptoms. The questionnaire was administered 14 months to 4 years after completion of radiotherapy. Results Of the 172 included breast cancer patients, only 13.9% expressed high decision regret, with most patients expressing little or no decision regret. More decision regret was associated with volumetric modulated arc therapy, chest wall irradiation, use of docetaxel as chemotherapy, lymphangiosis carcinomatosa, arm or hand swelling, and lower psychological well-being. Conclusion Although most patients reported little or no decision regret, our findings identify several treatment characteristics that are associated with more decision regret. Our findings also suggest that psychological well-being influences patients’ satisfaction with therapy decisions, implying that practitioners should pay special attention to maintaining psychological well-being during shared decision-making and ensuring that psychological assessment and treatment is provided after cancer therapy to deal with the long-term effects of radiotherapy. PO-1301 Decision Regret in Breast Cancer Patients after Adjuvant Radiotherapy C. Hoppe 1 , A. Schröder 2 , D. Koch 3 , D. Scafa 3 , C. Leitzen 3 , C. Schmeel 3 , A. Mustea 4 , A. Faridi 5 , F. Giordano 3

Poster (Digital): Lung

PO-1302 Impact of FEV1 and DLCO on survival and lung toxicities in NSCLC patients treated with radiotherapy