ESTRO 2024 - Abstract Book

S41

Invited Speaker

ESTRO 2024

Abstract:

The term 'quality of life' means very different things to different people. Quality of life is not the same for any two patients as patient needs and requirements are highly individual. It must be noted that the clinician is not the patient and while the best outcome for the patient is always the focus of any clinician, they do not have the lived experience of the patient and this needs to be acknowledged. Is there a need to balance the patient and clinician needs? More likely, the need is to tilt the balance most definitively in the direction of the patient. The presentation will explore the impact of late effects on quality of life and the relevance of the timing of late effects information for patients and their carers. In radiation oncology practice, toxicity and quality of life scoring systems can have inherent drawbacks and the opportunity afforded to us by patient reported outcome measures in measuring quality of life will be considered. Finally, follow up patterns globally vary significantly and can impact on quality of life when patients feel they have little or no support to manage late effects impacting on their lives.

3347

How to get upright radiotherapy into clinical use?

Mark Pankuch 1 , Sean Boyer 1 , Mingcheng Gao 1 , Draik Hecksel 1 , Brad Kreydick 1 , Steven Laub 1 , Chenguang Liu 1 , Hazel Wang 1 , William Hartsell 2 , Stephen Mihalcik 3 1 Northwestern Medicine Proton Center, Medical Physics, Warrenville, USA. 2 Radiation Oncology Consultants, Radiation Oncology, Downers Grove, USA. 3 Northwestern Medicine Proton Center, Radiation Oncology, Warrenville, USA

Abstract:

The cost of a proton therapy center has always been higher than that of a photon center. The greater costs come from the elevated expense of installing and maintaining the accelerator, the beam line and the delivery system along with the larger footprint of the building designed to accommodate them. Utilizing the treatment rooms to near capacity levels is often necessary to keep the proton systems financially viable. The Northwestern Medicine Proton Center is a four-room center with one gantry room, one fixed horizontal beam room and two inclined beam (IBL) rooms. IBL rooms permit both a horizontal proton beam angle and a second angle 30 degrees from vertical which increases their capabilities over the fixed beam room, but falls short of the capabilities of a gantry room. As the center began to fill with patients, the gantry room quickly filled to capacity, and the limited angles offered by the remaining rooms could not generate optimal plans for all of the remaining patients. The solution for the Northwestern Medicine Proton center was to implement upright treatments into the existing center. By treating in the upright position, the center effectively expanded the options for incident proton angles available in the fixed and IBL rooms. In upright treatments, the patient can be rotated around the beam, rather than rotating the beam around the patient, as is done when using a gantry. Over 600 patients have been successfully treated in the upright position at this center. The installation and integration of the upright imaging system and the development of the treatment chairs required substantial effort and careful considerations. Adaption and compromise to meet the limitations of the space and functionality of the current treatment rooms were critical to success. Optimizing and designing a room dedicated to