ESTRO 2025 - Abstract Book

S2385

Interdisciplinary – Other

ESTRO 2025

Results The maximum recorded dose was 6.13 Gy (supraglottic tumor), while the minimum was 0.16 Gy (right breast cancer). No adverse effects, such as pacemaker malfunction, sensing or stimulation errors, or thermal effects, were observed. All treatments complied with AAPM TG-203 safety parameters, except in two cases with minimal deviations. Conclusion Implementing the AAPM TG-203 protocol in radiotherapy for patients with pacemakers has demonstrated both safety and efficacy. Pre-treatment cardiological evaluation and continuous monitoring were pivotal in preventing complications, ensuring successful treatment outcomes.

Keywords: Pacemakers, radiotherapy, treatment guide

2913

Digital Poster Development of a spine cancer-related pain classification

Ori Barzilai 1 , Marie-Laure Vial 2 , Jorrit-Jan Verlaan 3 , Lisa Ruppert 4 , Joost Rutges 5 , Dean Chou 6 , Michelle Clarke 7 , Cordula Netzer 8 , Mohammed Karim 7 , Nic Dea 9 , Hanbo Chen 10 , John O'Toole 11 , Raphaele Charest Morin 9 , Sheng-fu Larry Lo 12 , Daniel Lubelski 13 , Charles Fisher 9 , Lisa Doan 14 , Michael Weber 15 , Ilya Laufer 16 1 Neurosurgery, MSKCC, New York, USA. 2 AOKFT, AOSpine, Davos, Switzerland. 3 Radiation Oncology, UMC Utrecht, Utrecht, Netherlands. 4 Physiatry, MSKCC, New York, USA. 5 Orthopedics, ErasmusMC, Rotterdam, Netherlands. 6 Neurosurgery, The Och Spine New York Presbyterian Allen Hospital, New York, USA. 7 Neurosurgery, Mayo Clinic, Rochester, USA. 8 Orthopedics, Universitätsspital Basel, Basel, Switzerland. 9 Spine surgery, VGH, Vancouver, Canada. 10 Radiation Oncology, Sunnybrook, Toronto, Canada. 11 Neurosurgery, Rush, Chicago, USA. 12 Neurosurgery, Northwell, New York, USA. 13 Neurosurgery, JHMI, Baltimore, USA. 14 Pain Management, NYU, New York, USA. 15 Orthopedics, McGill, Montreal, Canada. 16 Neurosurgery, NYU, New York, USA Purpose/Objective Pain affects up to 66% of cancer patients, with spine being the most common site of cancer pain. Spine tumor pain serves as the most common symptom and treatment indication for patients with spinal metastatic tumors. A large proportion of patients continue to experience significant pain after spine tumor-directed treatment. A systematic literature review of the key pain states associated with spinal tumors identified significant knowledge gaps in spine tumor-specific taxonomy, assessment, and treatment recommendations 1 . The objective of this study is to generate a core set of spine tumor descriptors and develop a mechanism-driven classification system for systematic pain assessment, treatment selection and focused pain experience measurement. Material/Methods A modified Delphi process was conducted among 66 participants including 62 AO Spine Knowledge Forum Tumor members (neurosurgeons, orthopedic surgeons, radiation oncologists) and 3 pain anesthesiologists and 1 physiatrist. Three survey rounds were followed by a structured virtual summary meeting. Consensus at a minimum threshold of 75% participant agreement was predefined. Results The survey included six categories, each with various subcategories 1) demographics included: age, sex, race, occupation, education and employment-status; 2) pain characteristics included: location, temporal-characteristics, pain-severity, pain-duration, pain-quality and response to treatment; 3) psychosocial factors included: cognitive, emotional, behavioral, social and education; 4) clinical exam included: findings over the pain site, range of motion, posture change, weight-bearing, Lasegue test, Duncan-Ely test, Spurling test, “heel-drop” test, Kemp test, sacroiliac provocation tests, paravertebral trigger points, presence of myelopathy; 5) diagnostic tests included: Imaging,