ESTRO 36 Abstract Book

S1018 ESTRO 36 _______________________________________________________________________________________________

EP-1864 Control of patients with pacemaker/implantable cardioverter defibrillator undergo radiotherapy. M. Puertas Valiño 1 , A. Mendez Villamon 1 , M. Gascon Ferrer 1 , C. Vazquez Sanchez 1 , P. Sanagustin Pedrafita 1 , J. Castillo Lueña 1 , M. Tejedor Gutierrez 1 1 hospital universitario miguel servet, radiotherapy, zaragoza, spain Purpose or Objective To establish a few basic criterias of control of the device, in patients submitted to irradiation, without generating an excessive load of work for the involved services and a There has been created a patient registration sheet, with the clinical information of these and with those parameters relating to the treatment, as well as symptoms suffered by the patient and the information it brings over of the functioning of the device. A protocol of action has been established, so that when a patient of these characteristics is considered to be subsidiary of treatment by ionizing radiation, some procedures are carried out: 1. Consultation to the Service of Cardiology of our center, for the first valuation. 2. Preparation of the treatment , bearing in mind, the distance of the field of irradiation to the device. Make sure that the device does not receive a direct, unshielded irradiation. 3. Schedule of treatment for these patients, making easier the control for the cardiologist of our institution. Once the treatment sessions have finished, the final review is realized and the opportune controls are ruled . Results From the beginning of the project in March 1, 2016, there have been radiated in our department, 16 patients with cardiac implantable devices . - 5 women and 11 men. - The middle ages are 76,8 years (66 years to 86 years). - All of them were non-pacemaker-dependent - The tumour pathology origin of the need of irradiation has been: -The dose of radiation the patients has been variable: between 30 Gy (300cGy/sesión) in case of cerebral metastases, to 69.3 Gy (210 cGy/sesión) in case of the carcinoma of larynx or an extreme hipofraccionamiento in the SBRT of lung, with dose of 60 Gy, in meetings of 1200cGy. In two cases, the patients received concomitant chemotherapy. - The used energies have been, in the majority of the patients, photons of 6, 10 and 15 MV. Only in a case of cancer of breast, the irradiation of photons was followed by 3 meetings electrons. The review of the device, it has not showed alterations of this one in any case. There have been checked the medication, syncopes, IC, as well as all the parameters of the programming of the pacemaker or defibrillator, without some alteration be observing. Conclusion In our patients some alteration has not been targeted in the device after the irradiation, independently of the dose. On balance, RT may be delivered safely in carefully selected patients without the need to remove the PM/ICD from the vicinity of the RT field. EP-1865 The utilization of retrospective registry for patient information of access to care M. Siekkinen 1 , M. Stepanov 2 , A. Hammais 3 , P. Rautava 4 1 Turku University Hospital, Cancer Centre, Turku, stress to the patient. Material and Methods - Carcinoma of lung 8 patients. -Carcinoma of breast 5 patients. -Brain Metastasis 1patient. -Cancer of rectum patient 1. Cancer of larynx patient 1.

Conclusion Alerts are an issue in the radiotherapy. This research shows that for each patient treatment the user must deal with 1 to 5 alerts depending on the supplier. This indicates that bad alerts management will not lead to false radiation. On the other hand an overkill from alerts will lead to alerts tiredness.A linear accelerator can make over more than one thousand alerts. For the user is unthinkable to deal with all these alerts. But act on a random basic is also not conceivable. EP-1863 Risk analysis for image guided lung SBRT A. Perez-Rozos 1 , I. Jerez-Sainz 1 , A. Roman 1 , A. Otero 1 , M. Lobato 1 , Y. Lupiañez 1 , J. Medina 1 1 Hospital Virgen de la Victoria, Radiation Oncology. Medical Physics., Malaga, Spain Purpose or Objective Stereotactic Body Radiotherapy (SBRT) is a complex technique that reduce number of sessions and increase fraction dose, with higher accuracy requirements. In this work we carry out a risk analysis of our lung SBRT simulation, planning and treatment process using Failure Modes and Effects methodology (FMEA). Material and Methods FMEA analysis was performed by a multidisciplinary team integrated by radiographers, nurses, medical physicists, and radiation oncologists. Main steps were: identify flux diagram of whole process, assign risk and probability for every steps, and specific analisys of higher RPN number steps to reduce global risk uncertainty. Results Main analyzed steps include: a. Simulation, b. Prescription and treatment planning c. Preparation and treatment verification d. Treatment delivery. Every step was then described with higher detail. The detail degree has to be enough to allow for clarity, but not too high to loose in small unimportant steps. In every substep we identifyed failures modes and effects and risk piority numbers (RPN) were assigned, using a score for severity, ocurrence and detection probabilities (scores from 1 to 10). RPN numbers were promediated between team members. Failure modes with the higher scores were given the maximum priority to subsequent study to apply specific QA or to take measurements to reduce RPN number. We have identifyed 32 events, the 5 with higher scores were selected in a first stage to reduce risk numbers. Critical steps involved isocenter transfer and integrity between image and treatment system, prescription errors between oncologist prescription and electronic one, and mistakes in treatment delivery . Conclusion Risk analysis in radiotheapy process must be a priority to identify weakness and reduce uncertainty. Multidisciplinary teams help to make flux diagrams, identify critical steps and increase global safety.