ESTRO 36 Abstract Book

S9 ESTRO 36 _______________________________________________________________________________________________

SP-0027 Evaluation of time, attendance of medical staff,and resources during stereotactic radiotherapy/radiosurgery:QUIRO-DEGRO trial A. Zabel-du Bois 1 , S. Milker-Zabel 1 , W. Popp 2 , J. Debus 1 , H. Sack 3 , R. Engenhart-Cabillic 4 1 University Hospital Heidelberg, Radiooncology and Radiotherapy, Heidelberg, Germany 2 Prime Networks AG, Prime Networks AG, Basel, Switzerland 3 University of Essen, Department of Radiation Oncology, Essen, Germany 4 Philipps-University Marburg, Department of Radiotherapy and Radiation Oncology, Marburg, Germany Purpose: The German Society of Radiation Oncology (DEGRO) initiated a multicenter trial to develop and evaluate adequate modules to assert core processes and subprocesses in radiotherapy. Aim of this prospective evaluation was to methodical assess the required resources (technical equipment and medical staff) for stereotactic radiotherapy/ radiosurgery. Methods and Materials: At two radiotherapy centers of excellence (University Hospitals of Heidelberg and Marburg/ Giessen) the manpower and time required for the implementation of intra- and extracranial stereotactic radiotherapy was prospectively collected consistently over a 3 months period. The data were collected using specific developed process acquisition tools and standard forms and were evaluated using specific process analysis tools. Results: For intracranial (extracranial) fractionated stereotactic radiotherapy (FSRT) and radiosurgery (RS), a total of 1925 (270) and 199 (36) records could be evaluated, respectively. The approx. time needed to customize the immobilization device was median 37 min (89 min) for FRST and 31 min (26 min) for RS, for the contrast enhanced planning studies 22 and 27 min (25 and 28 min), for physical treatment planning 122 and 59 min (187 and 27 min), for the first and routine radiotherapy sessions for FSRT 40 and 13 min (58 and 31 min), respectively. The median time needed for the RS session was 58 min (45 min). The corresponding minimal manpower needed was two technicians for customization of the immobilization device, 2½ technicians and one consultant for the contrast-enhanced planning studies, one consultant, ½ resident and ⅔ physicist for physical treatment planning, as well as one consultant, ½ resident and 2½ technicians for the first radiotherapy treatment and 2 ⅓ technicians for routine radiotherapy sessions. Conclusion: For the first time, the resource requirements for a radiotherapy department for the maintenance, protection and optimization of operational readiness for the application of intra-and extracranial stereotactic radiotherapy was determined methodically. Published in: Strahlenther Onkol. 2012 Sep;188(9):769-76 SP-0028 State of the art in heart effects M.C. Vozenin 1 1 Centre Hospitalier Universitaire Vaudois, Department of Radiation Oncology, Lausanne Vaud, Switzerland The therapeutic management of cancer has improved during the past decade and is today characterized by a significant increase in survival rates. Although effective on cure rates, both locoregional and systemic treatments present some concerns related to the development of chronic toxicities. The social impact of both acute and chronic toxicities of treatments is fully recognized and a specific attention is today paid to the toxicities induced by anti-cancer treatments as they impact on patients’ Symposium with Proffered Papers: Novel approaches in heart / lung matters

quality of life. About fifty percent of cancer patients are treated with radiotherapy (RT) which is, after surgery, the most important technique involved in curing cancer. Based on major technical advances in physics, imaging and ballistics, a high precision RT dose delivery safely reduces the volume of irradiated normal tissue and significantly decrease complications. These technological improvements make it possible to avoid organs at risk, such as the heart. This means that today radiation-induced cardiac toxicity is decreasing but in the mean time the evolution of treatment’s standards towards combined therapies suggests that heart toxicity will remain a major concern within the next years. More specifically, cardiac toxicity is known to occur in patients treated with combination of RT with anthracycline or taxanes and targeted therapies; but appropriate biological evaluation of acute and chronic toxicities induced by these bi- or tri- therapies are lacking. Our previous work, suggest differential activation of 2 members of the small GTPase pathway , i.e. Epac-1 and RhoB, in the pathogenesis of radiation-induced cardiac toxicity. These targets are currently investigated in mice treated with RT+Paclitaxel+Heceptine. In addition, several inflammatory mediators are release by dying cancer cells in the course of anti-cancer treatments and the contribution of such factors to cardiac toxicity is currently under investigation, models and first results will be presented. SP-0029 Pharmacological modulation of cardiac radiation injury M. Boerma 1 1 University of Arkansas for Medical Sciences, Other, Little Rock, USA For several decades, clinical and epidemiological studies have identified early and late manifestations of cardiac radiation injury in cancer patients who received a relatively high dose of radiation to all or part of the heart. Radiation therapy has undergone many improvements in treatment planning and radiation delivery. Nonetheless, in a subset of patients with thoracic cancers the heart is still partly exposed, and with the rapid increase in the number of long-term cancer survivors late side effects of cancer therapy such as those in the heart are still of concern. Current treatment of radiation-induced heart disease is no different from heart disease due to other causes, and there is no available pharmacological modulation that prevents or mitigates cardiac injury from radiation exposure. However, several potential pharmacological interventions such as anti-oxidant strategies, angiotensin converting enzyme inhibitors and transforming growth factor receptor inhibitors have been tested in pre-clinical models of cardiac radiation injury. This presentation gives an overview of some of these recent pre-clinical studies. OC-0030 In vitro study of FLASH vs. conventional dose- rate irradiation: Cell viability and DNA damage repair A. Beddok 1 , C. Fouillade 1 , E. Quelennec 1 , V. Favaudon 1 1 Institut Curie, Inserm U 1021 - CNRS UMR 3347, Orsay, France Purpose or Objective Favaudon et al. recently reported that high dose-rate (> 40Gy/s), 'FLASH” irradiation allows sparing C57BL/6J mice from radiation-induced pulmonary fibrosis. The mechanisms which underlie this difference are still elusive. The purpose of this study was to assess, on the one hand the cell viability and on the other hand the activation of two DNA damage response proteins (γH2AX and 53BP1) after FLASH vs. conventional dose-rate irradiation (CONV, 0.03 Gy/s).