ESTRO meets Asia 2024 - Abstract Book

S110

Interdisciplinary – CNS

ESTRO meets Asia 2024

During the year 2023, A 14-question survey under Google form was sent to the 16 centers of radiotherapy in Vietnam. The survey included questions about the radiation oncologists (RO) background, training and experience and their opinion about indication of hippocampal sparing technique as well as the state of the art of its implementation and use in their centers. When this technique was not implemented, or not considered as standard of care when WBRT is used, the reasons for that were asked in a semi directed complementary questionnaire. The analysis was thematic.

Results:

A total of 23 RO from 12 centers out of 16 across Vietnam have answered the survey. At that time of survey, the years of experience among participants ranged from 20 year to 6 months. Almost a half of ROs 12/23 (52.2%) in this study deal with all radiation indications without subspecialty. The remaining 11 ROs practice in bigger institutions where they sub- specialize in specific cancers types: Head & Neck, Breast, Lung, Central nervous system, Gynecology and Gastrointestinal. All of ROs (100%) in study apply radiotherapy for BM by WBRT and only 7 out of 23 (23.3%) ROs have access to stereotactic radiotherapy (SRS) for BM. Among the surveyed RO, 90% were aware of the technical aspect of HA in WBRT, and only 40% used it regularly for their patients. Regarding the learning curve to be proficient in the Hippocampus contouring, 19 RO agreed it was between 10 and 20 cases. For the roadblocks that could hinder the implementation in daily practice of HA-WBRT in Vietnam, according to the Vietnamese ROs that participated in this study, the major obstacle (73.3%) to the use of HA WBRT in routine practice is its higher price as well as expenses related to MRI imaging. The workload in physics panning systems and on liner accelerators were the second most important roadblocks.(Figure 2).

Conclusion:

Despite the results from the RTOG trial favoring the use of HA during WBRT (1) only 40 % of the centers across Vietnam declared using the HA during WBRT for brain metastasis. Main roadblocks to the use of this technique is the high price of the treatment and that of MRI imaging, as well as the overload of the Liner accelerators as well as of the planning systems

Keywords: hippocampal avoidance practice vietnam

References: Hippocampal Avoidance During Whole-Brain Radiotherapy Plus Memantine for Patients With Brain Metastases: Phase III Trial NRG Oncology CC001. J Clin Oncol. 2020 Apr 1;38(10):1019-1029. doi: 10.1200/JCO.19.02767. Brown PD, Gondi V, Pugh S, Tome WA, Wefel JS et al. for NGR oncology