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1408 poster INFORMATION TO PATIENTS WITH HEAD AND NECK CANCER DURING THE PERIOD OF RADIATION TREATMENT.
S 524
PATIENT IMMOBILIZATION AND SUPPORT AIDS
Patient care 1408 poster INFORMATION TO PATIENTS WITH HEAD AND NECK CANCER DURING THE PERIOD OF RADIATION TREATMENT. H. Egestad1 , S. Hanssen1 , J. H. Tunstad1 1
U NIV. H OSPITAL OF N ORTHERN N ORWAY, Tromsø, Norway
Purpose: The aim of this prospective single institution study is to get more knowledge of how to adapt communication with patients during the period of radical first-line radiotherapy Materials: The study includes 30 patients with newly diagnosed head and neck cancer. The protocol consists of clinical examination, assessment of the patients‘general condition, a questionnaire (EORTC QLQ with H&N module) and an interview at 0, 20, 40 and 60 Gy. The validated EORTC questionnaire was filled in at 0 and 60 Gy. Eight of the patients were depth interviewed. The protocol was approved by the local ethics committee. Results: Thirty of 37 patients who were asked for participation gave their informed consent and responded. The results show that 40% have been informed about skincare at 60 Gy. Forty-seven percent are informed about nutrition, and 23% about food and beverages that should be avoided during the treatment period. At the end of treatment 37% had a gastrostomy tube. Of all patients, 87% used analgesic medication at 60Gy. The average weight loss during six weeks was four kilos. Conclusions: The study shows that there is a great need for more information and supportive measures regarding nutrition and skin care. 1409 poster TOWARDS A HOSPITAL-BASED BNCT WITH A STANDARD RADIOTHERAPIC LINAC E. M. Donegani1 , A. Aiani1 , F. Basilico2 , D. Bolognini1 , P. Borasio3 , P. Cappelletti4 , P. Chiari5 , M. Frigerio6 , S. Gelosa6 , G. Giannini7 , S. Hasan1 , A. Mattera1 , P. Mauri5 , A. F. Monti6 , A. Ostinelli4 , M. Prest1 , E. Vallazza7 , A. Zanini8 1 U NIVERSITY OF I NSUBRIA, Physics , Como , Italy 2 CNR - I STITUTO T ECNOLOGIE B IOMEDICHE, -, Segrate, Italy 3 O SPEDALE S AN L UIGI, Oncology, Orbassano, Italy 4 O SPEDALE S ANT ’A NNA, Como, Italy 5 U NIVERSITY OF PAVIA, Biology, Pavia, Italy 6 O SPEDALE S ANT ’A NNA, Radiotherapy , Como, Italy 7 U NIVERSITY OF T RIESTE, Trieste, Italy 8 INFN SEZIONE DI TORINO, Torino, Italy
Purpose: Despite outstanding advances both in radiotherapy and chemotherapy over the last decades, there are still many types of cancers that cannot be cured by conventional therapies. A possible solution for radiochemo resistant tumors, extended or located close to vital organs seems to be the BNCT (Boron Neutron Capture Therapy), which combines the anatomical treatment principles of radiotherapy and the targeting standards of chemotherapy. This experimental radiotherapy requires the selective administration of 10 B to the tumor cells and subsequently the irradiation with a thermal (E<10 MeV) neutron beam. The high LET particles produced in the 10 B(n, α )7 Li capture reaction induce the apoptosis of the malignant cells. Proposed in the 1930s, BNCT is still in the early stages of development because of the need of a tumor-seeking 10 B-carrier and a thermal neutron beam at least of 508 ncm2 s1 , currently available only at nuclear reactors. The proposed system is developed within the INFN PhoNeS (PhotoNeutron Source) project and represents a milestone in the pathway towards the performance of BNCT treatments in a hospital environment. Materials: The collimators of the Varian Clinac 2100 C/D of the Radiotherapy Department at the S. Anna Hospital in Como (Italy) are used to photoconvert 18 MV photons into fast neutrons via giant dipole resonance. The MLC is fully open, whereas the jaws are closed to produce a 0.5.5 cm2 eld. An outer layer of PMMA is used to thermalize the neutrons. Being approximately of 3105 ncm2 s1 , the achieved neutron ux is at the moment not enough for BNCT treatments, but the system is under development and useful for exploring the feasibility of a hospital-based BNCT facility. Results: The neutron ux has been used to provide a 1D scan of the boron content in biological specimens, using a 500 MU/min dose rate and detecting the α particles emitted in the capture reaction with a microstrip silicon detector. An absolute calibration was performed using several samples with different known amounts of BPA (Boronophenylalanine); the minimum 10 B detectable amount is 5 ppm. Moreover, blood samples from a human lung affected by adenocarcinoma (g.), taken during an ex-vivo perfusion with BPA, were irradiated with the neutron ux to study the 10 B-uptake in the organ.
Conclusions: The proposed system is useful for exploring the feasibility of a hospital-based BNCT facility and is intended to be optimized for pharmacokinetic studies on 10 B carriers, neutron dosimetry and 2D imaging of 10 B in tissues.
Patient immobilization and support aids 1410 poster A RETROSPECTIVE STUDY COMPARING THE REPRODUCIBILITY OF THE WINGSTEP BREASTBOARD TO THE CONVENTIONAL MT-350 BREASTBOARD IN TANGENTIAL BREAST IRRADIATION C. Jensen1 , I. Fallmyr1 , N. Skottner1 1 Å LESUND H OSPITAL, Ålesund, Norway
Purpose: The reproducibility of patient positioning using the conventional breastboard is challenging due to the numerous individual settings these boards offer. The WingSTEP is a facile breastboard from IT-V, where only the head cushion offers individual settings. The aim of this study was to assess the precision and stability of the two immobilization devices, and determine whether the WingSTEP has as good, or better, precision and stability as the conventional MT-350 breastboard from MEDTEC. A secondary aim was to investigate the adequate CTV to PTV margin for both breastboards. A third aim was that the WingSTEP only costs around 30% of a conventional breastboard. Materials: Retrospectively the portal images of 60 patients treated with tangential breast irradiation technique were analysed. 30 patients where immobilized with WingSTEP and 30 with conventional MT-350 breastboard. Dose plans were based on CT scans with a spacing of 2 mm. All patients were cone beam simulated on the treatment machine just prior to the first treatment session. The portal images were evaluated against the reference digital reconstructed radiographs generated by the dose planning system. Around 1500 images were analyzed giving us systematic and random errors for each patient and the group. Results: The preliminary results show that there is no statistical significant difference between the two immobilization devices. The patients immobilized with the WingSTEP have a smaller random error than the conventional breastboard group, but the systematic error is somewhat larger for the WingSTEP group. There is also less rotation of the patients in the WingSTEP group. The CTV to PTV margins were 4 mm and 3 mm in the Lat/Vert direction for WingSTEP and MT-350, respectively, and 2 mm and 4 mm in the long direction for the WingSTEP and MT-350, respectively. Overall there is close to no systematic error in the two groups, which can be attributed to the cone beam simulation performed just prior to the first treatment fraction. Conclusions: The WingSTEP is a facile immobilization breastboard that shows as good, or better, reproducibility of patient position than our conventional breastboard. The WingSTEP is easy to handle and well regarded among the radiation technologists. The WingSTEP is now the standard immobilization breastboard in our clinic
PATIENT IMMOBILIZATION AND SUPPORT AIDS
Patient care 1408 poster INFORMATION TO PATIENTS WITH HEAD AND NECK CANCER DURING THE PERIOD OF RADIATION TREATMENT. H. Egestad1 , S. Hanssen1 , J. H. Tunstad1 1
U NIV. H OSPITAL OF N ORTHERN N ORWAY, Tromsø, Norway
Purpose: The aim of this prospective single institution study is to get more knowledge of how to adapt communication with patients during the period of radical first-line radiotherapy Materials: The study includes 30 patients with newly diagnosed head and neck cancer. The protocol consists of clinical examination, assessment of the patients‘general condition, a questionnaire (EORTC QLQ with H&N module) and an interview at 0, 20, 40 and 60 Gy. The validated EORTC questionnaire was filled in at 0 and 60 Gy. Eight of the patients were depth interviewed. The protocol was approved by the local ethics committee. Results: Thirty of 37 patients who were asked for participation gave their informed consent and responded. The results show that 40% have been informed about skincare at 60 Gy. Forty-seven percent are informed about nutrition, and 23% about food and beverages that should be avoided during the treatment period. At the end of treatment 37% had a gastrostomy tube. Of all patients, 87% used analgesic medication at 60Gy. The average weight loss during six weeks was four kilos. Conclusions: The study shows that there is a great need for more information and supportive measures regarding nutrition and skin care. 1409 poster TOWARDS A HOSPITAL-BASED BNCT WITH A STANDARD RADIOTHERAPIC LINAC E. M. Donegani1 , A. Aiani1 , F. Basilico2 , D. Bolognini1 , P. Borasio3 , P. Cappelletti4 , P. Chiari5 , M. Frigerio6 , S. Gelosa6 , G. Giannini7 , S. Hasan1 , A. Mattera1 , P. Mauri5 , A. F. Monti6 , A. Ostinelli4 , M. Prest1 , E. Vallazza7 , A. Zanini8 1 U NIVERSITY OF I NSUBRIA, Physics , Como , Italy 2 CNR - I STITUTO T ECNOLOGIE B IOMEDICHE, -, Segrate, Italy 3 O SPEDALE S AN L UIGI, Oncology, Orbassano, Italy 4 O SPEDALE S ANT ’A NNA, Como, Italy 5 U NIVERSITY OF PAVIA, Biology, Pavia, Italy 6 O SPEDALE S ANT ’A NNA, Radiotherapy , Como, Italy 7 U NIVERSITY OF T RIESTE, Trieste, Italy 8 INFN SEZIONE DI TORINO, Torino, Italy
Purpose: Despite outstanding advances both in radiotherapy and chemotherapy over the last decades, there are still many types of cancers that cannot be cured by conventional therapies. A possible solution for radiochemo resistant tumors, extended or located close to vital organs seems to be the BNCT (Boron Neutron Capture Therapy), which combines the anatomical treatment principles of radiotherapy and the targeting standards of chemotherapy. This experimental radiotherapy requires the selective administration of 10 B to the tumor cells and subsequently the irradiation with a thermal (E<10 MeV) neutron beam. The high LET particles produced in the 10 B(n, α )7 Li capture reaction induce the apoptosis of the malignant cells. Proposed in the 1930s, BNCT is still in the early stages of development because of the need of a tumor-seeking 10 B-carrier and a thermal neutron beam at least of 508 ncm2 s1 , currently available only at nuclear reactors. The proposed system is developed within the INFN PhoNeS (PhotoNeutron Source) project and represents a milestone in the pathway towards the performance of BNCT treatments in a hospital environment. Materials: The collimators of the Varian Clinac 2100 C/D of the Radiotherapy Department at the S. Anna Hospital in Como (Italy) are used to photoconvert 18 MV photons into fast neutrons via giant dipole resonance. The MLC is fully open, whereas the jaws are closed to produce a 0.5.5 cm2 eld. An outer layer of PMMA is used to thermalize the neutrons. Being approximately of 3105 ncm2 s1 , the achieved neutron ux is at the moment not enough for BNCT treatments, but the system is under development and useful for exploring the feasibility of a hospital-based BNCT facility. Results: The neutron ux has been used to provide a 1D scan of the boron content in biological specimens, using a 500 MU/min dose rate and detecting the α particles emitted in the capture reaction with a microstrip silicon detector. An absolute calibration was performed using several samples with different known amounts of BPA (Boronophenylalanine); the minimum 10 B detectable amount is 5 ppm. Moreover, blood samples from a human lung affected by adenocarcinoma (g.), taken during an ex-vivo perfusion with BPA, were irradiated with the neutron ux to study the 10 B-uptake in the organ.
Conclusions: The proposed system is useful for exploring the feasibility of a hospital-based BNCT facility and is intended to be optimized for pharmacokinetic studies on 10 B carriers, neutron dosimetry and 2D imaging of 10 B in tissues.
Patient immobilization and support aids 1410 poster A RETROSPECTIVE STUDY COMPARING THE REPRODUCIBILITY OF THE WINGSTEP BREASTBOARD TO THE CONVENTIONAL MT-350 BREASTBOARD IN TANGENTIAL BREAST IRRADIATION C. Jensen1 , I. Fallmyr1 , N. Skottner1 1 Å LESUND H OSPITAL, Ålesund, Norway
Purpose: The reproducibility of patient positioning using the conventional breastboard is challenging due to the numerous individual settings these boards offer. The WingSTEP is a facile breastboard from IT-V, where only the head cushion offers individual settings. The aim of this study was to assess the precision and stability of the two immobilization devices, and determine whether the WingSTEP has as good, or better, precision and stability as the conventional MT-350 breastboard from MEDTEC. A secondary aim was to investigate the adequate CTV to PTV margin for both breastboards. A third aim was that the WingSTEP only costs around 30% of a conventional breastboard. Materials: Retrospectively the portal images of 60 patients treated with tangential breast irradiation technique were analysed. 30 patients where immobilized with WingSTEP and 30 with conventional MT-350 breastboard. Dose plans were based on CT scans with a spacing of 2 mm. All patients were cone beam simulated on the treatment machine just prior to the first treatment session. The portal images were evaluated against the reference digital reconstructed radiographs generated by the dose planning system. Around 1500 images were analyzed giving us systematic and random errors for each patient and the group. Results: The preliminary results show that there is no statistical significant difference between the two immobilization devices. The patients immobilized with the WingSTEP have a smaller random error than the conventional breastboard group, but the systematic error is somewhat larger for the WingSTEP group. There is also less rotation of the patients in the WingSTEP group. The CTV to PTV margins were 4 mm and 3 mm in the Lat/Vert direction for WingSTEP and MT-350, respectively, and 2 mm and 4 mm in the long direction for the WingSTEP and MT-350, respectively. Overall there is close to no systematic error in the two groups, which can be attributed to the cone beam simulation performed just prior to the first treatment fraction. Conclusions: The WingSTEP is a facile immobilization breastboard that shows as good, or better, reproducibility of patient position than our conventional breastboard. The WingSTEP is easy to handle and well regarded among the radiation technologists. The WingSTEP is now the standard immobilization breastboard in our clinic