- Email: [email protected]
Assessing the Predictability of New Thermoplastic Masks in Head and Neck Patients Treated With Chemoradiotherapy
blinded clinical investigator using a Skin Toxicity Assessment Tool (STAT) based on a modified RTOG visual assessment scale. On day 1 of treatment, baseline photos are taken and patients complete a Quality of Life Questionnaire (QLQ). 7-10 days post-treatment, patients return for photos, STAT, 2nd QLQ, and Global Questionnaire (GQ) completion. Preliminary Results: Currently, 19 patients have completed treatment (8/19 medial BF; 11/19 lateral BF); preliminary results are based on data collected from these cases. In the control arm, 8/19 patients had > grade (G) 1 dermatitis vs. 7/19 using BF (42% vs. 37%). In the control arm, 3/19 patients had G2 dermatitis vs. 4/19 using BF (16% vs. 21%). Of the 4 BF arm patients that experienced G2 scores, 3/4 of these reactions occurred in the lateral half of the breast. Of the 7 BF patients that had > G1, 5/7 of the reactions occurred laterally, suggesting an increased susceptibility/sensitivity of the lateral aspect of the intact breast. Of the 4 occurrences of G2, 3/4 occurred bilaterally; 1 case occurred unilaterally in the lateral BF arm. GQ responses indicate that patients would use the BF again and thought it made a meaningful difference to their skin care (67% would use again; 20% would not; 0.07% did not respond or were undecided. QLQ and pain/pruritus scores have not been analyzed at this point. Conclusion: BFs protect skin from external trauma and help maintain integrity while allowing skin to breathe. By protecting irradiated skin from excess friction trauma, the severity of radiation skin toxicity and/or pain/pruritus scores in post-lumpectomy breast cancer patients may be reduced, or the time of onset delayed. Though preliminary results are marginally suggestive of benefit, continuation of our current study will provide more definitive data. TOP RANKED INSPIRE POSTER
What Factors Impact Referral of Patients by Radiation Therapists at the Princess Margaret Cancer Centre to the Electronic Living Laboratory for Interdisciplinary Cancer Survivorship Research (ELLICSR) Kitchen? Floortje Brus, BSc CCPEa, Christy Brissette, MSc RDb and Caitlin Gillan, MRT(T) BSc MEd FCAMRTa a The Michener Institute / University of Toronto, University Health Network Princess Margaret Cancer Centre b University Health Network - Princess Margaret Cancer Centre, ELLICSR Health, Wellness and Cancer Survivorship Centre Background: Dietary intervention plays an important role in supporting cancer patients undergoing radiation therapy, and particular nutritional problems are often best addressed by registered dietitians (RDs), and other nutritional education programs. Radiation therapists (RTTs) are at the forefront of support, and can aid in the detection of those in dietary need in order to make appropriate referrals. In the literature, several potential barriers are identified for healthcare professionals to identify cancer patients in need of dietary care. Specific statistics on radiation therapy patient referrals to various dietary services are not readily available, or show a lack of patient referrals from the radiation department. Therefore, it is important to consider the factors impacting referrals from RTTs to nutritional education programs. Methods: This study has a qualitative design exploring the subjective experiences and opinions surrounding dietary referrals of RTTs at a single large, urban cancer centre, to a dedicated nutrition and wellness education program for cancer survivors. This program is designed for patients looking for guidance in healthy eating and in managing side effects from their radiation treatment. Several audio-taped semi-structured interactive focus group sessions are to be held with a convenience sample of 12-24 RTTs. Their expressed ideas and opinions will be identified and coded into emerging themes. An iterative process will be applied until data saturation is achieved. Results: It is hypothesized that RTTs at this cancer centre may experience similar barriers as those discussed in the literature to identify cancer patients receiving radiation therapy in need of dietary care, impacting patient referral to the appropriate nutritional programs. Discussion and Conclusion: Should the results identify gaps or lack of understanding in the referral process, the need might be acknowledged for more awareness of available nutritional programs amongst RTTs, an improved
176
dietary needs assessment tool, or a more formal referral process based on consistent guidelines. Discussion about best practices and RTT roles in referral for dietary support could ultimately lead to reduced malnutrition rates and improved survivorship care for cancer patients undergoing radiation therapy at this centre, setting an example for other Canadian and international cancer centres. TOP RANKED INNOVATE POSTER
Assessing the Predictability of New Thermoplastic Masks in Head and Neck Patients Treated With Chemoradiotherapy Manpreet Sohi, RTT Student, Steven Lin, RTT Student and Sarah Kristensen, AC(T), BSc, CMD, CDS British Columbia Institute of Technology Introduction: Head and neck (H&N) patients treated with Intensity Modulated Radiation Therapy (IMRT) require an immobilization device called thermoplastic masks for their day-to-day treatment. Some patients require a new mask after the start of their treatment. The purpose of this retrospective study is to identity factors and establish trends that can predict when a new mask is required to be made during the treatment course. Materials and Method: Data from BC Cancer Agency’s Fraser Valley Centre (FVC) and Abbotsford Centre (AC) was collected. Treatment start date, date of the second CT scan, birth date, gender, primary site of the H&N cancer, stage of the cancer, the radiation technique, the treatment prescription, weight loss, presence of a gastric tube (G-Tube) and if so, the date of insertion, were recorded. Trends for oropharyngeal carcinoma patients were analyzed. The chemotherapy protocol, risk-factors and weight through treatment were collected for these patients. Results: From 61 H&N patients, 41 were oropharyngeal carcinoma patients. Of the 41 oropharyngeal patients, 32 were in late-stage, of which 17 were in the 50-59 age range; 13 of the 17 patients received cisplatin. All 17 patients had weight loss and a G-Tube insertion; 5 had the G-Tube inserted before the start of treatment and 12 after the start of treatment. Of the 17 oropharyngeal, late-stage, 50-59 age range, weight loss and G-Tube patients, 8 patients had their second CT scan during the 21st to 25th fraction of treatment. Discussion and Conclusion: The majority of the H&N patients that required a new mask after the start of treatment was found to have oropharyngeal carcinoma. Further analysis found that most of these patients were in the late-stage and were more commonly in the age range of 50 to 59 years. Most of the patients in this age range were on a chemotherapy protocol of cisplatin. All the patients in this age range with late-stage oropharyngeal carcinoma experienced weight loss and had a G-Tube insertion; however, most of them had the G-Tube insertion after the start of treatment. The presence of these factors led to the finding that patients require a new mask between their 21st and 25th fractions of treatment based on the timing of their second CT scan after the start of treatment. POSTERS
Does Prostate Biopsy after HDR Brachytherapy Have Any Clinical Significance? Laura D’Alimonte, MRT(T), MHSca, Gerard Morton, MDa, Andrew Loblaw, MDa, Hans Chung, MDa, Niki Law, MRT(T)a, Thomas Ciseski, MRT(T)a, Andrea DeAbreua, Alex Mamedova and Liying Zhangb a Odette Cancer Centre b Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre Background and Purpose: High dose-rate brachytherapy (HDR) and supplemental external beam radiotherapy (EBRT) is associated with a high disease control rate for men with intermediate and high risk prostate cancer. The value of routine post radiotherapy biopsy to predict ultimate disease control is unknown. Our purpose is to determine the association between posttreatment biopsy results and probability of biochemical disease-free survival in men treated with HDR + EBRT.
Conference Proceedings from RTi3 2014/Journal of Medical Imaging and Radiation Sciences 45 (2014) 162-188
What Factors Impact Referral of Patients by Radiation Therapists at the Princess Margaret Cancer Centre to the Electronic Living Laboratory for Interdisciplinary Cancer Survivorship Research (ELLICSR) Kitchen? Floortje Brus, BSc CCPEa, Christy Brissette, MSc RDb and Caitlin Gillan, MRT(T) BSc MEd FCAMRTa a The Michener Institute / University of Toronto, University Health Network Princess Margaret Cancer Centre b University Health Network - Princess Margaret Cancer Centre, ELLICSR Health, Wellness and Cancer Survivorship Centre Background: Dietary intervention plays an important role in supporting cancer patients undergoing radiation therapy, and particular nutritional problems are often best addressed by registered dietitians (RDs), and other nutritional education programs. Radiation therapists (RTTs) are at the forefront of support, and can aid in the detection of those in dietary need in order to make appropriate referrals. In the literature, several potential barriers are identified for healthcare professionals to identify cancer patients in need of dietary care. Specific statistics on radiation therapy patient referrals to various dietary services are not readily available, or show a lack of patient referrals from the radiation department. Therefore, it is important to consider the factors impacting referrals from RTTs to nutritional education programs. Methods: This study has a qualitative design exploring the subjective experiences and opinions surrounding dietary referrals of RTTs at a single large, urban cancer centre, to a dedicated nutrition and wellness education program for cancer survivors. This program is designed for patients looking for guidance in healthy eating and in managing side effects from their radiation treatment. Several audio-taped semi-structured interactive focus group sessions are to be held with a convenience sample of 12-24 RTTs. Their expressed ideas and opinions will be identified and coded into emerging themes. An iterative process will be applied until data saturation is achieved. Results: It is hypothesized that RTTs at this cancer centre may experience similar barriers as those discussed in the literature to identify cancer patients receiving radiation therapy in need of dietary care, impacting patient referral to the appropriate nutritional programs. Discussion and Conclusion: Should the results identify gaps or lack of understanding in the referral process, the need might be acknowledged for more awareness of available nutritional programs amongst RTTs, an improved
176
dietary needs assessment tool, or a more formal referral process based on consistent guidelines. Discussion about best practices and RTT roles in referral for dietary support could ultimately lead to reduced malnutrition rates and improved survivorship care for cancer patients undergoing radiation therapy at this centre, setting an example for other Canadian and international cancer centres. TOP RANKED INNOVATE POSTER
Assessing the Predictability of New Thermoplastic Masks in Head and Neck Patients Treated With Chemoradiotherapy Manpreet Sohi, RTT Student, Steven Lin, RTT Student and Sarah Kristensen, AC(T), BSc, CMD, CDS British Columbia Institute of Technology Introduction: Head and neck (H&N) patients treated with Intensity Modulated Radiation Therapy (IMRT) require an immobilization device called thermoplastic masks for their day-to-day treatment. Some patients require a new mask after the start of their treatment. The purpose of this retrospective study is to identity factors and establish trends that can predict when a new mask is required to be made during the treatment course. Materials and Method: Data from BC Cancer Agency’s Fraser Valley Centre (FVC) and Abbotsford Centre (AC) was collected. Treatment start date, date of the second CT scan, birth date, gender, primary site of the H&N cancer, stage of the cancer, the radiation technique, the treatment prescription, weight loss, presence of a gastric tube (G-Tube) and if so, the date of insertion, were recorded. Trends for oropharyngeal carcinoma patients were analyzed. The chemotherapy protocol, risk-factors and weight through treatment were collected for these patients. Results: From 61 H&N patients, 41 were oropharyngeal carcinoma patients. Of the 41 oropharyngeal patients, 32 were in late-stage, of which 17 were in the 50-59 age range; 13 of the 17 patients received cisplatin. All 17 patients had weight loss and a G-Tube insertion; 5 had the G-Tube inserted before the start of treatment and 12 after the start of treatment. Of the 17 oropharyngeal, late-stage, 50-59 age range, weight loss and G-Tube patients, 8 patients had their second CT scan during the 21st to 25th fraction of treatment. Discussion and Conclusion: The majority of the H&N patients that required a new mask after the start of treatment was found to have oropharyngeal carcinoma. Further analysis found that most of these patients were in the late-stage and were more commonly in the age range of 50 to 59 years. Most of the patients in this age range were on a chemotherapy protocol of cisplatin. All the patients in this age range with late-stage oropharyngeal carcinoma experienced weight loss and had a G-Tube insertion; however, most of them had the G-Tube insertion after the start of treatment. The presence of these factors led to the finding that patients require a new mask between their 21st and 25th fractions of treatment based on the timing of their second CT scan after the start of treatment. POSTERS
Does Prostate Biopsy after HDR Brachytherapy Have Any Clinical Significance? Laura D’Alimonte, MRT(T), MHSca, Gerard Morton, MDa, Andrew Loblaw, MDa, Hans Chung, MDa, Niki Law, MRT(T)a, Thomas Ciseski, MRT(T)a, Andrea DeAbreua, Alex Mamedova and Liying Zhangb a Odette Cancer Centre b Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre Background and Purpose: High dose-rate brachytherapy (HDR) and supplemental external beam radiotherapy (EBRT) is associated with a high disease control rate for men with intermediate and high risk prostate cancer. The value of routine post radiotherapy biopsy to predict ultimate disease control is unknown. Our purpose is to determine the association between posttreatment biopsy results and probability of biochemical disease-free survival in men treated with HDR + EBRT.
Conference Proceedings from RTi3 2014/Journal of Medical Imaging and Radiation Sciences 45 (2014) 162-188