Rethinking individual patient fixation in adjuvant photon radiation of breast cancer
Kristine Wiborg Høgsbjerg,
Denmark
PO-1187
Abstract
Rethinking individual patient fixation in adjuvant photon radiation of breast cancer
Authors: Kristine Høgsbjerg1, Harald Spejlborg2, Mette Skovhus Thomsen3, Birgitte Vrou Offersen4
1Aarhus University Hospital, 1: Department of Oncology, Aarhus, Denmark; 2Aarhus University Hospital, 1: Department of Oncology, 2: Department of Medical Physics, , Aarhus, Denmark; 3Aarhus University Hospital, 2: Department of Medical Physics, Aarhus, Denmark; 4Aarhus University Hospital, 1: Department of Oncology, 2: Department of Experimental Clinical Oncology, 3:Danish Center for Particle Therapy, Aarhus, Denmark
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Purpose or Objective
The incidence of early breast cancer (BC) patients (pts) treated with adjuvant radiation therapy (RT) in a vacuum bag (VB) has increased since initiation of the Danish Breast Cancer Group (DBCG) Proton trial.
The frequency and reason for more individualized treatment planning preparation is reported from a single institution.
Material and Methods
Pt, tumor and treatment characteristics were collected from the Electronic Patient Journal (EPJ) and the information system of Varian for pts treated in a VB. The time period of interest was the first six months of 2019 and 2021 representing the status before and after initiation of the DBCG Proton trial as of June 2020. Only pts with BC and indication for adjuvant RT were candidates. Since 2019, pts with bilateral BC have routinely been treated in a VB for correct application of the Varian Truebeam respiratory gating system.
Results
During 2019, five pts were treated in a VB, and they all had an IF due to restricted mobility of the arm. During 2021, 20 pts were treated in IF. Nine pts (45%) were treated in VB due to restricted mobility of the arm, seven (35%) due to bilateral BC and three patients (15%) had a VB in order to decrease the radiation dose to organs at risk (lungs and heart). For one patient the reason was not indicated. A lateral-decubitus position was used as a new technique in two cases to decrease the radiation dose to organs at risk.
Conclusion
Since initiation of the DBCG Proton trial, the photon clinic has individualized the photon RT by using more individualized treatment positioning and introducing the lateral-decubitus position. Furthermore, the level of accepting restricted arm mobility was lowered causing an increased number of pts with arm problems to be treated in a VB. It is likely that more patients may gain from using a VB and alternative treatment positions, and guidelines for identifying candidates for RT in a VB should be developed.