1133 poster Improved simulation and treatment technique of both the breast and the regional lymph...
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S474 Posters 1131 poster Difference in the image using the flatpanel as compared to the conventional image intensifier. Difference in image quality using the flatpanel as compared to the image intensifier R.E. Smits, J.M.T. Meijer, B.J. Kluivingh, B.P.H.M. Geelen Reinier de Graafgroep, Radiotherapy, Delft, The Netherlands Subject: Difference in the image using the Flatpanel as compared to the conventional image intensifier. Introduction: Difference in image quality using the Flatpanel as compared to the image intensifier. Method: Comparing old images made using an image intensifier to those using the Flatpanel Result: It is possible to depict more tissue structures using the Flatpanel. For example in the case of an image taken of a chest wall you can depict both rib and lung structures and the outline of the breast tissue. Conclusion: Because the Flatpanel has a higher resolution it is possible to distinguish far better between the different tissue structures as compared to a conventional image intensifier. 1132 poster Evaluation of the dose received by the lens and the thyroid during head and neck carcinoma irradiation by a 60Co unit M. Gui//aume, M. Ka/pers, J. Vercauteren, T. N'Guyen, M. Roelandts Jules Bordet, Radiotherapy, Brussels, Belgium Purpose: the study aimed to evaluate the importance of the scattered rays during cervical irradiation, which would imply a hazard for normal tissue. Patients and methods: selection of treated patients and of the 60Co unit, patient positioning, treatment planning, calibration and scoring of the absorbed dose by the mean of TLDs. Results: the dose absorbed from scattered rays by the thyroid parenchyma is higher than this absorbed by the lens, despite of a smaller exposition of the TLDs. Nevertheless the results are function of the radiation fields size and the distances from critic organs. Conclusion: if we extrapolate our results, the lens and the thyroid could receive a not negligible dose from scattered rays. 1133 poster Improved simulation and treatment technique of both the breast and the regional lymph nodes, using evolution J.M.T. Meiier, B.J. Kluivingh, R.E. Smits, B.P.H.M. Geelen Reinier de Graafgroep, Radiotherapy, Delft, The Netherlands Evolution is a new product from Nucletron. In this simulator a digital fiat panel intensifier replaces the conventional image intensifier. The department of Radiotherapy of the Reinier de Graaf Groep hospital in Delft is a validation site for Nucletron. Especially the improvement in image quality (by using 64.000 gray levels), the enlargement of the Field of View to 41x41 cm and the way in which Simplicity (the simulator workstation application) communicates with the Simulix software, show that Evolution is innovative. Depending on the needs of a radiotherapy department Evolution can certainly provide added value to this department. In our department a 5- field breast technique is used to treat both the breast and the regional lymph nodes. Because Simplicity enables us to simulate asymmetric fields and because of the possibilities of image enhancement etc we can simulate/irradiate these patients using just one isocenter. In view of the use of asymmetric fields and the need for good image quality with this technique it is an excellent showcase to explain the possibilities of Evolution. Because of the great progress in image quality and an increase in the possibilities of image enhancement and the integration of the system in a circle of other systems a simplification of the simulation technique is achieved, which in turn means a sizeable reduction of simulation time. 1134 poster Compliance in pelvic radiotherapy patients with oral elemental diet C. McGou.qh1, C. Baldwid, A. Norman 2, G. Frost3, P. Blake 2, D. Tail, H. Andreyev ~ .!Imperial College Faculty of Medicine, Department of Medicine & Therapeutics, London, United Kingdom *The Royal Marsden Hospitals NHS Trust, London, United Kingdom 3Hammersmith Hospitals NHS Trust, Department of Nutrition & Dietetics, London, United Kingdom Purpose: Most patients undergoing pelvic radiotherapy experience acute gastrointestinal side effects of treatment. Elemental diet during pelvic radiotherapy may reduce acute gastrointestinal toxicity. The aim of this study was to assess the volume of oral elemental diet patients undergoing radical pelvic radiotherapy are able to consume. Methods: Patients were asked to try to consume a target volume of E028 extra liquid (SHS International) throughout their course of radical pelvic radiotherapy and record daily intake. Patients were randomised to one of three target volumes of E028: 20%, 50% or 75% of total daily caloric requirements. Compliance with the target volume was measured. Full ethical approval was granted by the Royal Marsden Clinical Research and Ethics Committees. Results: 30 patients (27 female) aged 55.5 yrs (range 48.5- 63.8) participated, including 15 patients with endometrial, 11 with cervical and 4 with rectal carcinomas. Treatment doses ranged from 45-63Gy external beam radiotherapy with additional brachytherapy 8-22.5Gy according to site and stage of disease. 10 patients underwent concomitant chemotherapy. Weight at baseline was 71.1 Kg (range 56.7- 85.3) and there were no significant changes in weight by week 5. Intention to treat analysis revealed that compliance was achieved in only 3 patients, all from Group 1. Only 5 patients achieved 100% of their target volume at any time. 'Analysis of variance' with repeated measures was carried out and showed no differences in intake across the groups despite the different target volumes set. An inverse linear relationship between intake of E028 and time occurred (p=0.028). Intake decreased between the start and end of treatment (p=0.017): week 1 (350ml, SE 52.6), week 5 (189 ml, SE 45.2). 70% of Group 1 still managed to consume some of their target at week 5, compared to only 30% of Group 2 and 50% of Group 3. A high initial target appeared to discourage sustained compliance. Actual intake is described in the table. Table:
Transcript of 1133 poster Improved simulation and treatment technique of both the breast and the regional lymph...
S474 Posters
1131 poster
Difference in the image using the flatpanel as compared to the conventional image intensifier. Difference in image quality using the flatpanel as compared to the image intensifier R.E. Smits, J.M.T. Meijer, B.J. Kluivingh, B.P.H.M. Geelen Reinier de Graafgroep, Radiotherapy, Delft, The Netherlands Subject: Difference in the image using the Flatpanel as compared to the conventional image intensifier.
Introduction: Difference in image quality using the Flatpanel as compared to the image intensifier.
Method: Comparing old images made using an image intensifier to those using the Flatpanel
Result: It is possible to depict more tissue structures using the Flatpanel. For example in the case of an image taken of a chest wall you can depict both rib and lung structures and the outline of the breast tissue.
Conclusion: Because the Flatpanel has a higher resolution it is possible to distinguish far better between the different tissue structures as compared to a conventional image intensifier.
1132 poster
Evaluation of the dose received by the lens and the thyroid during head and neck carcinoma irradiation by a 60Co unit M. Gui//aume, M. Ka/pers, J. Vercauteren, T. N'Guyen, M. Roelandts Jules Bordet, Radiotherapy, Brussels, Belgium Purpose: the study aimed to evaluate the importance of the scattered rays during cervical irradiation, which would imply a hazard for normal tissue.
Patients and methods: selection of treated patients and of the 60Co unit, patient positioning, treatment planning, calibration and scoring of the absorbed dose by the mean of TLDs.
Results: the dose absorbed from scattered rays by the thyroid parenchyma is higher than this absorbed by the lens, despite of a smaller exposition of the TLDs. Nevertheless the results are function of the radiation fields size and the distances from critic organs.
Conclusion: if we extrapolate our results, the lens and the thyroid could receive a not negligible dose from scattered rays.
1133 poster
Improved simulation and treatment technique of both the breast and the regional lymph nodes, using evolution J.M.T. Meiier, B.J. Kluivingh, R.E. Smits, B.P.H.M. Geelen Reinier de Graafgroep, Radiotherapy, Delft, The Netherlands Evolution is a new product from Nucletron. In this simulator a digital fiat panel intensifier replaces the conventional image intensifier.
The department of Radiotherapy of the Reinier de Graaf Groep hospital in Delft is a validation site for Nucletron.
Especially the improvement in image quality (by using 64.000 gray levels), the enlargement of the Field of View to 41x41 cm and the way in which Simplicity (the simulator workstation application) communicates with the Simulix software, show that Evolution is innovative.
Depending on the needs of a radiotherapy department Evolution can certainly provide added value to this department.
In our department a 5- field breast technique is used to treat both the breast and the regional lymph nodes. Because Simplicity enables us to simulate asymmetric fields and because of the possibilities of image enhancement etc we can simulate/irradiate these patients using just one isocenter.
In view of the use of asymmetric fields and the need for good image quality with this technique it is an excellent showcase to explain the possibilities of Evolution.
Because of the great progress in image quality and an increase in the possibilities of image enhancement and the integration of the system in a circle of other systems a simplification of the simulation technique is achieved, which in turn means a sizeable reduction of simulation time.
1134 poster
Compliance in pelvic radiotherapy patients with oral elemental diet C. McGou.qh 1, C. Baldwid, A. Norman 2, G. Frost 3, P. Blake 2, D. Tail, H. Andreyev ~ .!Imperial College Faculty of Medicine, Department of Medicine & Therapeutics, London, United Kingdom *The Royal Marsden Hospitals NHS Trust, London, United Kingdom 3Hammersmith Hospitals NHS Trust, Department of Nutrition & Dietetics, London, United Kingdom Purpose: Most patients undergoing pelvic radiotherapy experience acute gastrointestinal side effects of treatment. Elemental diet during pelvic radiotherapy may reduce acute gastrointestinal toxicity. The aim of this study was to assess the volume of oral elemental diet patients undergoing radical pelvic radiotherapy are able to consume.
Methods: Patients were asked to try to consume a target volume of E028 extra liquid (SHS International) throughout their course of radical pelvic radiotherapy and record daily intake. Patients were randomised to one of three target volumes of E028: 20%, 50% or 75% of total daily caloric requirements. Compliance with the target volume was measured. Full ethical approval was granted by the Royal Marsden Clinical Research and Ethics Committees.
Results: 30 patients (27 female) aged 55.5 yrs (range 48.5- 63.8) participated, including 15 patients with endometrial, 11 with cervical and 4 with rectal carcinomas. Treatment doses ranged from 45-63Gy external beam radiotherapy with additional brachytherapy 8-22.5Gy according to site and stage of disease. 10 patients underwent concomitant chemotherapy. Weight at baseline was 71.1 Kg (range 56.7- 85.3) and there were no significant changes in weight by week 5. Intention to treat analysis revealed that compliance was achieved in only 3 patients, all from Group 1. Only 5 patients achieved 100% of their target volume at any time. 'Analysis of variance' with repeated measures was carried out and showed no differences in intake across the groups despite the different target volumes set. An inverse linear relationship between intake of E028 and time occurred (p=0.028). Intake decreased between the start and end of treatment (p=0.017): week 1 (350ml, SE 52.6), week 5 (189 ml, SE 45.2). 70% of Group 1 still managed to consume some of their target at week 5, compared to only 30% of Group 2 and 50% of Group 3. A high initial target appeared to discourage sustained compliance. Actual intake is described in the table.
Table:
