RADIOTHERAPY TREATMENT INTERRUPTIONS MANAGEMENT: AN ITALIAN SURVEY
PD-0076
Abstract
RADIOTHERAPY TREATMENT INTERRUPTIONS MANAGEMENT: AN ITALIAN SURVEY
Authors: Francesco Deodato1, Alba Fiorentino2, Gabriella Macchia1, Stefania Manfrida3, Nicola Dinapoli4, Mattia Falchetto Osti5, Giuseppe Sanguineti6, Elvio Russi7
1Gemelli Molise Hospital – Università Cattolica del Sacro Cuore, Radiation Oncology Unit, Campobasso, Italy; 2General Regional Hospital F. Miulli, Radiation Oncology Department, , Acquaviva delle Fonti, Italy; 3Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Radiation Oncology Unit Gemelli ART, Roma, Italy; 4Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Radiation Oncology Unit Gemelli ART, Roma , Italy; 5Sapienza Università di Roma, AOU Sant’Andrea, Radiation Oncology Unit, Roma, Italy; 6IRCCS Regina Elena National Cancer Institute, Department of Radiation Oncology, Roma, Italy; 7Teaching Hospital “S. Croce e Carle”, Radiation Oncology Unit, Cuneo, Italy
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Purpose or Objective
Unplanned radiotherapy (RT) breaks lengthen the overall treatment time and have a negative effect on local control and cure rates. Here, we report the results of a recent nationwide study providing data on the main causes of radiation therapy interruptions and management strategies to reduce or eliminate their clinical impact.
Material and Methods
Italian RT center directors participated in a study that investigated RT weekly schedules, the handling of RT interruptions, and guidelines use for handling interruptions.
Results
The survey was completed by 104 (56.8%) centers. With 2 (range 1-6) LINACS on average, only 5% of centers routinely conduct clinical activities six days a week; 22% of centers do so when dosage recovery is required; the remaining (73%) centers conduct clinical activities five days a week. The vast majority (93.1%) of centers considered interruptions a critical issue to manage, particularly for head and neck, cervix, lung and rectal cancer treatments. For 74% of respondents a 5-day or longer interruption could have an impact on the outcome of RT. The Royal College of Radiologists' international standards for interruption management were followed by 30 centers (28.88%), whereas 25 centers (24%) had their own set of rules. LINAC breakdowns (52%), toxicity (23%) and patient compliance (13%) were cited as the most frequent interruption causes. In the event of a LINAC breakdown, 80 centers have stated that patients will be treated in the other without recalculating the second machine.
The majority of centers (86%) recover lost doses by raising the overall dose (79%), treating patients on Saturday (34%), holding two sessions per day (18%), using an accelerated regimen in the final part of the treatment (17%). Only 28 centers (27%) consistently recover dosage.
Conclusion
The nationwide survey revealed a variety of approaches to recovering from RT disruption, emphasizing the necessity of national rules and company advice.