S2366
Physics - Quality assurance and auditing
ESTRO 2026
Digital Poster 2718
Dosimetric characterization of organs at interest and early toxicity in Hypofractionated Stereotactic Radiotherapy for acoustic neurinomas María Medina-Cobacho 1 , Camila Fernandez-Alcalá 1 , Victoria Vera-Barragán 1 , César Rodríguez-Alarcón 2 , María Jesús Macías-Castillo 2 , Patricia Ruiz-Leal 1 , Carmen Corral-Fernández 1 , Yesika Rios-Kavadoy 1 , Joaquin J Cabrera-Rodríguez 1 , Esther Agudo-Rey 1 , Juan Quirós-Rivero 1 1 Radiation Oncology, Hospital Universitario de Badajoz, Badajoz, Spain. 2 Medical Physics, Hospital Universitario de Badajoz, Badajoz, Spain Purpose/Objective: The management of acoustic neurinomas has evolved significantly with the introduction of hypofractionated stereotactic radiotherapy (hypo-FSRT), which aims to balance local tumor control while minimizing cranial nerve morbidity. However, dose constraints for adjacent organs at interest (OaI), including the cochlea, facial nerve, and trigeminal nerve, remain poorly defined in the hypofractionated setting. The objective of this study was to quantify the mean and maximum doses delivered to these OaI and to explore their association with early treatment-related toxicity in a cohort of patients treated with hypo-FSRT at a single institution. Material/Methods:
The analysis identified that team experience, equipment quality, interprofessional communication, and time pressure constitute cross-cutting factors that simultaneously affect both dimensions of safety. The methodological integration demonstrated that patient and professional safety are inseparable dimensions. For example, professional inexperience not only compromises implant precision but also prolongs radiation exposure. Similarly, equipment without adequate maintenance simultaneously compromises dosimetric quality and increases occupational exposure time. Conclusion: The study concludes that the combination of HFMEA and FRAM methods provides a more comprehensive assessment of radiological risks, enabling a systemic understanding of vulnerabilities and developing integrated strategies that simultaneously improve patient and professional safety. This holistic approach proves essential for proactive safety management in complex systems such as brachytherapy. References: DeRosier, J., Stalhandske, E., Bagian, J. P., & Nudell, T. (2002). Using health care Failure Mode and Effect Analysis: The VA National Center for Patient Safety’s prospective risk analysis system. The Joint Commission Journal on Quality Improvement, 28(5), 248–267, 209. https://doi.org/10.1016/s1070-3241(02)28025- 6Giardina, M., Cantone, M. C., Tomarchio, E., & Veronese, I. (2016). A Review of Healthcare Failure Mode and Effects Analysis (HFMEA) in Radiotherapy. Health Physics, 111(4), 317–326. https://doi.org/10.1097/HP.0000000000000536Hollnag el, E. (2012). FRAM, the Functional Resonance Analysis Method: Modelling Complex Socio-technical Systems. Ashgate. https://books.google.pt/books?id=bMfVCQAAQBAJ Keywords: brachytherapy, risk assessment, safety
A retrospective review was performed on patients diagnosed with unilateral acoustic neurinoma who underwent hypo-FSRT at the Hospital Universitario de Badajoz (Spain). All patients received a total dose of 25 Gy delivered in five consecutive daily fractions of 5 Gy each. Treatment planning was based on contrast- enhanced MRI and high-resolution CT fusion. Dosimetric parameters for the facial, trigeminal, and cochlear nerves were recorded, as well as tumor volume and laterality. Clinical and radiological follow- up included evaluation of hearing preservation, facial and trigeminal nerve function, and lesion stability. Results: Ten patients met the inclusion criteria. Half of the tumors were right-sided, and the median age at treatment was 58.5 years (37-73). All patients presented with hearing loss at diagnosis, and three additionally reported paresthesia. The mean gross
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