S1467
Interdisciplinary - Other
ESTRO 2026
processing of other RT data modalities, including DICOM files. References: 1. Baskar, R., Lee, K. A., Yeo, R., & Yeoh, K. W. (2012). Cancer and radiation therapy: current advances and future directions. International journal of medical sciences, 9(3), 193–199. https://doi.org/10.7150/ijms.36352. Raschka, S., Patterson, J., & Nolet, C. (2020). Machine Learning in Python: Main developments and technology trends in data science, machine learning, and artificial intelligence. ArXiv, abs/2002.04803. Keywords: machine learning, multi-modal, DVH It’s a risky business: using audit and a seminar series in a quality improvement project focusing on local re-irradiation practice William van den Berg, Sweta Bowles, Jackie Poxon Radiotherapy Department, Barts Health NHS Trust, London, United Kingdom Purpose/Objective: An increasing number of patients are returning for a further course of radiotherapy. Others have shown the importance of audit and consensus in formalising and standardising re-irradiation practice [1] [2] [3] [4]. Nonetheless local implementation of safe and effective re-irradiation processes presents specific challenges.At Barts Health, two core issues were identified when looking to enact our local re- Digital Poster 5076 irradiation policy. Firstly, the in-house radiobiology program was insufficient for current practice and; there was inconsistency in application of retreatment methods. To inform the design of a new program and increase awareness of re-treatment processes, we carried out an audit of previous re-irradiation cases and organised a series of seminars for the multi- disciplinary team. Material/Methods: All patients with a radiobiology document in their medical record between November 2023 and November 2024 were included. Analysis of OARs and radiobiology parameters was carried out per treatment technique.A total of 8 seminars were arranged over the course of 12 weeks, in what was labelled “Re-irradiation Awareness Month”. Speakers were from all staff groups and included some guest appearances. Posters and small stickers featuring a bespoke logo were printed for attendees to display. Results: A total of 191 radiobiology calculations were analysed. Of these, 137 (72%) were SRS, 42 (22%) were conventional and 12 (6%) were SABR. In addition, 146 (75%) were for brain treatments, 10 (5%) lung, 8 (4%)
H&N, 6 (3%) pelvis and 5 (3%) spine.The SRS data showed the same 3 OARs, α/β ratios and EQD2 tolerances were used in 100% of cases, likely due to an established process and specialised team, but showed variability in the recovery factor applied at different time intervals.The SABR retreatments showed variability in the choice of α/β used, but the method of calculating EQD2 tolerance using intended fractionation was consistent throughout, likely due to local adoption of national guidance.Conventional retreatments were by far the most varied, likely due to the wide range of personnel involved and lack of formal process, with the only consistency being in the choice of EQD2 tolerance per OAR, for which we have an approved list.The median number of attendees at each seminar was 53 (range 34 – 57). There was consistently good engagement, representation from every staff group, and significant discussion. Feedback has been overwhelmingly positive. Conclusion: Quality improvement efforts using audit and a multi- disciplinary approach can inform practice and increase engagement with safety-critical policies. References: [1] Muirhead, R. et al. (2022). Launch of the UK SABR Consortium Pelvic Stereotactic Ablative Radiotherapy Re-irradiation Guidelines and National Audit. Clinical Oncology.[2] West, N. et al. (2024). Consistency in reirradiation scenarios: Terminology, tissue recovery in calculations, units and reporting. Radiotherapy and Oncology.[3] Andratscke, N. et al. (2022). European Society for Radiotherapy and Oncology and European Organisation for Research and Treatment of Cancer consensus on re-irradiation: definition, reporting, and clinical decision making. The Lancet Oncology.[4] Paradis, K. et al. (2019). The Special Medical Physics Consult Process for Reirradiation Patients. Advances in Radiation Oncology. Keywords: re-irradiation, audit, quality improvement
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A systematic review of quality improvement interventions designed to improve access to cancer treatment for older patients Sugeeta Sukumar 1,2 , Ruhi Kanani 1,2 , David Cromwell 1,2 , Ajay Aggarwal 1,3 1 Department of Health Services and Research Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom. 2 National Cancer Audit Collaborating Centre, Royal College of Surgeons, London, United Kingdom. 3 Department of Oncology, Guys and St Thomas Trust, London, United Kingdom
Purpose/Objective: Older adults represent an increasing proportion of
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