S224
Clinical - Breast
ESTRO 2026
of moderate hypofractionation SIB reduced linac time by 15%. The largest absolute change was the predicted 58.8% reduction in linac time with the use of ultrahypofractionation with a SIB boost.
the MA.20 trial in which patients with ≥ 4 ALN metastases received axillary RT after ALND. Keywords: residual axillary LN, regional nodal irradiation
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Predicted impact of treatment protocol changes and auto-contouring on resources required to deliver adjuvant breast radiotherapy Daniel J Coyle 1 , Claire Fitzpatrick 2 , Elaine Tyner 2 , Brendan McClean 2 , Ruth Woods 2 , Frances Duane 2,3 , Jill Nicholson 2,3 , Orla McArdle 1,2 1 Beaumont RCSI Cancer Centre, Royal College of Surgeons Ireland, Dublin, Ireland. 2 Radiation Oncology, St Luke's Radiation Oncology Network, Dublin, Ireland. 3 Radiation Oncology, Trinity St James’s Cancer Institute, Dublin, Ireland Purpose/Objective: An activity based costing model allows the impact on resource allocation of new protocols for adjuvant breast cancer radiotherapy to be examined (1). This study aims to investigate the impact of auto- contouring; moderate hypofractionation (15 fractions) with simultaneous integrated boost (SIB) (2), expanded use of Deep Inspiration Breath Hold (DIBH), ultrahypofractionation (5 fractions) for nodal irradiation and ultrahypofractionation incorporating SIB +/- nodal irradiation (3). Material/Methods: All women referred for adjuvant radiotherapy for breast cancer treated with curative intent were included in a sequential retrospective cohort, commencing radiotherapy between January – July 2019. A total of 224 participants were included. Comprehensive demographic, tumour and treatment related characteristics were collected. Eligibility of each patient for treatment protocol changes was assessed on clinical, pathological and diagnostic data using inclusion criteria from published trials / trial protocols. The time for each task in the radiotherapy pathway, staff involved and staff salary scales were calculated based prior figures (1) and updated for new protocols. Infrastructure cost per Gy was calculated based on linear accelerator cost of € 2.5M, 10% annual service charge over 12-year lifetime with 2.7 patients treated per hour, giving € 37.72 per Gy. The impact of changing treatment protocols was calculated sequentially as shown in Table 1. Results: The combined impact of all five protocol changes resulted in a predicted 63% reduction in linac time required and a cost reduction of 33% from € 476,260 to € 320,492. The use of auto-contouring software reduced contouring time by 8.8% (184 hours). The use
Conclusion: The use of auto-contouring software and the
transition to ultrahypofractionated radiotherapy has the potential to reduce by up to 60% the resources required to treat one of the most common cancers. If ongoing trials demonstrate equivalence of outcome for ultrahypofractionated radiotherapy, this change in practice may provide large economic advantages for radiotherapy departments. References: 1. Coyle DJ. 2024. Resource Implications of Evolving Breast Cancer Radiotherapy Treatment Protocols. Breast 78:103816.https://doi.org/10.1016/j.breast.2024.10381 6.2. Coles CE. 2023. Dose-Escalated Simultaneous Integrated Boost Radiotherapy in Early Breast Cancer (IMPORT HIGH): A Multicentre, Phase 3, Non- Inferiority, Open-Label, Randomised Controlled Trial. The Lancet 401(10394):2124– 37.https://doi.org/10.1016/s0140-6736(23)00619-0.3. Pathak R. 2023. Largest Real-World Data of Regional Nodal Irradiation Using Ultra-Hypofractionated 5- Fraction Adjuvant Radiation Therapy for Breast Cancer from a Single Institute in India. International Journal of Radiation Oncology, Biology, Physics 117(2):S7– 7.https://doi.org/10.1016/j.ijrobp.2023.06.215. Keywords: Resources, infrastructure, cost Improved recurrence free survival of breast cancer patients treated with hypofractionated schedule and antihistamines Cindy Sharon Ortiz Arce 1 , Miguel Angel Souto Del Bosque 2 , Pamela Reyes Sierra 3 , Alejandra Leticia Hernández Ibarra 3 1 Radiotherapy, UMAE 25, IMSS, Monterrey, Mexico. 2 Radiotherapy, Christus Muguerza, Monterrey, Mexico. 3 Clinical Research, UMAE 25, IMSS, Monterrey, Mexico Purpose/Objective: In developing nations, limited access to radiotherapy (RT) makes hypofractionated schedules a frequent option, then we decided to analyze association of use of antihistamines and schedule of radiotherapy in Digital Poster 919
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