Author of

• 11645

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  P2.08 - Poster Session 2 - Radiotherapy (ID 198)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Radiation Oncology + Radiotherapy
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11670

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    P2.08-025 - A study of respiratory-induced tumour motion based on anatomical lung location using 4DCT in lung cancer patients (ID 2976)

    09:30 - 09:30  |  Author(s): D. Ball
    • Abstract

    Background
    Respiratory induced tumour motion is one of several challenges encountered when delivering radical radiotherapy to lung cancer patients. In recent years, four-dimensional computed tomography (4DCT) has improved our ability to accurately define lung tumour motion during breathing. Using 4DCT images, our study aims to compare the magnitude of lung tumour motion due to respiration, amongst different anatomical lobes and pulmonary zones. This may help guide personalised radiotherapy margins for patients with lung cancer.

    Methods
    This is a retrospective study of 100 consecutive patients from the Peter MacCallum Cancer Centre treated with curative intent radiotherapy for lung cancer. All 4DCT scans accessible from patients scanned between December 2009 and May 2013 were included. Images were analysed using the MIM v5.6 software. Tumour volumes were delineated by a single observer and propagated to include all 10 phases of the respiratory cycle. Movements were tracked in the superior-inferior (SI), anterior-posterior (AP) and medio-lateral (ML) directions by changes in the gross tumour volume centroid coordinates. Tumour motion characteristics were correlated with anatomical lobe, pulmonary zone, tumour volume, histopathology, spirometry and T-stage. Tumours with chest wall or mediastinal invasion were excluded. Statistical analyses were performed using Prism v6.0.

    Results
    Preliminary data from 82 patients showed the greatest mean movement in the SI direction among lower lobe tumours compared to those located in the upper lobes [Left lower, 8.0mm, n = 13, vs. Left upper, 1.3mm, n = 24] [Right lower, 6.4mm, n = 19, vs Right upper, 1.9mm, n = 28], p < 0.01. In all lobes, mean movements were similar in the AP [1.6mm, Right lower; 2.1mm, Right middle; 1.8mm, Right upper; 2.3mm, Left lower; 1.6mm, Left upper] and lateral directions [0.9mm, Right lower; 2.4mm, Right middle; 1.2mm, Right upper; 1.5mm, Left lower; 1.2mm, Left upper]. 35 patients were staged as T1, 30 as T2 and 14 as T3. Mean lung tumour motion decreased with increasing T stage in the SI direction [3.9mm, T1; 3.7mm, T2; 3.5mm, T3], however this was not statistically significant. Assessment of the association between tumour motion and spirometry findings is ongoing. Figure 1

    Conclusion
    The degree of lung tumour motion varies widely according to its position within the lung. The largest differences in tumour motion was between the upper and lower lobes in the SI direction. Analysis of all 100 patient datasets is ongoing.

• 12008

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  P2.25 - Poster Session 2 - Nurses (ID 249)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Nurses
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12010

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    P2.25-002 - How do patients with lung cancer experience radiation induced oesophagitis? (ID 2510)

    09:30 - 09:30  |  Author(s): D. Ball
    • Abstract

    Background
    Background Radiation induced oesophagitis (RIO) is a significant toxicity of lung cancer treatment that has profound clinical, social and economic implications. The literature suggests there is minimal evidence to support current analgesic regimes with the exception of systemic analgesia. More information is required to better understand the patient experience of RIO and how it can be managed. Aim To identify the properties and characteristics of RIO experienced by patients having radiotherapy to the chest for lung cancer.

    Methods
    Methods A qualitative exploratory study conducted with patients with lung cancer receiving radiotherapy to the chest. Patients participated in semi-structured interviews exploring their experience of RIO. Interviews were recorded, transcribed and content analysed.

    Results
    Results Twenty six patients participated: six with grade 1; 14 with grade 2 and eight with grade 3 RIO. Patients were interviewed following recovery from grade 3 RIO. Four key domains were identified: 1.Pain descriptors such as “feels raw “, “burning”, “like reflux but worse” were reported 2. Swallowing difficulties varied over time and were described as “felt like there was a blockage, “afraid I would choke,” “unable to get anything through”. 3. Self care efforts employed by the patients to manage these difficulties ranged from diet modification, allowing food and drinks to go cold before eating and eating slowly. 4. An aversion to taking regular analgesia was also evident. The overall impact on participants’ lives was often understated, even in the context of hospital admissions, insertion of nasogastric tubes and poorly controlled pain.

    Conclusion
    Conclusions This study demonstrates the complexity of RIO and suggests clinicians may underestimate the effect and severity of RIO. Given patients appear to continue to experience problems, despite treatment, better prophylaxis and management regimes are required.