Quality of Radiotherapy Workforce Training within the USA.

The training, competency requirements and scope of practice of professionals within a radiation oncology department vary across countries. The purpose of this review is to shed light on the current status of radiotherapy training in the USA by discussing current benchmarks for medical residency, physics residency, radiation therapy and dosimetry training programmes. Although there are notable strengths, the US radiotherapy workforce training system also faces several challenges when it comes to standardising education to develop a competent workforce that meets societal needs. Continued efforts are needed at a systemic level to improve training in areas such as brachytherapy and proton therapy, promote research involvement and develop trainees who are equipped to form a competent radiation therapy workforce.

A multi-institutional analysis of intraoperative radiotherapy for early breast cancer: Does age matter?

BACKGROUND: Single-session intraoperative radiation therapy (IORT) minimizes treatment demands associated with traditional whole breast radiation therapy (WBRT) but outcomes on local disease control and morbidity among the elderly is limited. METHODS: A multi-institutional retrospective registry was established from 19 centers utilizing IORT from 2007 to 2013. Patient, tumor, and treatment variables were analyzed for ages <70 and ≥70. RESULTS: We evaluated 686 patients (<70 = 424; ≥70 = 262) who were margin and lymph node negative. Patients <70 were more likely to have longer operative time, oncoplastic closure, higher rates of IORT used as planned boost, and receive chemotherapy and post-operative WBRT. Wound complication rates were low and not significantly different between age groups. Median follow-up was 1.06 (range 0.51-1.9) years for < 70 and 1.01 (range 0.5-1.68) years for ≥ 70. There were 5 (0.73%) breast recurrences (4 in <70 and 1 ≥ 70, p = 0.65) and no axillary recurrences during follow-up. CONCLUSIONS: IORT was associated with a low rate of wound complication and local recurrence on short-term follow-up in this cohort.

SU-E-J-77: Clinical Evaluation of a Three-Dimensional Optical Surface Based Imaging Device for Breast Treatment Setup.

PURPOSE: The purpose of this work is to evaluate the accuracy of a three-dimensional surface based optical imaging device for treatment setup of breast patients. A commercial system has been used to acquire live surface contour data, which are registered with a reference surface contour for setup corrections. This work is to investigate the accuracy of this system when compared with conventional portal images. METHODS: The system was clinically applied to twenty breast cancer patients receiving radiotherapy treatment. For each patient, conventional portal imaging before the first fraction was acquired and approved by clinicians. After approval of portal images, a reference surface contour was acquired. This reference contour was subsequently used to guide daily patient setup followed by weekly portal images. A total of 89 sets of portal images were acquired for these patients. On days when portal images were taken, optical images were used to guide for initial patient setup, then portal images were taken and evaluated in order to make direct comparison between the optical imaging system and the conventional portal images. RESULTS: Among 89 sets of portal images taken after optical imaging guidance, 11 (12%) sets of portal images required further adjustments in order to achieve clinically acceptable criteria. The average vector adjustments for these 11 fractions were 0.65 cm ± 0.30 cm. Average vector shifts made according to the optical imaging for all fractions of 20 patients was 0.66 ± 0.33 cm. CONCLUSIONS: Our data show that the commercial optical system can improve the accuracy of treatment setup for breast patients without additional radiation exposure. The observed discrepancy between the portal images and optimal images requires further investigation. The optical imaging guidance can be routinely used between normally scheduled portal imaging.