La qualità in radioterapia oncologica: i progetti della Rete - Rete Oncologica ...
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La qualità in radioterapia oncologica: i
progetti della Rete
ESTRO’s 2020 Vision “Every cancer patient in Europe will have access to state of the art radiation therapy, as part of a multi-disciplinary approach where treatment is individualised for the specific patient’s cancer, taking account of the patient’s personal circumstances”.
Multidisciplinary world sets patient
at the centre of the stage
Setting the stage: multi-stakeholder approach
Patient centric approach: equal partnership
Can Anatom-e be a suitable tool to standardize radiotherapy protocols in a oncological network such as Rete Oncologica Piemonte Valle d’Aosta ?
Target volumes in H&N SCC T2N1 tonsil cancer
• Selection of CTV: lymphatics at risk, elective lymph nodes (CTV: the weakest part of the chain) • A digital atlas from the combination of 150 atlases, on 3mm axial CT or MRI in the treatment position • Over 50,000 normal structures outlined • Contouring guides for post operative scenarios • Contour your patients with a side by side view or seamless overlay on your existing TPS
To assess whether Anatom-e-based
selection and delineation of
radiotherapy treatment volumes in
rectal cancer patients is more
homogeneous with the use of this
electronic platform among different
centersThe centers participating to this project are: • AOU Citta’ della Salute e della Scienza (Torino) • Ospedale San Luigi Gonzaga (Orbassano) • Ospedale Santa Croce ( Cuneo) • Ospedale Mauriziano (Torino) • Ospedale SS Arrigo and Biagio (Alessandria) • Ospedale Cardinal Massaia (Asti) • Ospedale Umberto Parini (Aosta) • Ospedale Civile (Ivrea)
Two clinical cases:
Rectal cancer: (cT3N2M0)
Atlas Anatom-e…….Our project Evaluation of the inter- and intra-observer variability in contouring radiation volumes for neoadjuvant treatment in locally advanced rectal cancer Outline the same case in two different days to assess the intra-observer variability Evaluation of the contouring with and without the use of Anatom-e among different centers to assess inter-observer variability
Patient centric approach:
Vision: key elements
every patient
access to state of the art RT
individualised
multi-disciplinary treatmentCentri RT:
2008, 2011
1. Novara (+ Vercelli)
2. Verbania (SS)
3. Biella
4. Ivrea
5. Asti 2010 2015, 2015
6. Alessandria
1999, 2007,
7. Cuneo 2014
8. IRCCS Candiolo
9. Mauriziano 2000, 2008
10. San Luigi (SS) 2010
11. Città Salute e Scienza
Brachiterapia
1. CSS (S. Anna)
2. IRCCS Candiolo 2005, 2005 2008, 2014
3. Asti
4. Cuneo
5. Novara
2001, 201330 Linac
(+ 1 privato)
14 area torinese
2.7 Linac/centro
1 centro/402.000 ab
6.8 Linac/1.000.000 ab Villa Pia
1999
SGAS
2000, 2004,
2010
9 Linac > 10 anni Mauriziano
2007, 2015
Molinette
2002, 2003,
S. Luigi 2010, 2010
2009
S. Anna
2010
Candiolo
2010, 2012,
2014ESTRO HERO: equipment
MV units per million inhabitants
Albania
Bulgaria
Estonia
Poland
Belarus
Montenegro
Lithuania
Hungary
Luxembourg
Slovenia
Portugal
Malta
United Kingdom
Austria
European median
Czech Republic
Germany
Spain
Italy
Iceland
Sweden
France
Ireland
Switzerland
Netherlands
Finland
Belgium
Norway
Denmark
0 1 2 3 4 5 6 7 8 9 10Directory of Radiotherapy Centres (DIRAC)
ESTRO HERO: equipment
MV units per department
Bulgaria
Belarus
Czech Republic
Switzerland
Albania
Estonia
Montenegro
Luxembourg
Malta
Iceland
Italy
Spain
Lithuania
Portugal
European median
France
Ireland
Hungary
Austria
Poland
Finland
Belgium
Sweden
United Kingdom
Netherlands
Denmark
Slovenia
Norway
0 1 2 3 4 5 6 7 8 9ESTRO’s Vision
Measurable in a patient centered key performance indicator
(kpi)
Raising awareness and better positioning of RT
in the multidisciplinary cancer care setting
will impact the KPI493
26.000 nuovi casi di 387 468
tumore maligno in
1050
Piemonte/anno
850
13.000 nuovi 250
pazienti RT/anno
634 950
1150Numero nuovi
pazienti trattati
nell’anno 2106
nei centri RT
Piemontesi:
10.815 Villa Pia
(+ 387 Aosta + SGAS
895
200 VMP)
(di cui 4.840 nel Mauriziano
580
torinese; 14/30
Linac sono in Molinette
area torinese) S. Luigi 1680
330
S. Anna
(42% del totale 480
delle diagnosi
oncologiche)
Candiolo
1005Patient centric & multidisciplinary approach
Increasing the proportion of patients who
actually receive radiation oncology as a
proportion of those who should receive it,
because this is in nearly none of the
European countries the case today.Distribuzione centri in Piemonte
TO1 476.912
TO2 419.861
(Rivoli,
Nord TO3 586.691
Pinerolo)
Ovest
(Cirié,
TO4 Chivasso, 520.384
Ivrea)
TO5 (Chieri) 310.307
VC 173.104
BI 172.635
Nord-Est
NO 349.773
VCO 171.390
(Cuneo,
CN1 Mondovì, 420.320
Savigliano)
SUD CN2 171.865
AT 206.947
(Alessandria,
AL 444.073
Casale, Novi)
TOTALE 4.424.262Precision Medicine
The following key messages
Advocacy for RO
Curative
medical
discipline
Access and Multidisciplinary
investments care
Radiation
oncology
cures cancer
safely, today
Safety Innovation
Cost
effectivenessYou can also read
