Adjusting patient positioning for radiotherapy may decrease risk of heart damage

A little can go a long way. When treating a patient for lung or esophageal cancer, new research shows small adjustments can reduce the amount of unintentional damage to the heart and improve chances of survival. 

The research was presented at the ESTRO 37 conference in Barcelona by Corinne Johnson, a medical physics PhD student at the University of Manchester in the U.K., according a press release from the European Society for Radiotherapy and Oncology (ESTRO). 

The study findings could help improve treatment guidelines to ensure radiotherapy accuracy and patient safety. 

"This study examines how small differences in how a patient is lying can affect survival, even when an imaging protocol is used. It tells us that even very small remaining errors can have a major impact on patients' survival chances, particularly when tumors are close to a vital organ like the heart," Johnson said. "By imaging patients more frequently and by reducing the threshold on the accuracy of their position, we can help lower the dose of radiation that reaches the heart and avoid unnecessary damage."  

Johnson and her colleagues analyzed 780 patients with non-small cell lung cancer treated with radiotherapy. Images were taken of the patients while on a treatment machine to determine whether the patient moved from their original position. 

The team used the imaging data to determine accuracy of radiotherapy dose throughout the entire course of treatment, as well as to see whether it shifted closer to or farther away from the patient's heart.  

Overall, they found that patients with modest shifts toward their hearts were roughly 30 percent more likely to die than those with shifts away from their hearts. Repeating the same methods with a group of 177 esophageal cancer patients led to an even greater difference of 50 percent more likely, according to the press release.  

"Johnson and her colleagues are now looking at the data in more detail to see whether particular regions of the heart are more sensitive to radiation than others, and they hope to investigate the effect of differences in patient position in other types of cancer," according to the release.  

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A recent graduate from Dominican University (IL) with a bachelor’s in journalism, Melissa joined TriMed’s Chicago team in 2017 covering all aspects of health imaging. She’s a fan of singing and playing guitar, elephants, a good cup of tea, and her golden retriever Cooper.

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