Author: Angela Gearhardt, Stephen F. Kry, Christopher Ryan Peeler, Julianne M. Pollard-Larkin 👨🔬
Affiliation: The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences; The University of Texas MD Anderson Cancer Center, The University of Texas MD Anderson Cancer Center 🌍
Purpose: Electronic medical devices (EMDs) must be carefully managed in radiation oncology to prevent radiation-induced device malfunction. Only one EMD, pacemaker/defibrillator, has a recommended protocol for clinical management. A lack of guidance on EMD management can leave patients receiving suboptimal and variable care. This international survey generates understanding about the current state of EMD management, which is a vital step in developing critically necessary protocols for additional EMDs.
Methods: Our survey was distributed to over 2,500 physicists’ emails internationally. The survey consisted of multiple choice and short answer questions concerning seven types of EMDs. Questions addressed many topics including: desire for guidance, frequency of EMD observance, existence of current policies, documentation and training of current policies, allowance of devices in primary beams, discouragement of neutron-producing energies and hypofractionation, estimation of cumulative dose, access to specialists for consultation, and difficulties experienced in implementing current protocols.
Results: Preliminary results include 224 completed responses. For the six devices that do not currently have a clinical management protocol, an average of 70% of respondents indicate their clinic would benefit from additional guidance. On average 30% of respondents indicate that these six devices are included in their pacemaker/defibrillator policy and 54% indicate that their clinic lacks a policy for these devices. There is variability among the institutional policies which do exist for these devices; seven different methods to determine cumulative device dose were reported.
Conclusion: Preliminary results of this survey indicate that there is great community desire for additional guidance regarding the clinical management of patients with EMDs in radiation therapy. This desire is reflected in the lack of institutional policies addressing EMDs internationally. This survey demonstrates both a need and desire for the creation of clinical management protocols for additional EMDs.