Anna Kirby
@AnnaKirby17
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Consultant Clinical Oncologist, Royal Marsden Hospital and Institute of Cancer Research
London, UK
Joined January 2016
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Most illuminating talk I have ever heard on Equity and Diversity from @JulieLarkin305 “The table is not ours to give access to, it belongs to all of us”. Catch up with it on #youngtrack #ESTRO2021 if you can.
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Very much enjoyed today’s “young” #ESTRO2020 lunch symposium and now back to hear Matthias Guckenberger in the ESTRO-EORTC session. See you there.
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Just days to go to#ESTRO2020. What better way to spend a lockdown winter weekend than connecting with long-lost colleagues & listening to a heavenly host of international experts update you on all that’s new and evolving in radiotherapy. All from the comfort of your home. Enjoy!
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Honoured to have been nominated to run for ESTRO President. Grateful for the advice and support of many colleagues, past and present. Regardless of the outcome, it is a pleasure being part of TeamRT.
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T4: UK needs to overcome reticence to treat IMC for fear of radiation-induced heart disease. Simple heart-sparing techniques key. #radonc
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T4: How can we identify the women at greatest risk of developing radiation-induced cardiac event (beyond MHD & known risk factors)? #radonc
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Successful prone centres seem to have longer average treatment slots. You need 20-30mins to set them up and CBCT to verify. #radonc
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We have used VMAT in a few patients requiring bolus. Also capable of getting MHD<3Gy but it's a day or so's work for physics! #radonc
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IMC RT approx. doubles mean heart dose. We have been using wide tangents and voluntary breath hold for most. MHD<3Gy in majority. #radonc
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My personal view is that protons will help in a minority of patients with unusual anatomy and requiring IMC RT. #radonc
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We still use ABC for VMAT patients (moving light field) and where bolus required (can't see light field on skin). #radonc
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Coaching adds around 5 mins to CT planning slot. VBH adds around 3mins to treatment slot (last audit showed 12min average on linac). #radonc
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Occasional patient can't tolerate it (maybe 1 in 100). Voluntary breath hold technique difficult in deaf patients. #radonc
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We have found DIBH to be more straightforward than prone. Voluntary breath hold as effective and reproducible as ABC (and cheaper!) #radonc
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As low as achievable. We autocontour heart in all left breast affected and in right breast patients undergoing IMC RT #radonc
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Re T2: Dose effect relationship described for mean heart dose but not yet LAD. LAD also difficult to outline. So OAR is whole myocardium
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