Detoxology herbal medicine Urology  Medical fellowship  Usmle Trauma doctor  Traumatology  Transport Medicine  Transplantology  Transfusion Medicine  Toxicology  Robotic surgery  Trauma surgery  Plastic Surgery  Bariatric surgery  Surgical Oncology  Laparoscopic surgery  General Surgery  Vascular Surgery  Thoracic Surgery  Pediatric Surgery  Medical students  Sports Medicine  Rheumatology   Radiotherapy  Radiotheraphy  Radiology  Pulmonology   Public Health Emergency Medicine  Endocrinology  Family Medicine  Flebology  Forensic Medicine  Gastroenterology  Geriatrics  obstetrics  Gynecology  Hematology  Hypertensiology  Internal Medicine  Laboratory Diagnosis  Medical Microbiology  Medical Rehabilitation  Medical informatics  Neonatology  Nephrology  Neurosurgery  Neurology  Nuclear Medicine  Occupational Medicine  Ophthalmology  Orthopedics  Otorhinolaryngology  Palliative Medicine  Pathology  Pediatrics  Physiotherapy  Proctolog y Psychiatry  detoxology  Aesthetic medicine surgical anatomy  Anesthesiology  Angiology  Audiology  Balneology  Cardiac Surgery  Cardiology  Clinical Genetics  Clinical Immunology  Clinical Pharmacology  Dentistry  Dental Surgery  Maxillofacial Surgery  Implant Dentistry  Orthodontics  Periodontics  Prosthodontics  Conservative Dentistry and Endodontics  Diabetology Medical Exams    MRCS FRCS MRCP MRCOG MRCPCH MRCPGP  MCCEE  MJDF/MFDS IELTS  Case Study
2012 AAPM Annual Meeting Coen Hurkmans, Ph.D., Department of Radiation Oncology,Catharina Hospital, Eindhoven, The Netherlands For more information about the American Association of Physicists in Medicine, visit http://www.aapm.org/ Guidelines for the management of patients with an internal cardiac pacemaker (ICP) or internal cardiac defibrillator (ICD) referred for radiotherapy exist but are outdated, as both ICP and ICD technology and radiation therapy techniques have evolved. (ICPs and ICDs are both CIEDs). Furthermore, the clinical practice of patient management varies widely and the number of patient with a ICP or ICD referred for radiation therapy is increasing. There is thus a clear need for updated guidelines, which are currently developed by the new AAPM TG 203. An overview of the literature, existing recommendations and dose measurement methods has been given the previous speakers of this session. In this presentation, the focus will be more on the management aspects. Which questions need to be answered to decide if a patient can receive radiation therapy? How can this be weighted against e.g. CIED relocation or replacement? It is clear that good communication between the patient, the treating cardiologist and radiation therapy department is of importance to come to the best multidisciplinary treatment approach. When radiotherapy is given, the practical measures that need to be taken should preferably be categorised based on the chance on CIED failure combined with the consequence for the patient in case of such failure. Thus, an important distinction may be made between pacing dependent and pacing independent patients. Examples of such risk classifications with corresponding practical implications will be presented, including the new Dutch national guideline recently authorised by the national cardiology, pacemaker technologists, medical physics and radiation oncology societies. Learning objectives: 1) Understand and list the questions that need to be answered to tailor the treatment to the individual patient and whom should be involved in this process. 2) Appreciate the reasons why only a crude categorisation of risks can be given. 3) Know how to interpret new CIED guidelines, their strengths and weaknesses and have sufficient knowledge to translate and incorporate these guidelines into your own institution.