Viability of mobile applications for remote support of radiotherapy patients

SUMMARY BACKGROUND Technological advances of the 21st century have provided greater communication, regardless of socioeconomic class and age group. Actions to promote the development of health applications are emerging around the world. OBJECTIVE To provide a perspective on the viability and usability of mobile applications dedicated to radiotherapy patients for remote support to health professionals proposing solutions to encourage Brasil in the development of these digital tools. METHODS Cross-sectional exploratory study by systematic review and literature review. We searched the PubMed, BVS, IBGE, and WHO databases, from 2014 to 2018. RESULTS 6 articles were found with topics related to the use of mobile applications in the health area, two of which were published in Portuguese and four in the English, on oncology, from 2014 to 2018. CONCLUSIONS We did not find an expressive number of works on this subject in Brasil. Mobile applications have the potential to assist in the remote support of radiotherapy patients. The latest studies suggest the need for a regulation of data protection protocols to be deployed.

RESUMO INTRODUÇÃO O avanço tecnológico no século XXI tem proporcionado maior comunicação entre todos, independentemente da classe socioeconômica e da faixa etária. Ações de fomento ao desenvolvimento de aplicativos para a área da saúde estão surgindo ao redor do mundo. OBJETIVO Oferecer uma perspectiva sobre a viabilidade e usabilidade dos aplicativos móveis dedicados aos pacientes radioterápicos para suporte remoto aos profissionais da saúde propondo soluções a fim de incentivar, no Brasil, o desenvolvimento dessas ferramentas digitais. MÉTODOS Estudo transversal de caráter exploratório por revisão sistemática e análise da literatura. Foram utilizadas buscas nas bases de dados: PubMed, BVS, IBGE, OMS, por publicações citadas de 2014 a 2018. RESULTADOS Foram encontrados cinco artigos com temas relacionados ao uso de aplicativos móveis na área da saúde, sendo dois nacionais, publicados em língua portuguesa, e três internacionais, no idioma inglês, dos quais esses últimos aplicados à oncologia no período de 2014 a 2018. CONCLUSÕES Não foi encontrado um número expressivo de trabalhos com este tema no Brasil. Aplicativos móveis têm potencial para ajudar no suporte remoto de pacientes radioterápicos. Os últimos estudos sugerem a necessidade de uma regulamentação de protocolos de proteção de dados transmitidos a ser implantada.

Impact and evaluation of the use of tri-dimensional over bi-dimensional plan for the breast and axillary lymph node irradiation with tangential fields for conservative breast cancer treatment

BACKGROUND: A comparative study of dose distribution delivered to the anatomically defined breast, axillary levels I-III, supra clavicle nodal, cardiac and left lung volumes treated by standard tangent fields using conventional technique, planned by either two dimensional (2D) or tri-dimensional (3D) radiotherapy treatment-plan was performed to determine if the dosimetry for the breast, regional lymph nodes and normal tissues at risk can be improved.MATERIAL AND METHODS: Data of the charts and images of 10 consecutive patients who underwent breast-conserving surgery for left-sided breast cancer and received post-operative RT at the Department of Radiation Oncology, Hospital A.C. Camargo, São Paulo, Brazil were reviewed and re-planned. All sets of images used for the study were saved separately and no modification was performed to the initial programmed plan for each patient. For 2D irradiation plans, two opposed fields to treat the breast volume were used and one appositional field was used to treat the supra clavicle nodes. After 2D dosimetric planning, a second 3D treatment plan, with CT tomography at 5-mm intervals in the same position as predetermined in the 2D simulation, was used for plan dose coverage comparison.RESULTS: The breast CTV dose coverage evaluated by the D85%, D90% and D100% presented statically significant differences favoring the 3D plan (p = 0.017; 0.011 and 0.005), with correlation indexes ranging from 42.6% to 57.2%. The same was observed for the supra clavicle nodes (p = 0.003; < 0.001 and 0.045) with correlation indexes ranging from 19.4% to 37.4%. For the axillary levels, a statistical significant difference on dose coverage was observed only for the axillary level III D100%, p = 0.001 and correlation index of 72.5%. For the cardiac area there was a statistical significant difference between the maximum and median given, p = 0.002 and p = 0.01, favoring the 3D plan. CONCLUSION: The use of 3D plan is necessary to include....