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Table 1 Questionnaire

From: Are heart toxicities in breast cancer patients important for radiation oncologists? A practice pattern survey in German speaking countries

Question number Question Possible answers:
1. Age ____ years
2. Sex • Male
• Female
3. Radiotherapy experience ____ years
4. Do you feel that there is enough evidence to support heart sparing for breast cancer patients? • Yes
• No
• I don’t know
5. Which dose do you consider a “safe” heart dose? ________ Gy
6. Which patients do you think will profit from heart sparing techniques? • all patients
• patients who underwent cardiotoxic systemic therapy
• patients with known arterial hypertension
• patients with known coronary heart disease
• patients < 50 y.o
• patients <60 y.o.
• patients <70 y.o.
• patients <80 y.o.
• patients <90 y.o.
• other (please specify):_______
7. Which dosimetric parameter do you consider most important? • V10 (the volume that receives 10 Gy or more)
• V20
• V30
• V40
• V50
• Dmean
• Dmax
• other (please specify):_______
8. For which structures are the previously chosen parameters important for you? • whole heart
• left anterior descending artery
• right coronary artery
• ramus circumflexus
• left ventricle
• right ventricle
• left atrium
• right atrium
• other (please specify):_______
9. You would offer heart sparing techniques to all breast cancer patients if: • It would be less time/ resource consuming.
• There would be better evidence in literature.
• I could decide by myself.
• The reimbursing would be better.
• I would not offer heart-sparing techniques to all patients.
• other (please specify):_______
10. Do you feel that there is enough evidence to support heart sparing for other cancer patients (e.g. Hodgkin lymphoma)? • Yes
• No
• I don’t know
11. Do you perform heart sparing for other cancer patients (e.g. Hodgkin lymphoma)? • Yes
• No
12. If yes, for which entities? _________________