ESTRO 2020 Abstract book

S177 ESTRO 2020

At one-year follow up patients, treated with CRT for AC (according to the prospective DK, PLAN-A study), were scored with NCI-CTCAE v.4.0 and EORTC QLQ-C30 and CR29. GI and urological items were evaluated. Weighted Kappa-statistics was used for interrater agreement for variables most consistent for CTCAE and PROs: incontinence, diarrhea and pain measures. CTCAE grade 0 corresponded to ‘‘not at all”, grade 1 to ‘‘a little”, grade 2 ‘‘to ‘‘quite a bit” and grade 3 to ‘‘very much”. Results We included 100 patients (mean age 62.9 years, 73% female). One-year data completion was 87% for CTCAE and 79% for PROs. Frequency of grade 3 toxicity was low: Overall pain, rectal pain and proctitis (all 1.2%). Grade ≥2 toxicity was most pronounced for pain (overall 14%, rectal 5.9%, bone 8.2%), followed by fecal and urinary incontinence 5.9% and 5.8%. All other grade ≥2 toxicities were below 5%. The highest PRO scores “very much” were pain measures (up to 6.4%), then bowel symptoms (up to 4.6% for unintentional release of gas), urinary symptoms (up to 2.5% for frequency). The two worst grades “quite a bit” and “very much” combined was highest for unintentional release of gas (27.7%), followed by urinary frequency (21.5%), pain (overall (16.7%), rectal (16.5%), skin (12.6%), abdominal (6.3)), diarrhea (12,6%), mucus in stool (12.9%) and unintentional release of stool (4.7%). Agreement between PROs and CTCAE was “good” for urinary incontinence Kappa, j = 0.62, but for overall pain j = 0.38, rectal pain j = 0.32, fecal incontinence j=0.27 and diarrhea j=0.26, only “slight” to “fair”. Conclusion At one-year FU Grade 3 CTCAE scores were low. PRO scores were generally higher and the weak agreement to CTCAE suggests that PROs are important tools complementary to CTCAE in evaluating patient symptoms. For reliable normal tissue complication probability analysis, and subsequent development of tools for priorities in RT planning, large datasets of prospectively collected toxicity data from patients treated with modern RT techniques are necessary. This will optimize objectives for RT planning and the coinciding PRO scoring will give the possibility to establish the value of PROs in normal tissue complication modelling. OC-0314 Pilot randomised trial of online self- monitoring of symptoms during pelvic radiotherapy A. Henry 1 , P. Holch 2 , J. Routledge 3 , K. Absolom 1 , K. Walker 4 , A. Gibson 1 , R. Carter 1 , J. Brown 4 , G. Velikova 1 1 University of Leeds, Leeds Institute of Medical Research, Leeds, United Kingdom ; 2 Leeds Beckett University, Social Sciences, Leeds, United Kingdom ; 3 Christie Hospital, Clinical Oncology, Manchester, United Kingdom ; 4 University of Leeds, Leeds Institute of Clinical Trials Research, Leeds, United Kingdom Purpose or Objective Radiotherapy and chemo-radiotherapy for pelvic cancers increases survival but has serious short and long-term pelvic-related adverse effects (AEs). Active monitoring and timely management of the acute AEs may improve patient experiences. eRAPID (electronic patient self- Reporting of Adverse-events: Patient Information and aDvice) approach uses a secure online system for patients to report AEs, providing either self-management suggestions or advice for hospital contact. This randomised feasibility/pilot study aimed to establish feasibility, recruitment/attrition rates, select a primary outcome

Conclusion Full adaptive planning is a time-feasible approach resulting in superior plan quality compared to non- adaptive robust planning and simple dose restoration, both in target coverage and OAR sparing.

Proffered Papers: Proffered papers 14: QoL and PROMs

OC-0313 Patient reported outcome and toxicity one- year after IMRT based chemoradiotherapy for anal cancer. C. Kronborg 1,2 , E. Serup-Hansen 3 , K. Wind 1 , A.C. Lefevre 1 , K. Spindler 1 1 Aarhus University Hospital, Oncology, Aarhus C, Denmark ; 2 DCPT, Danish Centre for Particle Therapy, Aarhus, Denmark ; 3 Herlev Hospital, Oncology, Herlev, Denmark Purpose or Objective The curative and organ preserving effect of chemo- radiotherapy (C-RT) for anal cancer (AC) is well established. The treatment is associated with significant toxicity, but due to the rarity of AC, systematic and prospective collection of toxicity data, and especially patient reported outcomes (PRO) are lacking. In other cancer types, PROs are associated with survival in clinical trials and provide unique information complementary to CTCAE ratings. Further, for improvement of radiotherapy planning and establishment of normal tissue complication models, detailed toxicity data from patients treated with modern IMRT based techniques are mandatory. We collected toxicity and PRO data prospectively from AC patients treated with modern IMRT/VMAT based RT. The aim of this study was to I: Report one-year PRO and toxicity data, and II: Determine agreement between PRO and toxicity ratings. Material and Methods