ESTRO 2020 Abstract book

S721 ESTRO 2020

all Sardinian patients and provide an evidence-based planning target. Material and Methods A committee of experts composed by radiation oncologists, physicist, epidemiologists, engineers and economists collected and analyzed data about technology and human resources available in all the three radiotherapy centers of the island. The recommendations for clinical staffing are based on national AIRO and AITRO Guidelines and IAEA. Data from AIRTUM estimated in Sardinia 10.000 new cancers cases every year (excluded non-melanoma skin cancer) 5.200 men, 4.800 women. If radiotherapy is a necessary component of treatment in about 52% of all newly cases diagnosed (Delaney et al), then in Sardinia are expected approximately 5200 patients to treat every year. Results In Sardinia are now employed 2 Brachiterapy units, 8 MV units (Linac) (1/206.000 abts), mean age 12,4 years (range 2-17), 2 in centers A and C and 4 in center B. Seven Linac have MLC and EPID, 1 Linac is provided with equipments for stereotactic radiotherapy and CT cone-beam on board. Six Linacs will be end of support after 2022. Radiation oncologists, not dedicated only to Linac, are 25 (5C, 7A, 12B) 1/114 treated pts, medical physicists are 11 (3A, 6B, 2C) 1.4 per Linac, RTTs are 40 (6A, 25B, 10C) 5 per Linac, nurses are 10 (2A, 5B, 3C). A B C centers treated 2750 pts/years (53% of expected treatments) corresponding to an extimated access rate of 27.5%. The rate of radiation treatments (expected/done) is quite different in the three centers: 40% C, 56% A, 59% B (exstimated access rate 21%, 28%, 30%). These results could depend on possible escape of patients in other Radiation cancer center in peninsular Italy, but exact numbers are not available in regional reimbursement registry. Conclusion Almost 50% of patients do not perform radiation treatments in Sardinia or do not perform at all because of geographical difficulties or waiting lists or lack of high technologies. The number of Linac are 1/206.000 abts, lower than in European Country or Italy (1/133.000 and 1/166.000 respectively). Economic investements have to guarantee to align the number of Linac to Italian average, implement new technologies and avoid default expected in 2022 when the number of Linac could collapse. PO-1278 Process mining for the optimization of palliative patients’ workflow in a radiotherapy department L. Placidi 1 , J. Lenkowicz 1 , L. Boldrini 1 , R. Gatta 1 , S. Manfrida 2 , A. Damiani 1 , V. Valentini 1 1 Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica Sacro Cuore, KBO Labs, Rome, Italy ; 2 Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica Sacro Cuore, Radiotherapy, Rome, Italy Purpose or Objective Palliative radiotherapy represents an important burden for radiotherapy services since palliative patient’s (PP) path of care can have different origins and types, potentially causing management difficulties and protract waiting and treatment time. Aim of this study is to analyze the event logs of a sample population of PP referred to our center to provide a continuative decision-making system and define a shared guideline for this group of patients. Material and Methods In 2018, a selected group of 290 consecutive patients treated in our radiotherapy department, have received one or more palliative treatments for bones and brain metastasis, excluding any SRT treatment. These PP were treated in four different linear accelerators, setting 500 treatments event logs. For each patient, several events log and attributes were automatically extracted based on two

Radiatiation Oncology Departments (ROD): number of radiation oncologists involved in the management of head and neck cancer (HNC), radiotherapy techniques availability; experience with IMRT use; IGRT methods; use of reirradiation in recurrent cancer; radiological imaging for the delimitation of target volume; experience in clinical trials participation and willingness to participate in the them. The surveys were emailed to medical and radiation oncologist of TTCC- GEORCC associated centres between 21 February and 15 May 2019. This work analyzes data regarding ROD items. Results Overall 165 surveys were sent to physicians in 96 centres. 117 responses were received, 113 (67%) valid for analysis. Specific surveys for ROD were sent out to 70 centres, receiving a response in 37 (52%) cases, all evaluable. 75% of the ROD have at least 1-2 radiation oncologist manly dedicated to HNC management. All ROD except one (97.2%) do provide IMRT/VMAT to all HNC patients; 88.9% of ROD have ≥ 4 years of experience in its use. Most of ROD (86.5%) use a combination of CBCT and DRR to perform IGRT. The most commonly used method for simulation and contouring is the CT including PET/CT and/or MRI co-registration in 64.9% of the cases; PET/CT for simulation and planning is available in 21.6%. Radical re-irradiation as part of the ROD portfolio is offered in 91.9%. 25% of the centres treat ≥ 100 patients per year. 51.4% of the centres have participated in head and neck clinical trials, 100% would be willing to take part in them. Conclusion As far as we know, this is the first national survey conducted to know the status of therapeutic resources in radiation oncology for the treatment of HNC. IMRT, considered the standard of treatment, is available in practically all but one of the responding centres; however, there is a national program of technological renovation underway so presumably 100% of the centres will have IMRT available in the middle term; also noteworthy is the high implementation of IGRT guided by CBCT. Some weakness should be stressed: due to the relatively low participation in that survey, data obtained may not accurately reflect the global ROD picture in Spain. We found worrisome that approximately one third of ROD do not use any kind of image co-registration for simulation and planning. However, the data provided will allow, first, a selection of centres with optimal characteristics to participate in clinical trials and, second, to promote measures to ensure that most of the ROD can adopt the standards for diagnosis and treatment of head and neck. PO-1277 Network of Radiotherapy Cancer Centers in Sardinia: equipment, staff and access to care S. Campoccia 1 , E. Orefici 1 , R. Barbara 2 , F. Cabras 1 , S. Loi 2 , P. Marini 3 , S. Orrù 2 , M.F. Dedola 3 1 ASL Nuoro, Radiotherapy Division, Nuoro, Italy ; 2 A.O. Brotzu, Radiotherapy Division, Cagliari, Italy ; 3 AOU Sassari, Radiotherapy Division, Sassari, Italy Purpose or Objective Sardinia is the second largest island in the Mediterranean sea, considered as a micro-continent. Population in Sardinia count 1.639.000 inhabitants (abts), with a population density of 69/km2 (a third of the national average). All radiotherapy is provided by a network of non centralized three cancer centers (center A, B, C), serving three macro areas with different density population (43/km2 A, 78/km2 C, 92/Km2 B). The purpose of this analysis is to provide an overview in terms of availability of equipment, human resources and access to care in 2018. This project was founded by Assessoradu de s'igiene e sanidade, the aim is to make an evaluation of the amount of economics resources that should be allocated to treat