Abstract Book

S199

ESTRO 37

Netherlands 6 IKNL, IKNL, Utrecht, The Netherlands

the worst pain score from days 0–14, followed by a return to baseline levels or below. Primary analysis of incidence of PF was by intention-to-treat (ITT) with patients with missing primary data classified as having PF. We also performed sensitivity analyses (SA) with missings classified as having no PF. Results From Jan 2012 to Apr 2016, 295 patients were randomized. PF incidence was 50% (ITT) or 25% (SA) for A, 34% or 16% for B, and 44% or 25% for C (ITT; p= 0.06 and SA; p= 0.15, Table 1). Although B had the lowest incidence of PF, a relatively high percentage did not return to baseline pain levels, preventing them from complying to the PF criterion and instead indicating pain progression. In those patients who experienced a PF, four daily doses of dexamethasone postponed the occurrence of PF (A: 88% on day 1-5 and 12% on day 6-14; B 73% and 27%; and, C 52% and 48%). In C, patients reported lower pain scores on day 2-5 (Figure 1). Toxicity and quality of life outcomes will be presented at ESTRO 37.

7 UMCG, Epidemiology, Groningen, The Netherlands 8 UMCU, Medical oncology, Utrecht, The Netherlands

Purpose or Objective Radiotherapy (RT) is an effective palliative tre atment for painful bone metastases, with over 70% responders, although pain is not always sufficiently controlled. Analyses from the Dutch Bone Metastasis Study on 1157 patients showed that during weekly follow up 35% of the patients reported a pain intensity of ≥ 5 on a numeric rating scale (range 0-10 (NRS)), despite pain medication. Pain management education may improve patient empowerment and, consequently, reduce pain intensity. The effect of nurse-led education (NLE) in patients undergoing RT for painful bone metastases was investigated as compared to care as usual (CAU). Primary endpoint was pain intensity at 12 weeks, secondary outcome was quality of life (QoL). Material and Methods In this multicentre, randomised phase 3 study, patients referred for short schedule RT, with uncontrolled pain (a score of ≥5 on a 0-10 NRS), were randomised between NLE or CAU before start of RT. The NLE consisted of a structured interview to assess pain and patients’ knowledge about pain and pain management. Based on patients’ lack of knowledge, tailored education was provided. A workbook including information on pain- related topics was given afterwards. At 1, 4, 8 & 12 weeks follow up, pain-related questions were addressed by phone. Relatives were welcome to attend the educational session. Patients in CAU received leaflets on RT, cancer pain and opioid use. Patient characteristics were assessed at baseline. Pain intensity and QoL were evaluated with the Brief Pain Inventory, EORTC QLQ-C15-PAL and EORTC QLQ-BM22 at baseline, and week 1, 4, 8 & 12. Power calculation showed that there were 89 patients per arm needed to detect a 10% difference in number of patients with a NRS<5 at 12 weeks (1-sided α=0.05; β 0.8). Results Between May 2011-April 2016, 354 patients were randomised (176 NLE, 178 CAU). At twelve weeks, 185 (NLE 95) had completed follow-up. 38 were excluded (30 NRS <5 at baseline, 7 no short schedule RT, 1 missing informed consent). At twelve weeks, 185 (NLE 95) had completed follow-up (72 stopped filling out questionnaires, 59 died prematurely). Baseline characteristics were similar in both groups; mean age 65 years, 56% men. At week 12, more patients in NLE than in CAU had controlled pain (NRS<5; respectively 70% and 47%, p=0.013). Moreover, patients in NLE reached faster a pain score <5 than patients in CAU (31 versus 54 days respectively, p=0.026). On all time points, no significant differences in QoL were found between both groups. Conclusion Controlled pain, i.e. a pain intensity <5, was reached faster and by more patients with painful bone metastases undergoing RT by the addition of nurse-led pain education.

Conclusion There was no significant effect of dexamethasone on the incidence of PF after palliative radiotherapy for painful bone metastases. In patients receiving four doses of dexamethasone mean pain scores were lower on day 2-5 after start of radiotherapy, and, the occurrence of PF was postponed. OC-0389 Pain education of patients with painful bone metastases reduces pain; a multicentre randomised trial J. Geerling 1 , Y. Van der Linden 2 , V. Mul 3 , E. De Nijs 4 , M. Oudhof 5 , N. Raijmakers 6 , G. De Bock 7 , A. De Graeff 8 , A. Reyners 1 1 UMCG, CCC- palliative team, Groningen, The Netherlands 2 LUMC, radiotherapy department, Leiden, The Netherlands 3 UMCG, CCC radiotherapy department, Groningen, The Netherlands 4 LUMC, palliative team, Leiden, The Netherlands 5 UMCU, radiotherapy department, Utrecht, The

Proffered Papers: CL 8: Gynaecology

OC-0390 Clinical outcome with dose escalation using IMRT in Cervical Cancer: A phase II randomized trial S. Gudi 1 , P. Naga 1 , U. Mahantshetty 1 , S. Chopra 1 , R. Engineer 1 , L. G 1 , Y. Ghadi 2 , S.V. Jamema 2 , S. Gupta 3 , S.K. Shrivatava 1 1 TATA MEMORIAL CENTRE, Radiation Oncology, Mumbai, India