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IMRT to conventional/3D techniques (14). Nearly half of patients with glioblastoma multiforme (GBM) are > 65 years. Aggressive RT regimes are associated with a high risk of neurological toxicity and impaired QoL (15). The utility of RT in patients in patients with GBM =/> 70 years has been demonstrated with median survival 29.1 weeks (50 Gy in 5 weeks) vs 16.9 weeks for supportive care only (16). The EORTC-NCIC trial which included good performance status patients =/> 70 years established RT plus concomitant temozolamide as standard of care for GBM. MGMT gene methylation predicts for benefit from combination therapy and is the most important prognostic factor in older patients. Older patients with localised locally advanced prostate cancer (PC) should be offered therapy. An NCIC RCT (78% > 65 years) showed significantly greater overall survival from a combination of androgen deprivation therapy (ADT) and RT (HR 0.70) compared to ADT alone (HR 0.46) (17). References: 1. Caudell JJ et al. Lancet Oncol 2017;18:e266-73;2.Speers C et al. Clin Cancer Res 2015;21:3667-77;3. Kunkler IH et al. Ann Oncol 2014;25:2134-2146; 4.Pfeffer MR, Blumenfeld P. Cancer J 2017:23:223-230; 5. Timmerman R et al. JAMA 2010;303:1070-1076; 6. Lagerwaard FJ et al. IJRBOP 2008;70:685-692; 7. Modh A et al. IJRBOP 2014;90:1168-1176; 8. Rowe BP et al. J Thorac Oncol 2012;&;1394-1399; 9.Palma D et al.. J Clin Oncol 2010;28:5153-5159; 10.Kunkler IH et al. Lancet Oncology 2015;16(3):266-73;11.Hughes KS et al.. J. Clin Oncol 2013;31:2382-2387;12.Huang SH et al. IJRBOP 2011; 79:46-51;13.Pignon T et al. Eur J Cancer 1996;32:2075- 81; 14.Nutting CM et al. Lancet Oncol 2011;12:127- 136;15.Minniti G et al. Rad Oncol 2017;12:101;16. Keime-Guibert F et al. N Engl J Med 2007;356:1527- 1535;17.Mason MD et al J Clin Oncol 2015;33:2143-2150. SP-0670 Implications of the ageing population for radiation oncology: cost-effectiveness J. Van Loon 1 1 MAASTRO Clinic, Radiation Oncology, Maastricht, The Netherlands Abstract text In view of the growing numbers of elderly cancer patients and the increasing demand from healthcare decision makers for economic evidence, measures to evaluate cost-effectiveness of radiotherapy in the elderly population will have to be incorporated in future clinical practice. Apart from the general challenges of performing economic evaluations in a technology driven discipline such as radiation oncology, there are some aspects specific for the elderly cancer population that have to be taken into account. With age, changes in clinical characteristics and tumour behavior occur and treatment tolerance could be worse. Furthermore, patient preferences will be different than for the younger population. These changes will influence the costs and outcome of a certain treatment. Hereby, a treatment which is deemed cost-effective for the general population might not be cost-effective for the elderly subgroup and the other way around. Effectively, age can have an influence on all parameters that form the input for an economic evaluation.* On the cost side, it may influence the resource utilization rate, while on the effect side it may influence baseline risks (for example the chance of tumor recurrence), the treatment effect and health state utility scores, that are influenced by eg toxicity and preservation of functionality. Furthermore, these parameters can vary even for subgroups within the elderly population itself, as preferences and treatment outcome will be different for fit compared to vulnerable or frail patients. In order to reliably inform policy makers and optimize resource use, efforts should be made to collect individual patient data in the elderly population, including utility

scores and results of geriatric screening/assessment. In this presentation, the influence of age on treatment decisions will be discussed, and through some practical examples of ongoing clinical trials, insight/recommendations will be given on how to obtain evidence on cost effectiveness of radiotherapy treatment in the elderly population. * J. Grutters, M. Sculpher, A. Briggs, et al: Acknowledging patient heterogeneity in economic evaluation : a systematic literature review. Pharmacoeconomics. 2013 Feb;31(2):111-23. SP-0671 Quality of Life in cancer patients in clinical trials in the radiation oncology setting A. Bottomley 1 1 EORTC, Quality of Life, Brussels, Belgium Abstract text Quality of life is a common endpoint in cancer clinical trials and often with elderly patients. The aim of this talk will be to briefly define what Quality of Life means, how it is best assessed and what are the key drivers of the Quality of Life movement in oncology and with the elderly patient. The talk will address tools that can be used in the elderly, and in patients undergoing radiation therapy. As an example, results of a new systematic review will be presented, detailing a critical evaluation of quality of life in clinical trials of breast cancer patients treated with radiation therapy. Furthermore, the presentation will highlight new methods to access Quality of Life and side effects and present the new EORTC electronic Item Library which aims to make adaptive checklists of tools that can be tailored for each trial, and added to standardized tools, to ensure that we capture the patient experience to the fullest extent. The presentation will also highlight challenges that researchers face when undertaking trials with Quality of Life, and where methodological design and analysis shortfalls have hindered the use, interpretation and uptake of Quality of Life in Randomized Controlled Trials. Several solutions will be proposed and discussed. SP-0672 Salvage prostate radiotherapy: when and how? B.A. Jereczek-Fossa 1 1 Università degli Studi di Milano - European Institute of Oncology, Oncology&hemato-oncology Dept/Radiotherapy Dept. of European Institute of Oncology, Milano, Italy Abstract text External beam radiotherapy (EBRT) is widely used as primary treatment for localized prostate cancer (PCa). A recently published randomized PROTECT study with a median 10-year follow-up, demonstrated that in localized low and intermediate risk prostate cancer, EBRT achieves similar results to radical prostatectomy in terms of tumor control and specific mortality. In recent years the development of modern techniques as intensity modulated radiation therapy (IMRT), image-guided radiation therapy (IGRT) and stereotactic body irradiation (SBRT), added to the progressive dose escalation of prescribed and delivered radiation, have been associated with good local control of the tumor and enhanced overall survival in patients affected by localized prostate cancer. However, still approximately 22 – 60% of patients develop biochemical failure after radical EBRT. Currently, the standard treatment for locally recurrent PCa is not defined, different therapeutic options are available and include: systemic therapy (androgen Symposium: Salvage prostate radiotherapy