ESTRO 2020 Abstract Book

S592 ESTRO 2020

correlated with the ICRU recto-vaginal point. Vaginal dose de-escalation is recommended, when feasible, to decrease the risk of sexual toxicity. PO-1120 Exploring Brachytherapy Educational Needs of Cervical Cancer Patients C. Jennifer 1 , A. Julius 2 , J. Manhertz 3 , C. Heck 4 , K. Chan 5 , K. Lawrie 6 , N.K. Quartey 6 , J. Papadakos 6 1 Radiation Medicine Program- Princess Margaret Cancer Centre- University Health Network, Department of Radiation Oncology- University of Toronto, Toronto, Canada ; 2 Collaborative Academic Practice-University Health Network, Department of Nursing- Princess Margaret Cancer Centre, Toronto, Canada ; 3 Collaborative Academic Practice- University Health Network, Department of Nursing- Princess Margaret Cancer Centre, Toronto, Canada ; 4 Collaborative Academic Practice, University Health Network, Toronto, Canada ; 5 Radiation Medicine Program- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada ; 6 Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Canada Purpose or Objective Brachytherapy plays an important curative role in the management of women with cervical cancers. Despite this, standardized patient education materials are lacking. The objective of this study were to determine the brachytherapy education needs of cervical cancer patients from the perspectives of both patients and health care A mixed methods, cross-sectional survey design was used. A literature review yielded no pre-existing validated, relevant questionnaires. Patient and HCP surveys were developed in-house by content and instrument development experts and then pilot-tested for validity, feedback and revisions. English-speaking women >18 years with cervix cancer treated with definitive chemo— radiotherapy, including brachytherapy, were eligible to participate. Patients were approached during their brachytherapy and consenting patients completed the survey during their first follow-up post-treatment. All radiation oncologists, brachytherapists, and nurses involved in brachytherapy were invited to participate via email and through an educational in-service. Descriptive statistics were used to analyze the results, including participant demographics, frequencies, percentages, and means as appropriate. Content analysis was used to analyze open-ended questions to identify themes. Results Between April 2017 and May 2018, 20 patients and 52 HCPs consented to participate and completed the survey. Median patient age was 60 years (range, 34-94), with 61% completing post-secondary education. The majority of HCPs were nurses (70%); all GYN radiation oncologists participated (n=4). The top informational needs identified by patients were vaginal stenosis prevention (“very important,” 89%), management of bleeding post- treatment (84%) and vaginal dilator use (74%). The majority of patients (85-90%) preferred to receive this information via pamphlets or one-on-one by their HCP. Content analysis revealed that patients desire a follow-up telephone call, with the majority preferring it within 2 weeks post-treatment. Only 44% of HCPs believed patients were “very satisfied” with their current brachytherapy education. The majority agreed that patients culture (96%) and age (90%) impacted how education is provided. Although one third of HCPs indicated uncertainty in providing brachytherapy education, the majority indicated they were comfortable (63%) and knowledgeable (53%) in providing patient education. Conclusion Evaluating brachytherapy education needs from the perspectives of cervix cancer patients and HCPs informed professionals (HCPs). Material and Methods

current practices and identified current gaps. Patients identified vaginal stenosis prevention and dilator use as the most important educational needs. These results will be used to facilitate the development of standardized patient education materials for both patients and HCPs that will be implemented and evaluated. PO-1121 Outcomes of post - radiation recurrent Gyn Cancers treated with Advanced Brachytherapy Treatments N. Lavanya 1 , R. Mittal 2 , G. Mulye 2 , D. Aravindaksham 3 , L. Scaria 3 , S. Kohle 4 , S. Kadam 3 , S. Chopra 5 , U. Mahantshetty 2 1 Tata Memorial Hospital, Radiation Oncolgy, Mumbai, India ; 2 Tata Memorial Hospital, Radiation Oncology, Mumbai, India ; 3 Tata Memorial Hospital, Medical Physics, Mumbai, India ; 4 Tata Memorial Hospital, Radiation Physics, Mumbai, India ; 5 Actrec- Tata Memorial Centre, Radiation Oncology, Mumbai, India Purpose or Objective To evaluate the outcomes and toxicities of re-irradiation using brachytherapy (BT) for patients with post - radiation recurrent gynaecological cancers. Material and Methods A retrospective analysis of patients with post radiation recurrent cervical, endometrial and vaginal cancers who were treated with reirradiation using BT between 2000 to 2018 was carried out. 67 patients were eligible for the final analysis. Patients underwent biopsy, restaging evaluation, deemed unsuitable for radical surgery were treated with reirradiation using BT. Eighteen patients (26.9%) underwent chemotherapy before the consideration of brachytherapy. BT application was done using MUPIT in 35, Vienna applicator in 20, Syed Neblett in 6, central vaginal cylinder in 3, multi-catheter intravaginal applicator in 1 patient and freehand technique in 1 patient. Descriptive statistics, relapse status, survival outcome & factors affecting outcome and late toxicities were analyzed. Results The median age at recurrence was 53 years (range: 35-73). The median gap between the 1 st and 2 nd radiation treatments was 25 months (IQR: 12 - 44). Vaginal involvement was seen in 52 patients (78%). All the patients completed planned HDR BT with various fractionation schedules (3.4 -4 Gy per fraction x 8-10 # for templates; 7- 9 Gy per fraction x 3-4# to GTV at relapse. The median 2 Gy equivalent dose was 40 Gy (IQR: 33-42 Gy). At 3-6 months follow-up after BT, 55 patients (82%) had complete response, partial response in 9, stable disease in 2 and progressive disease in 1 patient. With a median follow-up of 20 months (1-139 m) after completion of re-irradiation, 37 patients (55%) were relapse free, 15 pts (22.5%) had local relapse, and 15 pts had systemic / non-local (pelvic) relapses. The overall survival and relapse free survival rates at 2 years were 86% and 56% respectively. Local control at 2 years was (52 / 67 pts) 78%. On further analyses, volume of disease, time interval between 2 radiation treatments or doses delivered did not show any significant effect on outcomes. Grade >3 bowel/bladder toxicities were seen in 15 patients (22.4%). Nineteen patients (28.4%) had grade 2-3 vaginal fibrosis, and 3 pts vaginal ulceration / necrosis. One patient developed rectovaginal and vesico-vaginal fistulae (no disease)) while another one with vesico-vaginal fistula (due to disease progression). Another patient developed intestinal obstruction after 5 months of treatment. Conclusion Patients with post radiation local recurrent disease treated with reirradiation using BT resulted in reasonably favorable clinical outcomes. Reirradiation with BT was associated with higher grade 3-4 morbidity predominantly vaginal. Further evaluation to understand dose-response