ESTRO 2021 Abstract Book

S630

ESTRO 2021

Conclusion We found that waiting times between categories were better balanced when applying an automated prioritization strategy compared with a scenario where patients were booked in a standard semi-automatic fashion. Proposed strategy shows an overall reduction in waiting time and it reduced the chances of patients being unintentionally overlooked. Increase in waiting time for few categories can be further investigated with third level prioritization. A future implementation of this strategy can reduce the time needed for hospital staff to manually having to sort and prioritize incoming referrals. PD-0795 Futile palliative radiotherapy at the end of life. C. Iglesias Melero 1 , N.A. Linares Mesa 2 , M. Ruza Sarrasín 3 , S.B. Garduño Sánchez 3 , J.M. Rico Pérez 3 1 Hospital Universitario Juan Ramón Jiménez, Radiatherapy Oncology, Huelva, Spain; 2 Hospital Universitario Juan Ramón Jiménez , Radiotherapy Oncology, Huelva, Spain; 3 Hospital Universitario Juan Ramón Jiménez, Radiotherapy Oncology, Huelva, Spain Purpose or Objective Most cancer patients have symptoms in the end-of-life setting. Many of them benefit from palliative radiotherapy (RT). However, overtreatment is a matter of concern. Overall Survival <30 days after RT is claimed a surrogate for futile RT. According to published data up to 33% of patients undergo futile radiotherapy. We aim to assess the rate of patients at our department who receive palliative radiation therapy during the last month of their lives and identify predictive factors of futile treatment. Materials and Methods Observational prospective study of 70 unselected symptomatic patients assessed for palliative radiotherapy. Baseline ECOG PS 3-4 patients were excluded unless poor PS was caused by severe bone pain which could be relived with radiotherapy. Demographics and baseline cancer related prognostic factors were recorded. Performance Status (PS), Palliative Performance Status (PPS), Charlson Comorbidity Index (CCI) and Karnofsky Index (KI) scores were calculated for each patient. Patients were followed until death. The endpoint was the rate of patients undergoing futile RT (OS<30 days). Proportions were compared using the χ2 test. Kaplan method was used to calculate overall survival (OS). Results 70 patients (63% male, 37% female) with a median age of 69 years (43-94) were included. CCI score was 0-2 (42,2%), 3 (23,1%) and >3 (34,7%). ECOG PS was 0-1 (37,1%), 2 (48,6%) and 3 (14,3%). PPS score was < 60, 60, 70 and ≥80 in 22’9%, 28,6%,15’7% and 32’8% respectively. They main reasons for referral were bone pain (48,5%) and neurological symptoms secondary to brain metastases (20%). 82,9 % of patients had extensive metastatic disease. The most frequent metastatic sites were liver (32,9%), lung (31,4%) and brain (21,4%). The most frequent primary sites were lung (25,7%), digestive tract (18,6%) and breast (15,7%). Median OS of the entire group was 4 months. 15.7% of patients died within 30 days after RT starting. None of them completed RT due to either worsening of general condition or death. Futile RT rate did not correlate with any of the variables analyzed (primary site, disease stage, symptomatic metastatic site, CCI, PPS or ECOG PS). An increased risk of futile RT was observed for patients scoring <= 70 in either KI or PPS scales. This difference did not reach statistical significance. Conclusion 15.7% of our patients underwent futile palliative radiotherapy. No statically significant correlation with any of the variable analyzed was found. The low number of patients and some heterogeneity in the population (reflecting real life practice) may be responsible for it. Our data (non-significant increase of risk for poor KI and PPS scores) suggest that both KI and PPS could be a useful scale for better selection of patients undergoing palliative radiotherapy. PD-0796 Auditing prescribing practice in Advanced Practitioner Therapeutic Radiographers (RTTs) M. McCloskey 1 , J. Malpass 1 , R. Davies 1 , M. Mant 1 , P. Treasure 1 , A. Webster 1 1 Guy's and St Thomas' NHS Foundation Trust, Department of Radiotherapy, London, United Kingdom Purpose or Objective Auditing prescribing practice is a mandatory element of non-medical prescribing for RTTs; however, the suitable methodology to do so is undetermined. The purpose of this study was to develop and utilise an audit tool for evaluating prescribing practice records for RTTs. Materials and Methods The initial feasibility audit tool was developed for Phase 1. After the feasibility Phase 1 the audit tool was refined for Phase 2, based on feedback from RTTs. An independent review by a Nurse and Pharmacist has occurred for Phase 3 which is about to commence. To date, Phase 1 and 2 have been completed. In Phase 1, 40 randomly selected patients were audited. Each RTT (n=4) assessed 10 patients managed by a colleague, i.e. for inter-variability. In Phase 2, 40 randomly selected patients were audited. Each RTT (n=4) first assessed 10 patients managed by a colleague and then they assessed those same 10 patients managed by themselves, i.e. for inter and intra-variability. In Phase 1 RTT scored each event using 9 criteria and in Phase 2 using 11 criteria (Figure 1). For each phase, the score = criteria achieved/total number of criteria.