ESTRO 2022 - Abstract Book

S160

Abstract book

ESTRO 2022

for completion, tailored self-care advice and contact information of health care providers can be sent to patients automatically. It has already been shown that regular completion of (e)PROs has an impact on symptom-management and even survival in advanced cancer patients receiving chemotherapy. However, these benefits have not been proven in palliative radiotherapy as of yet. There are many validated (e)PRO measures (PROMs) available, most of them focusing on general or disease- related QoL. With the current data, it is difficult to say which PROM is most appropriate and will provide the most meaningful data for the palliative radiotherapy setting, especially in the case of clinical follow-up. Follow-up of specific symptom occurrence from either treatment or disease progression may be a more relevant endpoint for palliative radiotherapy patients than general QoL. There is no data on patients’ acceptability, experience and adherence to more intensive ePROM completion, as needed for follow-up after palliative radiotherapy, compared to completion for benchmarking, which usually requires less effort. Our own exploratory research has shown that the majority of palliative radiotherapy patients would be willing to complete ePROMs on a regular basis if they would be used for follow-up. Built-in self-management strategies, such as self-care information and feedback on when to contact a health care provider can further encourage patients to use ePROMs. Focusing on self-management could give patients a feeling of independence. Part of a self-management strategy is to let patients to play an active role in their care and provide them with professional assistance when they deem this necessary. This strategy may make ePRO-based follow-up after palliative radiotherapy more feasible, because contacting a health care professional for advice remains the responsibility of the patient. Active e-PRO follow-up by health care professionals is also a possibility. However, following frequent ePROs of this relatively large patient population as well as providing and planning (telephone) consultations in case of increasing symptoms, may interfere with a patient’s freedom and independence. The additional workload of this second approach could also be a major barrier for ePRO implementation in daily practice, as this would probably require extra staff. In order to make ePROs after palliative radiotherapy a real success, one should make an effort to make them a part of a general, multidisciplinary palliative care policy. Ideally this would entail that ePROs for radiotherapy, chemotherapy and general wellbeing are offered to the patient, depending on their current treatment situation and be made available to multiple health care providers in and outside of hospital.

Symposium: Lymphopenia

SP-0192 Lymphopenia: Are we reinventing the wheel?

E. Deutsch

France Abstract not available

SP-0193 How can we reduce the chance of patients developing lymphopenia: Protons vs photons?

A. Abravan 1

1 The University of Manchester, Radiotherapy related research, MANCHESTER, United Kingdom

Abstract Text Radiotherapy remains the mainstay treatment for the majority of patients diagnosed with cancer. Lymphopenia, a drop in circulating lymphocyte counts part of white blood cells, usually occurs after treatment of cancer with radiotherapy either alone or with chemotherapy. Radiation induced lymphopenia can have an adverse effect on the treatment outcome of patients with various tumor types and negatively affect patients’ survival. Lymphopenia happens when circulating lymphocyte counts, lymphoid tissue, and bone marrow are being irradiated (1, 2). The severity of lymphopenia has been correlated with the integral dose to the body, the dose to the heart and lung, and the dose received by the bone marrow. A reduction in dose received by these structures can be achieved using proton therapy due to the favourable depth-dose characteristics of protons, substantially reducing the volumes of healthy tissues being irradiated specially to medium and low dose. This potentially would lead to sparing lymphocyte counts and mitigating lymphopenia. This presentation will give an overview on the current evidence on the expected gain in sparing lymphocyte counts using protons compared with photons. 1. Abravan A, Faivre-Finn C, Kennedy J, McWilliam A, van Herk M. Radiotherapy-Related Lymphopenia Affects Overall Survival in Patients With Lung Cancer. Journal of Thoracic Oncology. 2020;15(10):1624-35. 2. Abravan A, Vasquez Osorio E, Green A, McPartlin A, van Herk M. Anatomical Association of Dose Distribution With Radiotherapy-Related Lymphopenia in Oropharynx Cancer. International Journal of Radiation Oncology*Biology*Physics. 2021;111(3, Supplement):e419.

SP-0194 What is the impact of technique on the risk and severity of treatment-induced lymphopenia?

C. Muijs 1