ESTRO 2022 - Abstract Book

S60

Abstract book

ESTRO 2022

We present the process of developing a printed PtDA to assist in the choice of high (66 Gy in 3 fractions) or lower (45 Gy in 3 fractions) dose of SBRT for a tumor in the lung located adjacent (< 1 cm) to the thoracic wall. When treating tumors in this location with radiation therapy, there is an increased risk of causing chest wall pain or rib fractures in the patient. For this reason, reduction of the dose is common at the discretion of the physician, without asking for the patient’s preference. We want to involve the patients in this decision by using the PtDA. Materials and Methods The Regional Center for SDM at Vejle Hospital has developed a generic PtDA template in print, which forms the basis for our PtDA. The template consists of a frame that forms the setting for the decision that is to be made. Placed inside the frame is then different cards showing pros and cons for the different options, the timeline for the course and statistics. Results During the spring of 2021, drafts for the paper cards showing the different dose levels, the timeline and statistics on the risk of side effects and expected local control were produced. We conducted a half-day workshop with both patients, relatives, physicians and RTT’s in May 2021. Drafts received comments and suggestions for improvement, statistics was altered to be easier to understand and patient stories were collected during the day. In particular, the direct input from patients helped improve the PtDA. The result of this process was the second draft, which was then subjected to an alpha-test with four individual physicians, where the design and wording of the PtDA was further refined. During the process there was a tight collaboration with a consultant at the Center for SDM, who also made comments about the design before the workshop was held.

Example of card with statistics

Conclusion The final PtDA consists of a frame and 12 sheets and will be demonstrated at the conference. The PtDA will serve as the intervention in an upcoming RCT.

PD-0085 SBRT in the management of oligometastatic gynaecological cancer: a mono-institutional experience.

G. Mandurino 1 , A. Fodor 2 , S.L. Villa 1 , F. Zerbetto 3 , S. Baroni 1 , A. Sanchez Galvan 4 , R. Tummineri 1 , C.L. Deantoni 1 , P. Mangili 4 , A. Del Vecchio 4 , S. Arcangeli 1 , N.G. Di Muzio 1,5 1 IRCCS San Raffaele Scientific Institute, Department of Radiation Oncology, Milan, Italy; 2 IRCCS San Raffaele Scientific Institute, Department of Radiation Oncology, Milan, Italy; 3 IRCCS San Raffaele Scientific Institute, Department of Radiation Oncology, MIlan, Italy; 4 IRCCS San Raffaele Scientific Institute,, Department of Radiation Oncology, Milan, Italy; 5 Vita-Salute S. Raffaele University, Department of Radiation Oncology, Milan, Italy Purpose or Objective The use of stereotactic radiotherapy (SBRT) for oligometastases is supported by several literature studies, but in the setting of gynecological tumors, this scenario remains unexplored. This study reports a preliminary assestement of clinical outcomes in a cohort of 46 patients (pts) with oligometastatic gynaecological cancers. Materials and Methods From 4/2009 to 5/2021, 85 lesions in 46 pts were treated with SBRT. Five lesions of 4 pts were treated with Image Guided- helical Intensity Modulated Radiotherapy (IG-IMRT) to a median dose of 54 (35-63) Gy in 6 (5-10) median fractions prescribed at 95% of the Planning Target Volume (PTV). Eighty lesions of 42 pts were treated with robotic SBRT to a median dose of 40 (18-60) Gy in a median of 5 (1-8) fractions, prescribed at a median isodose of 80% (68-84%). Nine PTVs (10.6%) were in the same field of previous adjuvant or salvage radiotherapy performed with IG-IMRT with a median dose of 50.4 Gy. Primary histology was: uterine in 42%, ovarian in 33%, cervical in 15.3% and other (fallopian tubes, vulva and vagina) in 9.4 % of lesions, respectively. Target locations were 53.7% lymph nodes, 33% lung, 6% bone, 6% central nervous system and 3.5% liver. Gross tumor volume was defined by the fusion of CT, PET/CT and/or MRI images. Toxicity was assessed using CTCAE version 4.03 criteria.