ESTRO 2023 - Abstract Book

S42

Saturday 13 May

ESTRO 2023

We developed an observational study selecting patients treated in the Radiation Oncology department of a Spanish public hospital were selected retrospectively from January 2017 to February 2022 through an intrahospital management tool. U- Mann Whitney test was used to study our data, atypical data and patients with incomplete values are eliminated. Results A total of 14164 patients were treated during this period. Due to lack of information or atypical values, only 8448 patients were selected. It was spent a median of 9 days (interquartile range, IQR, 10) from treatment decision until the first delineation (4 days for simulation CT and 5 for delineation), 8 days (IQR 8) for physics dosimetry, and 9 days to the first treatment day (IQR 8). A median of 34 days (IQR 26) was employed to start the treatment. We found an asymmetric distribution of the number of patients throughout the year, reaching maximums in June and August. However, it was found a significant increase (p-value < 0.05) in total delay in December (median 37 vs 35 days) or during the summer months (34 vs 31 days). When analyzing the data of patients treated during the COVID-19 pandemic (2020 and 2021), we found no significant changes compared to the previous period (2018 and 2019).

Conclusion Our results suggest that vacation rest periods may have a negative impact on the quality of care. Therefore, we believe that it is essential to carry out single-center studies to analyze its impact and reduce it. No significant changes were experienced, neither in the delays nor in the number of patients treated during the COVID-19 pandemic, maintaining the same care activity as in previous periods. The main limitation of this study is the potential bias in the analysis of delays due to pathologies, as is the case of prostate cancer, which is susceptible to prolonged delays due to possible periods of hormone therapy prior to treatment. New strategies such as promoting the single act or self-contouring software approaches could be possible strategies to reduce delays. PD-0076 Radiotherapy Treatment Interruptions Management: An Italian Survey F. Deodato 1 , A. Fiorentino 2 , G. Macchia 1 , S. Manfrida 3 , N. Dinapoli 4 , M.F. Osti 5 , G. Sanguineti 6 , E. Russi 7 1 Gemelli Molise Hospital – Università Cattolica del Sacro Cuore, Radiation Oncology Unit, Campobasso, Italy; 2 General Regional Hospital F. Miulli, Radiation Oncology Department, , Acquaviva delle Fonti, Italy; 3 Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Radiation Oncology Unit Gemelli ART, Roma, Italy; 4 Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Radiation Oncology Unit Gemelli ART, Roma , Italy; 5 Sapienza Università di Roma, AOU Sant’Andrea, Radiation Oncology Unit, Roma, Italy; 6 IRCCS Regina Elena National Cancer Institute, Department of Radiation Oncology, Roma, Italy; 7 Teaching Hospital “S. Croce e Carle”, Radiation Oncology Unit, Cuneo, Italy Purpose or Objective Unplanned radiotherapy (RT) breaks lengthen the overall treatment time and have a negative effect on local control and cure rates. Here, we report the results of a recent nationwide study providing data on the main causes of radiation therapy interruptions and management strategies to reduce or eliminate their clinical impact. Materials and Methods Italian RT center directors participated in a study that investigated RT weekly schedules, the handling of RT interruptions, and guidelines use for handling interruptions. Results The survey was completed by 104 (56.8%) centers. With 2 (range 1-6) LINACS on average, only 5% of centers routinely conduct clinical activities six days a week; 22% of centers do so when dosage recovery is required; the remaining (73%) centers conduct clinical activities five days a week. The vast majority (93.1%) of centers considered interruptions a critical issue to manage, particularly for head and neck, cervix, lung and rectal cancer treatments. For 74% of respondents a 5-day or longer interruption could have an impact on the outcome of RT. The Royal College of Radiologists' international standards for interruption management were followed by 30 centers (28.88%), whereas 25 centers (24%) had their own set of rules. LINAC breakdowns (52%), toxicity (23%) and patient compliance (13%) were cited as the most frequent interruption causes. In the event of a LINAC breakdown, 80 centers have stated that patients will be treated in the other without recalculating the second machine. The majority of centers (86%) recover lost doses by raising the overall dose (79%), treating patients on Saturday (34%), holding two sessions per day (18%), using an accelerated regimen in the final part of the treatment (17%). Only 28 centers (27%) consistently recover dosage. Conclusion