ESTRO 2023 - Abstract Book

S604

Monday 15 May 2023

ESTRO 2023

PD-0739 Evaluation of a radiotherapy late effects service S. Bostock 1 , G. Bestwick 2 , E. Smith 1

1 Gloucestershire Hospitals NHS Foundation Trust, Radiotherapy - Gloucestershire Oncology Centre, Cheltenham, United Kingdom; 2 Gloucestershire NHS Foundation Trust, Radiotherapy - Gloucestershire Oncology Centre, Cheltenham, United Kingdom Purpose or Objective Radiotherapy can result in debilitating late effects that greatly impact on a person's physical and psychological health. To address this a Therapeutic Radiographer-led Late Effects Service was piloted. Patients were given the opportunity to talk about their symptoms and the impact they have - physically and emotionally. A joint management and support action plan was created aimed at reducing the impact late effects have on each individual’s daily life and ability to function. The aim of this study is to evaluate the impact of the late effects service on the patient’s using it. Materials and Methods Those patients seen within the Late Effects Service from May 2020 to July 2022 were invited to complete a questionnaire (dichotomous yes / no and free text responses) after their 1st appointment and a second questionnaire (10-point Likert scale questions and free text responses) after 3-4 months of using the service. The patients had completed radiotherapy between 6 months and 20 years previously. Quantitative data was used to evaluate how well the service met patient’s needs - if a difference were made to how late effects impacted on their daily life/ if the patient found it helpful. Thematic analysis of patient’s comments provided qualitative evidence on the impact the service has had. Results Questionnaires were returned from 34 patients after their initial Late Effects consultation and 17 patients after 3 months of using the service. 97% patients reported their initial appointment met their expectations, that they had a positive outcome and gained a better understanding of their symptoms and how to manage them. After 3-4 months of using the service 100% patients scored at least 8 out of 10 for how satisfied they are with the service (mean 9.65, standard deviation 0.61). When asked how much difference the late effects service has made to how symptoms affect their daily life the mean response was 7.47 (SD 2.65) with 76% of patients scoring 7 or higher. Patients were also asked how the service has met their needs. Again, the mean response score was high at 8.88 (SD 1.80). 76% of patients scored 8 or higher and 65% of patients scored 10. The lowest score was 5. Themes identified from patient comments on both questionnaires were 1) positive emotions - patients reported feeling more hopeful, positive and reassured; 2) information - patients reported that the information provided helped them understand their symptoms better; 3) positive outcomes - including symptoms resolved or reduced with action plans implemented and 4) praise for the therapeutic radiographer leading the service. Conclusion The pilot Radiotherapy Late Effects Service had a considerable positive impact on patients’ ability to understand and manage their symptoms. This led to quality-of-life improvements alongside a reduction in the significance of symptoms. The pilot demonstrated the continued need for this service in delivering holistic person-centred care and supporting patients to move forward after cancer treatment. PD-0740 Which cervical cancer patients need adaptive planning? A new approach to predicting target motion L. Wang 1 , S. Mason 2 , D. McQuaid 1 , M. Blackledge 2 , H. McNair 1 , E. Harris 2 , S. Lalondrelle 3 1 Royal Marsden Hospital NHS Trust, Radiotherapy department, Sutton, United Kingdom; 2 Institute of Cancer Research, Department of Radiotherapy and Imaging, Sutton, United Kingdom; 3 Royal Marsden Hospital NHS Trust and Institute of Cancer Research, Department of Radiotherapy and Imaging, Sutton, United Kingdom Purpose or Objective Target motion during cervix cancer radiotherapy can lead to geographic miss. Use of an internal target volume (ITV) for the low-risk clinical target volume (CTV-LR) based on full and empty-bladder CTs (CT-FB and CT-EB) can model the range of motion of a specific patient. However, this often fails to predict target position during treatment. Patients may be termed “movers” if the uterine fundus tip at planning moves over an arbitrary threshold between CT-FB and CT-EB: such cases can be highlighted for adaptive techniques such as plan-of-the-day. However, some non-movers at planning become movers at treatment. A method to identify these "occult movers" is lacking. We analysed planning CT features and patient demographics to identify markers of occult movers pre-treatment. Materials and Methods 160 images from 20 cervix cancer patients were evaluated. For each, CT-FB, CT-EB, planning MRI and 5 randomly chosen cone-beam CTs were contoured (CTV-LR, bladder, rectum) following the EMBRACE-II protocol. ITVs were created by interpolating between CT-EB and CT-FB CTV-LR contours and expanded by 7 mm to create a planning target volume (PTV). The MRI was ignored for ITV creation and treated as another fraction. A patient was designated "covered" if the CTV-LR was >95% covered in 5/6 fractions and the CTV-HR (tumour and cervix) in 6/6 fractions. Potential explanatory variables (EVs) included various measures of organ shape, and contents on planning CT (Box 1) plus age, BMI, tumour grade and FIGO stage. Poster Discussion: Inter-intra fraction