ESTRO 2023 - Abstract Book

S1233

Digital Posters

ESTRO 2023

1 University Hospitals Sussex, Sussex Cancer Centre, Brighton, United Kingdom; 2 University of Oxford, Medicine & Surgery, Oxford, United Kingdom; 3 Institute of Cancer Research, Uro-oncology, London, United Kingdom; 4 Royal Marsden Hospital, Academic Urology Unit, London, United Kingdom Purpose or Objective Patients with muscle invasive bladder cancer can be offered radical cystectomy or radiotherapy (with a radiosensitiser). It has not been possible to conduct a randomised controlled trial and, partly because of this, there is variability in practice despite NICE (UK) guidance to offer patients a choice between modalities. Qualitative work following the SPARE RCT which had to close early demonstrated a lack of equipoise for clinicians, relating to both cancer control and impact of treatment on quality of life. Even when patients are offered a choice decision-making can be challenging due to lack of comparative data to support information provision. The Q-ABC study programme incorporates both qualitative and quantitative evaluation of quality of life after treatment using a non-randomised comparative cohort approach, here we present results from the qualitative study, interviewing patients and carers, (Q-ABC-QIS ISRCTN13881914.) Materials and Methods Participants were patients who had received radical treatment (radiotherapy or cystectomy) between 1 and 2 years previously and people they identified as “supporting them through treatment” (carers). Patient participants did not need to identify a carer to be eligible to participate. Participants were recruited from 4 sites across the south of England including a specialist hospital, a teaching hospital and two district general hospitals. Individual semi-structured interviews were conducted and analysed qualitatively using a Framework approach. Results 20 patients and 14 carers were interviewed. Themes included adaptation to “the new normal” with acceptance of these changes in the context of parallel changes with age and “what the alternative is” – i.e. progressive cancer. Many participants, and particularly carers reported a feeling of “skating on thin ice” with anxiety about recurrence. Participants identified with a construct of “luck” despite the impact of treatment and this was often comparative to other patients they had been treated alongside. Cancer diagnosis and treatment had complex bi-directional effects on close relationships and significant impact on carers’ day to day lives. Conclusion After a recovery and adjustment period patients and carers are generally accepting of changes to their quality of life after radical treatment. Findings can be used to enhance current treatment information and patient support. Patient and carer priorities and approaches have informed the recently completed quantitative study. Together with the outcomes of the quantitative Q-ABC study a more robust understanding of the impacts of radical treatment of bladder cancer will be used to support interventions to standardise practice and ensure patients are supported in treatment decision making.

PO-1517 Timing of Salvage Radiotherapy After Prostatectomy: From Randomized Trials to the Real World

M.F. Sánchez 1 , R. Lagos 1 , P. Bettoli 2

1 Fundación Arturo López Pérez, Unidad de investigación y epidemiología clínica, Santiago, Chile; 2 Fundación Arturo López Pérez, Department of Radiation Oncology-Fundación, Santiago, Chile

Purpose or Objective Salvage radiotherapy (sRT) can have similar outcomes to adjuvant radiotherapy (aRT) if it is administered at the earliest evidence of biochemical recurrence. RADICALS-RT is a randomized clinical trial (RCT) which supports this hypothesis. Therefore, a policy of observation after radical prostatectomy with early sRT have become the new standard of care. The aim of the present study is to assess the impact of a RCT in the clinical practice regarding the timing of sRT for prostate cancer initially treated with radical prostatectomy.

Materials and Methods Data from patients who underwent sRT after radical prostatectomy at our institution was retrospectively collected. Patient demographics, disease-related clinical information and PSA level before sRT were recorded. Patients with non-metastatic prostate cancer were eligible if they had undergone radical prostatectomy, received sRT given later to those who develop a rising PSA, and had at least one specified risk factor (pT3 or 4, Gleason score 7–10, positive margins, or preoperative PSA of 10 ng/mL or more). Patients were divided in 2 groups based on the date of RADICALS-RT presentation at ESMO (November 2019). Two groups were created and analyze: from

February 2016 to October 2019 (group 1) and from November 2019 to September 2021 (Group 2). After our first report was release in October 2021, our GU institutional group revisited our postoperative radiation therapy policy. A third group (group 3) was created and analyzed with the previous ones after this institutional intervention (from November 2021 to September 2022).

Results Two hundred and seventy patients were recruited over 7 years between February 2016, and September 2022. One hundred and sixty-two patients were assigned to group 1, 67 to group 2 and 41 to group 3. Median age at diagnosis was 67 years. pT2, 3a, 3b and 4 were 33.3%, 30%, 28.5% and 08.2% respectively. Median PSA at diagnosis was 7.9 ng/mL. Thirty seven percent of patients had a PSA 10 ng/mL or