ESTRO 2023 - Abstract Book

S440

Sunday 14 May 2023

ESTRO 2023

Radioterapia e Medicina Nucleare, Ospedale Mater Salutis di Legnago, Verona, Italy; 16 Radiation Oncology, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy; 17 IRCCS, Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy; 18 Medical Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy Purpose or Objective In the ARISE multicenter prospective observational study we evaluated the adequacy of pain management during radiotherapy (RT) using the Pain Management Index (PMI). However, the PMI has several limitations. In particular, in patients with severe pain despite the use of strong opioid drugs, the PMI is 0, improperly indicating the adequacy of therapy. Therefore we introduced a new index (MIAMI: ModifIed pAin Management Index) aimed at overcoming this PMI limitation. Moreover, we used the MIAMI to evaluate the adequacy and efficacy of analgesics prescribed to patients referred to RT. Materials and Methods Patients, tumors, drug therapy, and pain characteristics were collected during the first visit in RT departments. A Pain Score was defined with values between 0 (no pain; NRS: 0) and 3 (severe pain; NRS: 7-10). An Analgesic Score was defined with values between 0 (no pain medication) and 3 (use of strong opioids). The PMI was calculated by subtracting the pain score from the analgesic score. All patients with PMI<0 or patients with PMI ≥ 0 but with pain score>1 (NRS>4) were considered to have a negative MIAMI score (MIAMI-). On the contrary, all patients with PMI ≥ 0 and pain score<2 (NRS ≤ 4) were considered to have a positive MIAMI score (MIAMI+). Practically, if the PMI<0 includes only patients with inadequate analgesic therapy, the MIAMI includes both patients for whom analgesic therapy is inadequate and those for whom it is ineffective. Results One thousand forty-two patients were included. Seven-two percent of them complained of pain and were taking analgesic drugs. Patients were referred to curative and palliative RT in 48.7% and 51.2% of cases, respectively. Patients undergoing curative RT showed PMI<0 and MIAMI- in 34% and 39% of cases, respectively, while in palliative RT the rates of PMI<0 and MIAMI- were 28% and 66%, respectively (Figure 1).

Conclusion From our analysis the following conclusions can be drawn: (i) the higher rate of inadequate pain therapy in patients candidates for curative RT shows the lack of attention to this symptom in patients in better clinical condition; (ii) the very high rate of patients candidates for palliative RT with inadequate or ineffective pain therapy suggests that patients are referred to this treatment too late, when pain can no longer be controlled with drugs, but when also the likelihood of achieving symptom relief with RT is clearly lower. MO-0561 Defining Patient Empowerment from a radiation oncology perspective: An Expert and patient consensus M. Shouman 1 , S. Tari 2 , F. Mumm 3 , M. Hoyer 4 , J.G. Eriksen 5 , C. Le Péchoux 6 , A. Laprie 7 , D. Krug 8 , U. Ricardi 9 , V. Valentini 10 , B.A. Jereczek-Fossa 11,12 , I. Meattini 13 , M. Mast 14 , B. Slotman 15 , B.R. Pieters 15 , L. Motisi 16 , A. Rembielak 17 , A.M. Kirby 18 , C. Nieder 19 , C. Salembier 20 , S. Blamek 21 , P.C. Lara 22 , F. Couñago 23 , Y. Lievens 24 , P. Ost 25 , R. Bultijnck 26 , K. Kuehlmeyer 27 , F. McDonald 28 , P. Blanchard 29 , M. Guckenberger 16 , C. Belka 1 1 University Hospital, LMU München, Department of Radiation Oncology, Munich, Germany; 2 Comprehensive Cancer Center Munich (CCC Munich LMU), Lebensmut e.V., Munich, Germany; 3 University Hospital, LMU Munich, Department of Internal Medicine III, Munich, Germany; 4 Aarhus University, Danish Center for Particle Therapy, Aarhus, Denmark; 5 Aarhus University Hospital, Aarhus, Department of Experimental Clinical Oncology, Aarhus, Denmark; 6 Gustave Roussy Cancer Campus, Department of Radiation Oncology, Villejuif, France; 7 Claudius Regaud Institute, Toulouse University Cancer Institute-Oncopole, Radiation Oncology Department,, Toulouse, France; 8 University Hospital Schleswig-Holstein, Department of Radiation Oncology, Kiel, Germany; 9 University of Turin, Department of Oncology-Radiation Oncology, Turin, Italy; 10 Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Radiation Oncology and Hematology Department, Roma, Italy; 11 University of Milan, Department of Oncology and Hemato-Oncology, Milan, Italy; 12 IEO European Institute of Oncology IRCCS, Division of Radiation Oncology, Milan, Italy; 13 Azienda Ospedaliero Universitaria Careggi, Radiation Oncology Unit, Oncology Department, Florence, Italy; 14 Haaglanden Medical Center, Research&Development, Leidschendam, The Netherlands; 15 Amsterdam University Medical Center, Department of Radiation Oncology, Amsterdam, The Netherlands; 16 University Hospital Zurich, University of Zurich, Department of Radiation Oncology, Zurich, Switzerland; 17 The Christie NHS Foundation Trust, Department of Clinical Oncology, Manchester, United Kingdom; 18 Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Department of Radiotherapy, Sutton, United Kingdom; 19 Nordland Hospital, Department of Oncology and Palliative Medicine, Bodø,