ESTRO 2023 - Abstract Book

S842

Tuesday 16 May 2023

ESTRO 2023

patients’ knowledge and decrease decisional conflict. Effective implementation of shared decision making is increasingly being considered as requiring a multifaceted approach, including a particular focus on individuals with lower health literacy skills. Overall, continuing efforts to substantiate, fine-tune, and promote shared decision making are required to ensure that decisions are made that align with what matters most to individual patients in order to offer person-centered care.

SP-1031 The RTTs role in shared decision making L. Smets 1 1 University Hospitals Leuven, Department of Radiation Oncology, Leuven, Belgium

Abstract Text Nowadays patients become more involved in the decision-making process. Incorporating patients’ preference when making treatment decisions not only leads to better clinical outcomes, but also promotes satisfaction and treatment adherence. Decision support tools, such as a patient decision aid, can facilitate shared-decision making. This talk will review the role of patient decision aids in shared-decision making, the effect of decision aids in people facing treatment decisions and their development. I will discuss the role of nurse specialists and RTTs in shared decision-making. I will also showcase the recent results of our development study of a patient decision aid for patients with rectal cancer.

SP-1032 The patient voice S. Gijssels Belgium

Abstract not available

Joint Symposium: ESTRO-RANZCR: Role of radiotherapy in renal cell carcinoma: From the primary to the metastatic setting

SP-1033 Primary renal cell carcinoma S. Siva Australia

Abstract not available

SP-1034 Oligometastatic renal cell carcinoma C. Franzese 1 1 Humanitas University, Humanitas Research Hospital IRCSS, Radiotherapy and Radiosurgery department, Milano, Italy Abstract Text Kidney represents a common site of primary malignant tumor, with renal cell carcinoma (RCC) accounting for 80-90% of all cases. The incidence rate of kidney cancer has been increasing in the last years, and 30% of patients undergoing surgical resection of the primary tumor will develop distant metastases during follow-up, most commonly into lung, liver, or bone. Survival of metastatic kidney cancer patients is still today unsatisfactory with an overall 5-year survival rate ranging between 20 and 40%. Systemic therapies, including tyrosine kinase inhibitors (TKIs), targeting vascular endothelial growth factor receptor (VEGFR), and immune checkpoint inhibitors (ICIs), represents nowadays the standard of care for metastatic kidney cancer. However, the use of metastases-directed surgery or local ablative treatments, including radiation therapy, have been investigated in the last years. A meta-analysis showed that metastatic patients benefit from metastasectomy in terms of overall survival compared to non-operated patients. Related to radiotherapy, kidney cancer has been considered historically as a radioresistant tumor, nevertheless the use of high dose per fraction typical of stereotactic radiation therapy is able to overcome this old concept of radioresistance. Several published studies showed high rates of tumor control after stereotactic radiation therapy both in the kidney primary and metastatic settings. Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) are able to ablate intracranial and extracranial oligometastases from kidney cancer with local control rate higher than 90%. The encouraging efficacy data together with a mild pattern of toxicity, makes stereotactic radiation therapy as a valid alternative to more invasive treatment. SRS and SBRT can potentially be used for oligorecurrent disease in order to control the whole visible burden of disease, or in the oligoprogressive setting to control few isolated metastatic foci progressing on a background of metastatic disease responsive to an on-going systemic therapy. This talk will discuss the most recent advancements and evidences about the role of stereotactic radiation therapy in the management of oligometastatic kidney cancer.

SP-1035 Immunotherapy and SABR for renal cell carcinoma S. Kroeze 1 1 Cantonal Hospital Aarau, Centre for Radiation Oncology KSA-KSB, Aarau, Switzerland

Abstract Text With the new developments in radiotherapeutic approaches to safely irradiate moving targets, it is now possible to treat kidney lesions with a high enough dose to obtain a good local control. Because of this, SBRT is now advancing to taking its place next to focal therapies for renal cell carcinoma. The use of SBRT in RCC is currently mostly in the inoperable situation. It was shown by the IRock collective, that also larger lesions can be safely treated. Even in the situation of a vena cava tumor thrombus, for which the resection frequently means a too invasive option and the prognosis is poor, SBRT may be an elegant option in the multimodality treatment setting in combination with immunotherapy. Cytoreductive nephrectomy used to play a beneficial role in combination with tyrosine kinase inhibitors. In the era of immunotherapy, the role of cytoreductive nephrectomy remains controversial. The Checkmate 214 trial showed that survival rates were better with nivolumab/ipilimumab compared to sunitinib in a group of intermediate/poor-risk patients.