ESTRO 2024 - Abstract Book

S5649

RTT - Patient experience and quality of life

ESTRO 2024

628

Digital Poster

Therapist-recorded prospective patient assessment during EBRT for prostate cancer from 2001 to 2017

Tara Rosewall 1 , Vickie Kong 1 , Andrew Bayley 2

1 Princess Margaret Cancer Centre, Radiation Therapy, Toronto, Canada. 2 Sunnybrook Regional Cancer Centre, Radiation Oncology, Toronto, Canada

Purpose/Objective:

Over the last few years, systematic patient assessment and documentation of toxicity during radiotherapy has become more widely implemented in Canada. There is clear evidence of this practice improving the quality and consistency of care for individual patients. This work will describe the prospective toxicity documentation practices of Radiation Therapists (RTs) in our centre for all radical prostate cancer patients and use that data to summarize on-treatment toxicity over a period of 16 years.

Material/Methods:

This study is a single centre, retrospective chart review of patients who received curative intent external beam radiotherapy (EBRT) for prostate cancer between 1st August 2001 and 1st January 2017 at our institution. The RT assessed weekly toxicity data for these patients was quantified according to RTOG or CTCAE (ver. 3) grading systems for skin, bowel and urinary adverse events. From August 2001, the weekly grades and any new toxicity related medications were entered routinely by RTs into the electronic patient record. Following REB approval, database query methods were used to interrogate the radiotherapy electronic chart and gather treatment course and toxicity information for all patients treated within the study period. Following completion of all data collection activities, an independent auditor reviewed a random sample of 2% of the data collected.

Results:

A total of 5461 patients with prostate cancer were treated using EBRT with radical intent during the study period. Of that eligible cohort, 5207 patients had toxicity documented by RTs (1578 using RTOG, 3677 using CTCAE). Overall, >60% of possible weekly assessments were documented in 74% of patients. An average documentation rate of >80% was maintained for years 2001 to 2011, but had dropped to 35% by 2017. Toxicity was most commonly documented in weeks 1 to 6 (>70% complete documentation). For RTOG Grade 2 and above (G2+), urinary toxicity increased steadily from week0 to week9, to maximum of 33% G2+ at week 9. The frequency of RTOG G2+ bowel toxicity peaked at week6, to a maximum of 6% G2+. For CTCAE G2+, the frequency of rash, pruritus, vomiting, nausea and haematuria were <1%. The frequency of G2+ urinary toxicity increased steadily from week0 to week9, to a maximum of 19.5% (frequency), 7.3% (cystitis) and 4.9% (bladder spasms). The frequency of G2+ bowel toxicity increased slowly from week0, to a maximum of 4.9% (proctitis) and 9.8% (diarrhea) in week9. Grade 4 toxicity was rarely seen (cystitis 1pt, haematuria 1pt). By the final week of treatment, 15% of patients had been prescribed an alphablocker, 3% an anti-diarrheal, and 3.5% cortisone cream.

Conclusion: