ESTRO 36 Abstract Book

S998 ESTRO 36 2017 _______________________________________________________________________________________________

H. Hansen 1 , M. Skovhus Thomsen 2 1 Aarhus University Hospital, Clinic for Radiotherapy and Radiation Oncology, Aarhus C, Denmark 2 Aarhus University Hospital, Department of Medical Physics, Aarhus C, Denmark Purpose or Objective In our department all appointments are booked when the referral is received, i.e. a 100% pre-booking is performed. In 2014-15 every 7th treatment course for patients referred and booked to palliative treatment in our department was cancelled before the planned start of radiotherapy. This study investigated the reasons for cancellations of palliative treatment courses prior to start of radiotherapy as well as possible common denominators among the cancelled patients . Material and Methods A retrospective exploratory study of reasons for cancelling planned palliative radiotherapy treatment was established. Patients were included if they had been booked for palliative radiotherapy treatment between 1January 2015 and 30 June 2015. Two sets of data were collected. Firstly, data on age, gender and diagnosis was collected on all planned palliative radiotherapy treatments (n =787). Secondly, data on all patients who had been cancelled before planned start of treatment (n=105) was obtained. Data on cancelled patients included demographic and clinical data as well as other relevant data recorded in the time between referral to palliative radiotherapy and cancellation. If a patient had been cancelled more than once during the study period data was only collected on the first cancellation. Results Of the 787 planned radiotherapy courses, 106 (13 %) courses were cancelled before planned start of treatment. Of the 106 courses cancelled, one patient accounted for two cancelled treatments. The median time between referral and planned start of treatment for the cancelled courses was 14 days, showing that the majority of cancelled patients were planned to start radiotherapy much earlier than the maximum time limit of 28 days specified in the Danish legislation. Results of data collected on all planned palliative radiotherapy treatments showed that patients' age, gender and diagnosis did not differ between the courses cancelled before planned start and courses started. Main reasons for cancellation were death before start of treatment, the patient being too weak to start treatment or treatment was no longer relevant. Five of the 33 patients cancelled because they were too weak to receive palliative radiotherapy, died in the time interval between cancellation and the day they were supposed to start treatment. The total number of patients who died before planned start of treatment was 29 (28 %) (Table1).

The main reasons for cancelling palliative radiotherapy were the patient either being too weak to receive treatment/ dying before beginning of treatment or because treatment was no longer relevant. The other data collected could not explain the number of patients being cancelled. More knowledge is needed about the differences between patients starting palliative radiotherapy treatment and patients being cancelled before start of treatment. EP-1852 A research interventional clinic within the NHS to enable participation in prostate clinical trials K. Crowther 1 , A. O'Neill 1,2 , S. Murray 3 , J. Cousins 3 , O. Stewart 3 , G. Totten 3 , S. Hynds 3 , K. Parsons 3 , P. Shiels 1 , C. Logan 1 , D. Mitchell 1 , C. Lyons 1 , S. Jain 1,2 1 Cancer Centre- Belfast City Hospital, Radiotherapy, Belfast, United Kingdom 2 Centre for Cancer Research and Cell Biology, Queen's University, Belfast, United Kingdom 3 Belfast City Hospital, Northern Ireland Cancer Trials Network, Belfast, United Kingdom Purpose or Objective Within prostate cancer clinical trials there has been an increasing move towards hypo-fractionated and Stereotactic Ablative Radiotherapy (SABR) regimes. This has led to an increased requirement for Image-Guided Radiotherapy (IGRT). At our centre, it was therefore necessary to implement a service to facilitate the implanting of fiducial markers (FM) and other interventional procedures to enable our participation in such clinical trials. Material and Methods Funding for this service was secured from a research grant. A multi-disciplinary working group of Consultant Clinical Oncologists, Radiographers, Hospital Management, Nurses, Clinical Trials team and Clinical Research Fellows was formed. This group ensured the service was introduced in a safe and controlled manner by meeting at regular intervals throughout the set-up process, writing protocols and work instructions, and designing and implementing a competency-based training programme for staff undertaking and assisting with the procedures. This service is now a prerequisite for three clinical trials at our centre. Procedures include; prostate FM insertion under Trans Rectal Ultrasound (TRUS) guidance, collection of prostate tissue for research purposes and the insertion of a prostate hydrogel spacer. Results Since December 2015, there have been 34 patients through this clinic. All patients received FMs and three patients also had prostate biopsies taken and insertion of the hydrogel spacer. As part of service evaluation for the first five months, patients attending this clinic received a post-procedure phone call 72 hours after FM insertion by the Clinical Research Radiographer to monitor for any complications. 11 patients who had attended the clinic for FM insertion received this call; seven patients reported no issues, two reported loose bowels/diarrhoea, one patient reported haematuria and one case of possible prostatitis was also reported. Conclusion This service has been a significant development in facilitating participation in local and national prostate cancer radiotherapy trials. Patient-reported acute side effects and toxicity resulting from the procedures undertaken would indicate they are well tolerated with minimal complications reported. Demand for this service continues to grow with the opening of further clinical trials. Performance and efficiency of this clinic demands an ongoing collaborative approach by a large multi- disciplinary group working across professional, departmental and institutional boundaries .

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