ESTRO 36 Abstract Book

S748 ESTRO 36 2017 _______________________________________________________________________________________________

or within 30 days of targeted/immunotherapy, reporting severe (≥Grade 3) toxicity were included. Results A total of 49 studies were included. Of these, 13 (321 patients) were prospective studies, 27 (653 patients) retrospective studies and 9 (16 patients) case reports. The number of patients per study ranged from 1 to 106 (median 15). Targeted agents concurrent with cranial SRT were tested in 34 studies and with extra-cranial SRT in 19 studies. For cranial SRT, severe toxicity was observed in 14% (89/644) of patients, for extra-cranial SRT in 16% (84/524). Severe toxicity possibly related to cranial SRT or extra-cranial SRT was observed in 6% (5.4% Gr3; 0.6% Gr4; 0% Gr5) and 9% (7.6% Gr3; 0.8% Gr4; 0.6% Gr5), respectively. Overall, concurrent cranial SRT was well tolerated, except when combined with BRAF-inhibitors (severe toxicity in 20/75 patients (27%)). Furthermore, there is a high risk of morbidity when extra-cranial SRT is combined with EGFR-targeting tyrosine kinase inhibitors and bevacizumab, which was not observed after cranial SRT. Conclusion The currently available information concerning toxicity after concurrent SRT and targeted/immunotherapy is limited. The focus of published studies lies mainly on concurrent cranial SRT, where the combination generally is well tolerated. For extra-cranial SRT, no definitive conclusions can be drawn. This review underlines the need for clinical studies testing the combination of SRT and targeted drugs/immune check point Inhibitors. EP-1415 Interventions to Address Sexual Problems in People with Cancer L. Barbera 1 , C. Zwaal 2 , D. Elterman 3 , W. Wolfman 4 , A. Katz 5 , K. McPherson 6 , A. Matthew 7 1 Odette Cancer Centre - Sunnybrook Health Sciences Centre, Radiation Oncology, North York- Toronto, Canada 2 McMaster University, Oncology, Hamilton, Canada 3 University Health Network, Urology, Toronto, Canada 4 Mount Sinai Hospital, Obstetrics and Gynecology, Toronto, Canada 5 CancerCare Manitoba, Cancer and Sexuality Counselling, Winnipeg, Canada 6 Cancer Care Ontario, Patient and Familty Advisory Council, Toronto, Canada 7 University Health Network, Surgical Oncology, Toronto, Canada Purpose or Objective Objective: Sexual dysfunction in people with cancer is a significant problem. This guideline aimed to address the following question: “What is the effectiveness of pharmacologic interventions, psychosocial counselling or devices to manage sexual problems after cancer treatment?” Material and Methods Methods: This guideline was created with the support of the Program in Evidence-Based Care. We searched for existing systematic reviews, guidelines and relevant primary literature from 2003-2015. Men and women were evaluated separately. No restrictions were made on cancer type or study design. When first approaching the guideline the working group chose to focus on sexual disorders commonly known to arise in people with cancer. These included decreased desire, arousal disorders, pain (in women) and erectile dysfunction (in men). Only studies that evaluated the impact of an intervention on a sexual function outcome were included. Results Results: The panel made one overarching recommendation that there be a discussion with the patient, initiated by a member of the health care team, regarding sexual health and dysfunction resulting from the cancer or its treatment. The Expert Panel felt that this is vital since the

additional recommendations cannot be used unless someone has taken the initiative to ask. There were numerous limitations of the existing literature. However, we made additional recommendations on 11 outcomes: 6 for women (sexual response, body image, intimacy/relationships, overall sexual function/satisfaction, vasomotor symptoms, genital symptoms) and 5 for men (sexual response, genital changes, intimacy/relationships, overall sexual function/satisfaction, vasomotor symptoms). There is a role for medication or devices in particular circumstances. Psychosocial counselling however had the largest evidentiary base for most of the outcomes. Conclusion Conclusion: To our knowledge this is the first evidence based guideline to comprehensively evaluate interventions to improve sexual problems in people with cancer. The guideline will be a valuable resource to support practitioners and clinics in addressing this important aspect of being human. EP-1416 A new model of care to improve clinical trial participation in radiation oncology M. Grand 1,2,3 , M. Berry 1,3,4 , D. Forstner 1,3,4 , S. Gillman 1,3 , P. Phan 1,3 , K. Wong 1,4,5 , S. Vinod 1,4,6 1 Liverpool Hospital, Cancer Therapy Centre, Liverpool, Australia 2 Ingham Institute for Applied Medical Research, Clinical Trials, Liverpool- NSW, Australia 3 Campbelltown Hospital, Cancer Therapy Centre, Campbelltown- NSW, Australia 4 University of NSW, South Western Sydney Clinical School, NSW, Australia 5 Ingham Institute for Applied Medical Research, CCORE, Liverpool- NSW, Australia 6 Western Sydney University, Clinical School, NSW, Australia Purpose or Objective Clinical trial participation is becoming increasingly recognised as an indicator of quality of care in oncology. Previously, Radiation Oncology (RO) clinical trials at Liverpool and Macarthur Cancer Therapy Centres, Sydney, Australia were managed by a general oncology clinical trials unit. The focus was largely on pharmaceutical and large collaborative group trials, and less on investigator initiated studies. This model was heavily reliant on individual clinicians remembering to screen and recruit patients. Recognising our low rates of participation in clinical trials, we decided to develop and implement a new model of care to support clinical trials in RO. Material and Methods A new team dedicated to RO clinical trials with specific skill sets in nursing, radiation therapy and clinical research, was formed in December 2014. Strategies were devised to improve performance which included development of standard operating procedures, Good Clinical Practice (GCP) training, and active education and communication. Work processes were changed to be less reliant on clinicians, with more co-ordination by the RO clinical trials team. Active screening was conducted through attendance at multidisciplinary team meetings, screening clinic lists and development of a MOSAIQ screening tool for clinicians. The model involved regular auditing and feedback to clinicians to identify poor recruiters or poorly recruiting trials, and provide clinical trials support to improve this. Results Across both Liverpool and Macarthur Cancer Therapy Centres, screening activity increased from 51 patients screened in 2014, to 339 in 2015, and to 487 up to August 2016. Participation in clinical trials, as a percentage of new patients seen in RO clinics, increased from 2.6% in 2014, to 12.4% as of August 2016 (Fig 1). The number of