ESTRO 38 Abstract book

S102 ESTRO 38

Radiation Therapy Oncology Group toxicity criteria 7 and for each subsequent week of treatment. Results 594 total responses were received with 542 included in the survey after exclusions. The effect on skin toxicity of the skin care product used, as well as other patient and treatment factors were analysed. No significant differences were found in RTOG grades between any of the skin products used. Weight, cup size, diabetes, cardiovascular disease, mastectomy and beam energy were all found to have statistically significant higher RTOG grades. Conclusion This survey shows that intrinsic factors are more likely to determine skin toxicity and confirms the SCOR guidelines that any SLS free, topical product can be used for radiotherapy skin care. OC-0198 Using PROs and PROMs in routine head and neck cancer care: what do RTs perceive as barriers? H. Nguyen 1 , P. Butow 2 , H. Dhillon 2 , L. Morris 1 , A. Brown 1 , K. West 1 , P. Sundaresan 1,3 1 Radiation Oncology Network, Western Sydney Local Health District, Sydney, Australia ; 2 Centre for Medical Psychology & Evidence-based Decision-making CeMPED, The University of Sydney, Sydney, Australia; 3 Sydney Medical School, The University of Sydney, Sydney, Australia Purpose or Objective Patient-reported outcomes (PROs) are direct reports from patients about the status of their health condition without amendment or interpretation by others. Patient-reported outcome measures (PROMs) are usually validated questionnaires that patients complete by self-assessing their health status. Domains assessed include the patient’s physical, emotional, social and overall quality of life. The use of PROMs to measure PROs has been shown to improve patient overall survival and toxicity outcomes, patient- health professional (HP) communication and service-level quality. Yet, PROMs are not routinely used in many oncology institutions worldwide. The aim of this study was to examine HPs’ perception of barriers to the routine use of PROs and PROMs in the care of head and neck cancer (HNC) patients. This report specifically focuses on perceptions of RTs caring for HNC patients. Material and Methods A custom survey was created to assess HNC HPs’ perceptions of barriers to routine PRO use. To create the survey, existing literature was reviewed and potential barriers and enablers to routine PRO use were collated and categorised as patient-level, service-level or HP- level. Participants were asked to rate the degree to which they believe these items are barriers/enablers to PRO use by answering “not at all”, ‘very little”, “quite a bit” and “very much”. The survey was pilot tested amongst selected HPs before being electronically disseminated to HPs involved in the care of HNC patients in Western Sydney Local Health District, Australia. Results There were 122 participants; 58% (n =71) of whom were RTs. The response rate amongst RTs was 94.7%. Most RTs (59.2%) had never heard of PROs whilst very few (2.9%) have used PROs to guide patient care. At the patient level, the perceived unavailability of PROMs in patients’ preferred languages and patient difficulty understanding PROMs were rated as “quite a bit/very much” by 67.6% and 54.3% of RTs respectively. At the service-level, factors perceived as “quite a bit/very much” a barrier to PRO use included low workplace awareness of PROs (69.6%), low organisational support (69.6%) and insufficient staff resources (69.6%). At the HP-level, factors perceived as “quite a bit/very much” a barrier to PRO use included lack of knowledge regarding how to use PROs (66.7%), concern regarding need for additional time to interpret and action

grade 2 oesophagitis. No patients reported grade 3 or higher oesophagitis. There was a significant difference in the number of patients receiving a mean oesophageal dose of ≥ 31 Gy with grade 2 toxicity compared to those receiving < 31 Gy (p=0.025). There was a significant difference in grade 2 toxicity in patients who had ≥ 1 cm of pharynx included in supraclavicular fields compared with those with < 1 cm (p=0.0116). A trend was observed in patients with left-sided SCF treatment, with more experiencing a grade 2 toxicity; this could be explained by the anatomical location of the oesophagus in this region. There was also an increased trend of grade 2 toxicity in patients who did not receive IMC RT; the reason for this may require further investigation. There were no overall significant differences in smoking history, oesophageal length and chemotherapy regimen. Conclusion This study has identified two potential predictors for moderate oesophageal toxicity in early breast cancer patients receiving RT to the breast or chest wall and supraclavicular nodes. By limiting the mean dose to the irradiated oesophagus to < 31 Gy during the planning process, and if possible ensuring < 1 cm of pharynx is included in the field, oesophageal toxicity could be reduced. OC-0197 A survey of UK practice of radiotherapy skin care for breast patients H. Nisbet 1 , S. Matthews 1 , R. Cooke 1 1 Oxford University Hospitals NHS Foundation Trust, Radiotherapy Department, Oxford, United Kingdom Purpose or Objective Radiation induced skin toxicity is one of the most common toxicities experienced with radiotherapy treatment and is characterised by erythema, heat, pain, swelling and pruritus. The management of skin toxicities has often been driven by established practices and local conventions rather than on research and evidence, resulting in non- standardised practice with little or no justification 1, 2 . In 2015 The Society and College of Radiographers (SCoR) published guidelines 3 to promote an evidence-based approach. However, a lack of evidence to support or refute the use of any particular product for topical application meant that only general guidance is given. In addition, it is advised that any moisturiser containing sodium lauryl sulphate (SLS) should be avoided as it causes skin irritation. The 2012 SCoR survey of UK practice showed that nearly 70% of radiotherapy departments advised the use of aqueous cream for prophylactic skin care 2 , a product that contains SLS. As a result, the new guidelines provided a review of the evidence base for skin care practice but simultaneously advised against the most common cream in use, creating uncertainty on what products can be recommended to patients. Therefore the objective was to survey current UK skin care practice for patients undergoing treatment to the breast following the implementation of the new guidelines and to evaluate if any one particular topical product had fewer associated skin toxicities. Material and Methods All UK departments were invited to participate via the SCoR Radiotherapy Information, Support and Review Special Interest Group online forum and provided with a skin assessment tool to record skin toxicity details. Extrinsic factors recorded were treatment technique and beam energy. Intrinsic factors included the co-morbidities of diabetes and cardiovascular disease, smoking, alcohol consumption, weight and patient demographics. The skin care products used during treatment were also documented. Participating departments had implemented the 2015 guidelines and for comparability only external beam radiotherapy to the breast and chest wall, excluding nodal treatment, were included. An assessment of the skin was recorded in week one using the