ESTRO 38 Abstract book

S103 ESTRO 38

PROs (56.5%) and lack of knowledge on how to integrate PROs into clinical practice (55.1%). Top enablers highlighted by RTs were staff education on how to use PROs (82.4%), clear definition of roles (80.9%) and designated time for staff to monitor and respond to PROs (80.9%). Conclusion This study has highlighted important barriers and enablers to the routine use of PROs in HNC care as perceived by RTs. Most barriers appear to lie at the service and HP levels. Findings from this study will guide future interventions to address these barriers such that successful and sustainable implementation of routine PRO collection may be achieved. OC-0199 Patient-reported outcomes after stereotactic body radiotherapy in lung cancer: The Lung PLUS study L. Van der Weijst 1 , R. Bultijnck 1 , A. Van Damme 1 , M. Van Eijkeren 1 , V. Surmont 2 , Y. Lievens 1 1 Ghent University Hospital, Radiation Oncology, Gent, Belgium; 2 Ghent University Hospital, Respiratory Medicine, Gent, Belgium Purpose or Objective Stereotactic body radiotherapy (SBRT) is the treatment of choice for early stage non-small cell lung cancer (ES- NSCLC) patients unwilling to undergo or ineligible for surgery. SBRT may bring along toxicities, adversely affecting health-related quality of life (HRQoL), with impact on the patients’ physical, psychological and social wellbeing. Fatigue is a frequently reported side-effect in patients undergoing SBRT. We here report the initial results of patient-reported toxicity, HRQoL and fatigue in the Lung PLUS study. Material and Methods Lung PLUS is a monocentric, prospective, longitudinal study, investigating the predictive value of Patient- Reported Outcomes (PROs), functional exercise capacity (6-minute walk test – 6MWT) and circulating cell-free DNA circulating DNA (cfDNA) on outcome in ES-NSCLC undergoing SBRT. PROs are collected at baseline, and at 1, 3, 6, 9 and 12 months after treatment. Outcome data (overall survival; local and loco- regional control; and metastatic relapse) are recorded during the entire course of follow-up. Socio-economic determinants are collected at baseline. HRQoL is measured with a validated questionnaire (EORTC QLQ-C30). The patient-reported toxicities, collected with the patient-reported outcome measurement (PROM) version of the Common Terminology Criteria for Adverse Events (CTCAE) (PRO-CTCAE), are as follows: pain, fatigue, cough, anxiety and dyspnea. A meaningful clinically important difference (MCID) of HRQoL was defined as a 10-point difference on the total score of 100 of the EORTC QLQ-C30 between time points. The mixed model approach was applied to analyze the longitudinal data. Results Between June 2017 and October 2018, 25 patients (median age: 73) out of the 50 patients planned have been recruited. The majority was male (64%) and had stage I disease (96%). Total dose was 60Gy, delivered in 3 (26%), 5 (17%) or 8 fractions (57%). Data is available of 25, 19 and 17 patients at baseline, 1 and 3 months after SBRT respectively. So far, no significant differences in overall toxicity (p=0.681), HRQoL (p=0.187) and fatigue (p=0.221) over time have been found. MCID in HRQoL was found in 50% (40% deterioration; 10% improvement) and 27% (all deteriorated) of patients respectively at 1 and 3 months after SBRT. Graph 1 provides an overview of individual overall HRQoL over time. Toxicity and HRQoL are significantly correlated (p<0.001) over time.

Data based on 18 patients due to excessive missing data of one patient. Conclusion The initial results of the Lung PLUS study indicate that HRQoL, toxicity and fatigue levels remain stable after SBRT in ES-NSCLC. Updated results will be presented.

Poster Viewing : Poster viewing 4: Head-Neck and Lung

PV-0200 Accelerated- vs chemo-radiation as organ sparing strategies for laryngeal/hypopharyngeal carcinoma A. M. Elamir 1 , S. Huang 1 , W. Xu 2 , M. Yu 2 , A. Spreafico 3 , A. Bayley 1 , S.V. Bratman 1 , J. Cho 1 , M. Giuliani 1 , A. Hope 1 , J. Kim 1 , B. O'Sullivan 1 , J. Ringash 1 , J.R. De Almeida 4 , D. Chepeha 4 , D. Goldstein 4 , J. Irish 4 , J. Waldron 1 , A. Hosni 1 1 Princess Margaret Cancer Centre / University of Toronto, Department of Radiation Oncology, Toronto- Ontario, Canada ; 2 Princess Margaret Cancer Centre / University of Toronto, Department of Biostatistics, Toronto- Ontario, Canada ; 3 Princess Margaret Cancer Centre / University of Toronto, Department of Medical Oncology, Toronto- Ontario, Canada ; 4 Princess Margaret Cancer Centre / University of Toronto, Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology-, Toronto- Ontario, Canada Purpose or Objective To evaluate the outcomes of locoregionally advanced laryngeal/hypopharyngeal squamous cell carcinoma (SCC) following concurrent chemoradiation (CRT) and accelerated radiation therapy (ART). Material and Methods Retrospective review was conducted of stage III-IVB (AJCC/UICC-7th edition) laryngeal/hypopharyngeal SCC patients who were treated with curative-intent radiation therapy (RT) from 2000-2016. Patients were preferentially managed with CRT; those unfit or who declined chemotherapy received ART scheduled based on physician and patient preference: moderately accelerated, 70 Gy/35f/6w (A-Mod); hypofrationated, 60 Gy/25f/5w (A- Hypo); or accelerated hyperfractionation, 64 Gy/40f/4w (A-Hyper). Cases were matched 1:1 from our prospective quality assurance system based on: age, smoking and ECOG performance status (PS), T- and N-category, larynx vs hypopharynx, and IMRT vs 3D conformal RT. With propensity score matching, outcomes were compared following: 1) CRT vs the three ART regimens separately, 2) The three different AF-RT schedules. The primary endpoint was 5-yr local control (LC, evaluated by competing risk method) and secondary endpoints were 5- yr regional and distant control, cancer specific survival (analyzed by competing risk method), and overall survival (OS, measured by Kaplan-Meier method). Results Among 679 patients included, 195 received concurrent cisplatin (only 65 [33%] were able to receive 3 cycles of Q3-week cisplatin, 102 [52%] received 2 cycles, 14 [7%] tolerated only 1 cycle, while 14 patients [7%] received