ESTRO 38 Abstract book

S124 ESTRO 38

than 5,500 patients (pts) to varying degrees, from 3% to more than 50% of the prescribed dose. Five cohorts of pts were defined according to their specific cause of over- irradiation. We report the Mortality and Morbidity Review of those radiotherapy accidents. Material and Methods Cohort 1: Between 2004 and 2005, 24 prostate cancer pts were over-irradiated more than 20%, because of the improper use of a treatment planning system. For prescribed doses between 69 Gy and 78 Gy, pts received doses between 81 Gy and 120 Gy. Cohort 2: Between 2000 and 2006, 409 prostate cancer pts received 9-10% radiation overdose because of failure to consider doses delivered by daily portal imaging. For prescribed doses between 70 Gy and 78 Gy, pts received doses between 76.7 Gy and 85.5 Gy. Cohort 3: Between 1987 and 2000, at least 5,000 pts were irradiated with 3% (1,100 pts), 5.5% (3,600 pts), or 7.1% (306 pts) more radiation than planned, depending on the photon energy used for their radiotherapy. The cause was an error in the homemade informatic program written to carry out calculations of monitor units (MU). Cohort 4: in 1993, 8 breast cancer pts received a dose 20- 68% higher than the prescribed dose because of an inappropriate correction factor used for the calculation of MU when filters for tangential beams were used. Cohort 5: in 1999, 36 breast cancer pts had radiation overdose to the heart because of exclusive use of direct 6 MV photon beam to deliver 50 Gy to the internal mammary chain. Moreover, one patient developed a radiation-induced myelitis after overlap of irradiation fields for breast cancer in 1998 and vertebral bone metastasis in 2003. Adverse effects of radiotherapy were graded according to CTCAE v3.0 grading system. Accident severity was graded according to ASN/SFRO scale (classification of radiation protection events affecting patients). Results Cohort 1: 10 pts died from radiation-induced injury of the gastrointestinal and/or genitourinary tract. This accident was rated level 7 (up to 7) on the ASN/SFRO scale. Cohort 2: among 405 evaluable pts for toxicity, 372 (82.5%) developed late gastrointestinal toxicity (LGIT) ≥ Grade 1, 155 pts (38%) had LGIT Grade ≥2, 66 pts (16%) had LGIT Grade 3, and 2 pts died of radiation-induced rectovesical fistula (level 6 on the ASN/SFRO scale). Cohort 3: 2 pts died of radiation-induced rectovesical fistula (level 6 on the ASN/SFRO scale). Cohort 4: 1 patient developed a radiation-induced grade 3 skin complication (level 3 on the ASN/SFRO scale). Cohort 5: 9 pts (24%) developed radiation-induced grade 4 cardiac adverse events (level 4 on the ASN/SFRO scale). Conclusion Overall, 14 radiation-induced deaths occurred after these accidents. Since 2007, each French radiotherapy center is now inspected once a year by ASN. National measures have been taken to prevent recurrence of such accidents. PV-0255 Advocating for radiation oncology through the development of a massive open online course M. Leech 3 , C. Poole 1 , S. Gallagher 2 , W. Fox 2 1 Trinity College, Discipline of Radiation Therapy, Dublin, Ireland ; 2 Trinity College, Trinity Online Services, Dublin, Ireland; 3 TCD Discipline of Radiation Therapy, Trinity College, Dublin, Ireland Purpose or Objective Radiotherapy is an effective and cost effective treatment for most cancers however there is sub-optimal access worldwide and it is underutilised. Lack of information and awareness of radiation therapy is reported within the literature as a patient-related barrier to accessing radiation therapy. The aim of this project was to develop a massive open online course to inform cancer patients,

transparency of their reporting. Robustness of this analysis and instrument comparison were examined using the Kendall coefficient of concordance and Inter-Class- Correlation coefficients. Results The systematic review lead to the selection of 15 records matching the search strategy: these were most frequently conducted in Canada (n=4) and France (n=3). Instruments’ mean score were evaluated respectively at 59.4%, 69.7% and 73.6% for CHEC, CHEERS and QHES. The overall quality score was fairly good, even an in-depth analysis per criteria reveals that essential costing items - discount rate, time horizon, sensitivity analysis - were only partially completed. Over time, instruments scores rise specifically for QHES. The statistical analysis confirms that raters have scored in a similar manner. In addition, as inter-rater reliability coefficients show that that the reviewers score converged more with CHEC (ICC=0.86***)) than for QHES (ICC=0.73***) and CHEERS (ICC=0.64***).

Conclusion The two-fold objectives of the present quality appraisal demonstrate a fairly good quality of reporting overall amongst EBRT costing studies published in the last decade. While we found no major difference in the instrument score, the CHEERS checklist has the most extensive consideration of cost components across all three instruments. Yet essential improvement in reporting both acknowledged costing methodology and sufficient input information need to be put forward in order to continue improving the quality of future HEE study, supporting indirectly appropriate decision-making about the allocation of scarce healthcare resources. PV-0254 Mortality and Morbidity Review of serial radiotherapy accidents in Epinal, 1987-2006 J. Simon 1 , P. Maingon 1 , E. Francois 2 , E.H. Labib 3 , M. Vincent 3 , N. Alain 3 , L. Mihaï 3 , M. Christian 3 , P. Didier 3 1 Hôpital Pitié-Salpétrière, Radiotherapy, Paris, France ; 2 Centre Antoine Béclère, Centre Universitaire des Saints- Pères, Paris, France ; 3 Institut de cancérologie de Lorraine, Radiotherapy, Vandoeuvre-les-Nancy, France Purpose or Objective Between 1987 and 2006, five serial accidents occurred in the radiotherapy department of the Jean Monnet Hospital in Epinal, France, resulting in over-irradiation of more