ESTRO 38 Abstract book

S463 ESTRO 38

radiation oncology team to enhance continuity of care, we noted significant changes in practice patterns. In addition to a continued increase in the number of inpatients treated with radiation, we noted a significant decrease in number of fractions prescribed to our palliative patients and a significant decrease in length of inpatient stay after a radiation oncology consultation. We hypothesize that this is due to enhanced communication between our dedicated inpatient radiation oncology team and allied medical oncology and palliative care providers. PO-0879 Mobile health for monitoring of health status in palliative care patients: a feasibility study M. Pavic 1 , V. Klaas 2 , G. Theile 1 , J. Kraft 1 , G. Tröster 2 , M. Guckenberger 1 1 University Hospital Zürich, Radiooncology, Zurich, Switzerland ; 2 Swiss Federal Institute of Technology, Wearable Computing Laboratory, Zurich, Switzerland Purpose or Objective Discharge from hospital is a vulnerable phase in palliative patients’ trajectories resulting in frequent unplanned readmissions. We examined the feasibility of remote monitoring of palliative patients using wearables in form of a smart-phone and a bracelet, aiming to detect deterioration of health status early and to prevent emergency readmissions. Material and Methods Patients treated with palliative intent in an inpatient setting were recruited for this prospective single-center observational feasibility study. Inclusion criteria were age >18, a severe medical condition (metastatic cancer or severe cardiac/pulmonary disease), ECOG performance status ≤2, no relevant cognitive impairment and good knowledge of German language. Patients were provided with two mobile health devices, an Android smartphone with a pre-installed activity monitoring app developed for this study and a sensor-equipped bracelet that recorded physical and social activity, vital signs and daily subjective ratings of pain and distress. Quality of life was assessed weekly by means of the EORTC QLQ-C30. The follow-up period was 12 weeks and started at discharge from hospital. Results Between February 2017 and February 2018 68 patients were eligible, of which 31 (46%) patients with a median age of 64 years (range 39-85) consented to participate. All included patients had a cancer diagnosis. Twenty-five patients completed the study period of 12 weeks, 3 died in between, 3 discontinued. On average, the bracelet was worn on 53 % of the study days. Wearing time per study day was on average 63 % (time considered between 8:00 and 20:00). The smartphone was worn at 85 % of the study days and wearing time was 50 % per day (8:00 to 20:00). Completion rate of digital questionnaires for patient reported outcome/of subjective ratings (of pain and distress) was 73%. During the study period 8 unplanned hospital readmissions occurred. Patient reported ratings of pain, distress and QLQ-C30 scores were not associated with emergency readmission, whereas heart rate variability (HRV) while resting (root mean square of the successive differences), resting heart rate and speed of steps differed significantly between groups of patients with emergency readmissions versus no readmission. Conclusion Monitoring of palliative cancer patients using wearables is feasible. First results indicate that features of resting HRV, resting heart rate and speed of steps might be promising mobile health biomarkers to predict unplanned hospital readmission and are more significant than subjective ratings PO-0880 Validation of a predictive model for survival in patients receiving radiotherapy for bone metastases

Conclusion LC-RT remains the most common RT fractionation scheme for palliative treatment of breast cancer bone metastases. However, the use of SC-RT is increasing, particularly in more recent years, and for older patients and treatments at academic/research centers. As observed in multiple randomized trials, we also demonstrate equivalent OS between SC-RT and LC-RT after propensity matching. PO-0878 Implementing a dedicated inpatient radiation team with multidisciplinary palliative care rounds D. MARK 1 , P. Gilbo 1 , S. Joseph 1 , A. Goenka 1 , B. Bloom 1 1 Northwell Health, Radiation Medicine, Lake Success, USA Purpose or Objective To improve inpatient radiation care in our academic tertiary center, we have initiated a two pronged approach: we implemented daily inpatient multidisciplinary palliative care rounds (MPCR) including radiation oncology, medical oncology, and palliative care to improve interdisciplinary communication, and then started a dedicated inpatient radiation oncology team consisting of an attending and physician assistant to enhance continuity of care. We analyzed the impact of both interventions on number of inpatient treatment courses, recommended number of fractions, treatment completion rates, and length of inpatient stay. Material and Methods We initially implemented MPCR in July 2017 and then implemented our dedicated inpatient radiation team in January 2018. We retrospectively reviewed records for patients treated at our inpatient facility from 1/2017- 6/2018 and recorded demographic data, treatment details, and length of inpatient stay after a radiation oncology consultation. We compared 6 months of baseline data (1/2017-6/2017), to data after the implementation of MPCR (7/2017-12/2017) and after the implementation of a dedicated inpatient care team (1/2018-6/2018). Results 307 inpatient treatment courses were administered during this 18 month interval. There was a 35% increase in number of inpatient radiation treatments courses in the 6 months after development of MPCR (77 compared to 104) and a 63% year-to-year increase in the 6 months after both interventions (77 compared to 126). Number of fractions recommended after both interventions decreased from a mean of 6.1 (1/2017-6/2017) to 4.9 (1/2018-6/2018) which was significant (p=0.02). There was an increase of single fraction treatment courses offered from 7 (1/2017- 6/2017) to 21 (1/2018-6/2018), and this trended toward significance (p=0.09). Treatment terminations did not significantly differ between time periods (11.7% initially, 13.5% after MPCR, and 11.1% after implementation of the dedicated team). Lastly, we noted a significant decrease of length of stay after a radiation oncology consultation from a mean of 16.2 days at baseline (1/2017-6/2017), to 14.7 days after the implementation of MPCR (7/2017- 12/2017), to 12.3 days after the implementation of a dedicated inpatient radiation oncology team (p=0.004 when comparing 1/2017-6/2017 to 1/2018-6/2018). Conclusion Through the implementation of daily inpatient multidisciplinary rounds and a dedicated inpatient