ESTRO 38 Abstract book

S864 ESTRO 38

three regions treating sarcoma patients across Scotland. Medical Education is used by the network to promote clinical excellence, share clinical practice in transparency and learn through mistakes. A Mortality and Morbidity session is introduced into each of the education days to enable all members of the network to share their practices and share key learning points with peers. Results The data on QPIs is collected locally by each NHS Board and the analysis is performed locally, regionally and nationally with the resultant actions being assigned to the local NHS Board, the sarcoma specialist centre (there are five) or the Scottish Sarcoma Network. Education sarcoma days are well attended and based on evaluation are connecting specialists and health care professionals with patients, carers, charities, universities and local authorities, all working along the lines of promoting care and raising awareness for sarcomas. Conclusion SSN is an example that successful networking, which is enhanced through the education days can utilise limited resources by coordination and collaboration to provide best possible and uniform services closer to patient’s home in challenging geographical circumstances. EP-1603 Survival after adjuvant radiotherapy for aggressive fibromatosis depend upon time and β- catenin J.S. Kim 1 , H.J. Kim 1 , M. Lee 2 , K.C. Moon 3 , S.G. Song 3 , H. Kim 4 , I. Han 4 , I.H. Kim 1 1 Seoul National University Hospital, Department of Radiation Oncology, Seoul, Korea Republic of ; 2 Hallym University College of Medicine, Department of Radiation Oncology, Seoul, Korea Republic of ; 3 Seoul National University Hospital, Department of Pathology, Seoul, Korea Republic of ; 4 Seoul National University Hospital, Department of Orthopaedic Surgery, Seoul, Korea Republic of Purpose or Objective We identified the prognostic factors influencing progression-free survival (PFS) of patients with aggressive fibromatosis (AF) after postoperative radiotherapy (PORT). We also assessed the correlation between immunohistochemistry (IHC) features of β-catenin/SMA and PFS. Material and Methods The records of 37 patients with biopsy-proven AF treated by PORT from 1984 to 2015 were retrospectively reviewed. Fifteen patients underwent wide excision for AF and 22 patients received debulking operation. The median total dose of PORT was 59.4 Gy. IHC of β-catenin and SMA were evaluated in available 11 and 12 patients, respectively. IHC staining intensity was graded and compared between low and high intensity. Log-rank test and Cox proportional hazard model were performed. Results The median follow up duration was 105.9 months. The 5- year PFS rate was 70.9%. The tumor size and margin status were not related to PFS in univariate analysis (p=0.197; p=0.716, respectively). Multivariate analysis showed that increased interval from surgery to PORT was independent risk factors for PFS (HR 1.303, 95% CI 1.023-1.650, p=0.032). PORT after recurrence had marginal significance (HR 7.550, 95% CI 0.964-59.110, p=0.054). Patient with 2 risk factors, AF recurrence and interval from surgery to PORT >5 weeks, had significantly lower 5-year PFS than patients with no risk factor (43.8% vs. 100.0%, p=0.022). Nuclear β-catenin intensity had a tendency to inversely correlate with 5-year PFS, although it did not have statistically significance (low intensity, 44.4% vs. high intensity, 100.0%, p=0.260). SMA intensity was not related to PFS (p=0.700). Conclusion

Patients from the Rare Cancer Network database were studied. Kaplan Meier estimate was used to assess survival curves and Cox proportional hazards regression was used to assess risk factors for LC, DFS and OS. Results Between 2000 and 2017, 121 patients met inclusion criteria. Primary site was lung in 30%, mediastinum 34% and pleura in 36%. 39 % and 32% received RT and CT. Median follow-up was 34 months (range, 2-141). Local control, DFS and OS at 10 years was 52%, 18.7% and 7.2%, respectively. In multivariate analysis RT (P=0.003) and R1 margin status (P=0.041) retained a significant association with local control. Only R1 resection (P=0.002) remained associated with a decreased risk of death in multivariate analysis. Overall, 7 patients (6%) developed grade 3 treatment-related chronic toxicity events Conclusion This joint analysis revealed that OS remains modest in this group of patients, mainly given by the high risk of local and distant failure. Our results suggest that resected ITS can benefit from adjuvant RT. EP-1602 Role of clinical networks in sarcomas: The Scottish Sarcoma Network(SSN)Experience J. Nixon 1 , F. Cowie 1 , J. White 2 , P. Chong 3 , S. Lo 4 , D. Bodie 5 , L. Hayward 6 , M. Ferguson 7 , L. Campbell 8 1 the beatson west of scotland cancer centre, Oncology, glasgow, United Kingdom ; 2 the beatson west of scotland cancer center, oncology, glasgow, United Kingdom ; 3 gartnaval hospital, surgery, glasgow, United Kingdom ; 4 glasgow royal infirmary, plastic surgery, glasgow, United Kingdom ; 5 aberdeen royal infirmary, surgery, aberdeen, United Kingdom ; 6 edinburgh cancer center, oncology, edinburgh, United Kingdom ; 7 nhs tayside, oncology, dundee, United Kingdom ; 8 national health services, nsd, glasgow, United Kingdom Purpose or Objective The Scottish Sarcoma Network(SSN) is one of the few National Managed Clinical Networks (MCNs) in Scotland. It was established in November 2004 with its core aim being to improve communication and collaboration between treating centres and promote patient care for sarcoma patients across Scotland. MCNs are virtual entities designed to drive upwards the standards of patient care through integration of services and collaboration. They are defined as “ linked groups of health professionals and organisations from primary, secondary and tertiary care, working in a co-ordinated manner, unconstrained by existing professional and Health Board boundaries, to ensure equitable provision of high quality clinically effective services throughout Scotland .” We aim to share our experience to achieve better care for sarcoma patients across Scotland. Material and Methods The National Network Lead rotates across centres and works closely with the National Manager, Subspecialty Leads and sub-groups, NHS staff, patients, carers, charities, Universities and Local Authorities to enhance patient care. Ambition and Action (2016) details a commitment to delivering the national cancer quality programme across NHSScotland, with a recognised need for national cancer Quality Performance Indicators(QPIs) to support a culture of continuous quality improvement. The sarcoma QPIs were implemented for patients diagnosed in 2014/15, refined based on the first year’s results and reported for years two and three, reviewed after three years and will be reported for year four in December 2018. A weekly National Sarcoma MDT hosted by the SSN is ensuring same standards of care for all sarcoma patients. SSN plays a pivotal role in the QPI process and decision making regarding steps towards continuous improvements. In addition, three education days are organised by the network and are hosted in each of the