ESTRO 38 Abstract book

S879 ESTRO 38

The software is accessed remotely via Citrix and includes Pinnacle treatment planning system (TPS) V14 (Philips), Mosaiq Record and Verify (R&V) SystemV2.62 (Elekta) together with RADCALC (RC) V 6.3 ( Lifeline software Inc) and PerFRACTION™ 3D from SunNuclearCorporation. Plan production, Plan quality assessment and Plan metrics using Dose Volume Protocol (DVP) and Quality Checks(QC)- A suite of scripts run within TPS based on the institutes clinical protocols and planning guidelines. Plan production – Palliative Scripted class solution DVP – reports the plan and DVH dose metrics independently extracted in a tabular format enables the planner to review OAR and PTV constraints using a visual traffic light system . Once plan is locked the report is auto generated and attached into the correct patient in R&V. QC -Checks plan integrity against planning guidelines such as beam energy, normalisation and calculation grid which can be configured. QC interrogate R&V for information such as patient demographics and compare to TPS. RadCalc® - independent MU check and creates a configurable QA reports which is auto loaded into R&V for approval if it meets the tolerance. RadCalc® Reconciler - Ensures accurate reconciliation between the planning data in TPS and R&V. Comparison occurs in RC. prerequisites require data export of the final Clinical plan from TPS to RC and R&V to RC. The RTP-Filter informs the user of any differences and the report can be configured to display discrepancies only . PerFRACTION™3D – independent automated phantom- less end to end QA solution for all patient plans and fractions. A report is automatically compiled and accessed via the web user interface. A traffic light system efficiently flags any issues with the option of viewing more information if needed. Results Learning from the trial period from November 2018 to be presented together with detailed process map as well as Clinical case studies.

6 Università Federico II, Radioterapia Oncologica, Napoli, Italy ; 7 Seconda Università di Napoli, Radioterapia Oncologica, Napoli, Italy ; 8 Emicenter, Radioterapia Oncologica, Napoli, Italy ; 9 Università di Bologna Ospedale Sant'Orsola, Radioterapia Oncologica, Bologna, Italy ; 10 Azienda Sanitaria Locale Rieti, Radioterapia Oncologica, Rieti, Italy ; 11 Fondazione di Ricerca e Cura 'Giovanni Paolo II'- Catholic University of Sacred Heart, Unità Operativa di Radioterapia, Campobasso, Italy ; 12 Università di Messina, Dipartimento di Diagnostica per Immagini e Radioterapia, Messina, Italy ; 13 Istituto Nazionale Tumori di Napoli- IRCCS Fondazione Senatore Pascale, Radioterapia Oncologica, Napoli, Italy ; 14 IRCCS "Casa Sollievo della Sofferenza", Unità di Radioterapia Oncologica, San Giovanni Rotondo, Italy Purpose or Objective Palliative Radiotherapy (PR) for bone metastases is a possible treatment for metastatic patients but often clinical practice and absence of shared guidelines can limit choice of correct regimen. Prognostic scores can help clinician to tailor time, dose and volume in PR. In this study we investigate about decision variance after application of Mizumoto Prognostic Score (MPS) to Nine clinical cases were selected with a complete indication of MPS parameters: 3 cases were of A class (prognosis > 6 months), 3 of B class (prognosis between 6 and 12 months) and 3 of C class (prognosis between 12 and 24 months). Radiotherapy Oncologists (ROs) with different grade of experience [in training RO (IT), Junior RO (JRO), Senior RO(SRO), Junior RO Team Palliative member(JROP), Senior RO Team Palliative member (SP)] underwent a questionnaire to explore what RT regimen would choose before and after MPS application. The questionnaire were administered on blind by phone. Results were recorded on CRF Excel format and analyzed on RStudio. Descriptive statistical analysis and concordance Fleiss’ kappa test were used to discriminate variance of answers between groups. Results The questionnaire was administered to 75 ROs (12 IT; 13 JROP; 17 JRO; 25 SRO; 8 SP). Median conversion rate of RT dose prescription after MPS application was 9.3% (1.3- 18.6%). In particular median conversion rate was: 13.8% for IT; 11.1% for JROP; 8.5% for JRO; 10.2% for SRO; 15% for 15%. According to Fleiss’ kappa parameters, evaluation of agreement in dose prescription showed an improving in 5.18% at the overall analysis after MPS application. Analytical case evaluation of agreement showed a basal good level of concordance between ROs in C class cases (46.8-66.6%), with an implement of agreement between 5.6 and 15.6 %. A and B class cases showed a poor level of basal agreement (25-35.2%), that after MPS rise since to 38.6%. MPS score application resulted in increase of the agreement in the choice of pattern of care, beyond clinician's experience and actual patient's prognosis. Conclusion This preliminary investigation about prognostic score used in palliative radiotherapy has showed that MPS application can change RT prescription in 9.3% of participant with different grade of experience in palliative care. Globally, there was also an increase of the agreement in final dose prescription, although only of 5.18%. Further analysis on subgroups, experience in palliation and clinical cases stratification would be reported in extensive publication, together with more questionnaire results. EP-1632 Response prediction of palliative radiotherapy to painful spinal bone metastases J. Akhgar 1 , J.C. Peeken 2 , S.U. Pigorsch 3 , S.E. Combs 2 1 Klinikum rechts der Isar - Technical University of Munich TUM, Department of Radiation Oncology, Munich, Germany ; 2 Klinikum rechts der Isar - Technical different clinical cases Material and Methods

Conclusion Using Standardisation as a prerequisite automation can be achieved. The automation allows production of consistently good plans and streamline of checks. The time saving can be utilised to support a Rapid Access Palliative clinic. EP-1631 AIRO Palliative Study Group investigation on prognostic score in clinical practice: PROPHET Trial F. Cellini 1 , V. Masiello 1 , S. Manfrida 1 , E. Lattanzi 2 , L. Marino 3 , F. Arcidiacono 4 , A. Santacaterina 5 , L. Cervone 1 , A. Diroma 1 , A. Romano 6 , R. Di Franco 7 , F. Pastore 8 , G. Siepe 9 , C. Donati 9 , R. Cassese 10 , M. Santarelli 10 , F. Deodato 11 , S. Pergolizzi 12 , E. Maranzano 4 , P. Muto 13 , S. Parisi 14 , V. Valentini 1 1 Fondazione Policlinico Gemelli IRCCS, Radioterapia Oncologica, Roma, Italy ; 2 Università di Parma, Radioterapia Oncologica, Parma, Italy ; 3 REM Center, Unità di Radioterapia, Catania, Italy ; 4 Ospedale Santa Maria, Centro di Radioterapia Oncologica, Terni, Italy ; 5 Azienda Ospedali Riuniti Papardo-Piemonte Messina., Unità Operativa di Radioterapia, Messina, Italy ;