ESTRO 38 Abstract book

S890 ESTRO 38

studies (4%). Northern Italy produced the very most of Italian research papers (58.7%). The age of the first/second Author was evaluated on 716 papers: in more than 50% of cases, the first author was younger than 40. Conclusion Despite a general gradual improvement, RT clinical research suffers in Italy (as elsewhere) from insufficient funding, with a negative impact on evidence production. It is worth noticing that clinical research is still appealing and accessible to junior Italian RO. EP-1654 Hypofractionation in breast cancer: possible advantages and logistical implications I. Meaglia 1 , M. Paolini 1 , C. Bocci 1 , G.B. Ivaldi 1 , M. Liotta 2 , P. Tabarelli de Fatis 2 1 ICS Maugeri Società Benefit SpA, Servizio di Radioterapia, Pavia, Italy ; 2 ICS Maugeri Società Benefit Spa, Servizio di Fisica Sanitaria, Pavia, Italy Purpose or Objective In the last three decades, hypofractionation has been an interesting and promising field of investigation. The primary and most important benefit of treating, for instance, breast and prostate cancer with a hypofractionated regimen is the improved therapeutic index that can be obtained; moreover, there are other advantages in terms of logistics, patient convenience and resource allocation. Here, we present our speculations about a routinely use of a hypofrationated regimen in breast after conserving surgery, and how its introduction in our Department has had an impact on our waiting list. Material and Methods From 2010 to 2017 we used a hypofractionated regimen of 20 fractions, 5 fractions a week, with a weekly concomitant boost. in February 2018, we started a new 15 fractions regimen (5 fractions a week, and weekly concomitant boost), reducing overall treatment time to 3 weeks. In both cases the weekly concomitant boost follows whole breast irradiation immediately. Considering that we scheduled to keep 13 daily slot for breast radiotherapy in a dedicated linear accelerator, we estimated how many patients could be treated with the 15 fractions regimen in one year, assuming 250 working days. Then, we calculated the expected reimbursement (according to the current rates used in the Lombardy social reimbursement based Health System) and compared with the old 20 fractions schedule. We also checked if our waiting list changed during the six months since the introduction of the new fractionation regimen, comparing with historic data from our scheduling activity. Results In one year we estimate to treat 217 patients using the 15 fractions schedule compared to 162 patients that can be irradiated with the 20 fractions regimen in the same time. The expected reimbursement for each patient is 3200 euro for the 20 fractions schedule and 2750 for the 15 fractions regimen. With almost the same number of daily treatments performed, in the first 6 months of the 15 fractions schedule, we registered an average waiting time to start radiotherapy ranging from 16,3 to 30,1 days (median 24 days) for breast cancer patients. Previously, these patients had to wait at least one month in most of the cases (range: 24,6 - 37,5 days, median 29 days). The introduction of the 15 fractions regimen also affected the waiting list for other clinical scenario such as palliative treatments: in 2016 we calculated an average waiting time of 20,2 days (more than twice than the 10 days suggested by ISTISAN). From February to July 2018 palliative patients had a waiting time less than 10 days for 3 out of 6 months. Conclusion A hypofractionated regimen allows to treat more patients in the same interval of time with a reduction of the cost for each treatment. The potential increase in number of trated patients can affect the waiting list in a positive

were significantly higher than in patients with SBM derived from other histologies such as lung cancer, malignant melanoma or urothelial cancer. The median survival time and 6-months-survival rates following RT were 5.4 months (95% CL 4.4 – 7.2 months) and 48%, respectively. To predict BS, the Karnofsky performance status (KPS) was the strongest predictive factor in our study; further statistically significant factors were the application of chemotherapy, number of SBM and primary tumor classification. Conclusion Prognostic assessment of elderly patients with SBM should be at least based on the primary tumor classification and the KPS. In the event of palliative RT, more hypofractionated radiation schedules are advisable for patients with a very poor prognosis to reduce hospitalization times and to maintain the residual quality of life. EP-1653 Evaluation of Italian Radiotherapy research: preliminary analysis A. Fiorentino 1 , R. Mazzola 2 , V. Lancellotta 3 , S. Saldi 3 , S. Chierchini 3 , A.R. Alitto 4 , P. Borghetti 5 , F. Gregucci 2 , M. Fiore 6 , I. Desideri 7 , L. Marino 8 , D. Greto 7 1 General regional Hospital "F. Miulli", Radiation Oncology Department, Acquaviva delle fonti BA, Italy ; 2 Ospedale Sacro Cuore Don Calabria, Radiation Oncology, Negrar, Italy ; 3 University of Perugia, Radiation Oncology, Perugia, Italy ; 4 Fondazione Policlinico Universitario A. Gemelli IRCCS, Radiation Oncology, Roma, Italy ; 5 University and Spedali Civili, Radiation Oncology, Brescia, Italy ; 6 Campus Bio-Medico University, Radiation Oncology, Rome, Italy ; 7 University of Florence, Radiation Oncology, Firenze, Italy ; 8 REM- Viagrande, radiation Oncology, Catania, Italy Purpose or Objective The difficulty in conducting meaningful clinical research is a multifactorial issue, involving political, financial and cultural problems, which can lead to unexpected negative long-term consequences, in terms of knowledge advancement and impact on patient care. Aims of the present review were to evaluate the publications of Italian Radiotherapy (RT) groups during a 20-year period and to verify if research is still appealing to young radiation oncologists (RO) in Italy. Material and Methods PubMed database was searched for English-language articles published by Italian groups by 2 independent RO, from January 1985 to December 2015 using as keywords “radiotherapy” combined with “Italy” [(radiotherapy) AND (Italy)]. Studies eligible for inclusion in this analysis were: case reports, radiobiological studies, clinical and dosimetric retrospective or prospective studies (Phase I-II- III) in which RT was used, systematic or not reviews and meta-analyses. Exclusion criteria were: study not conducted in Italy, study in which RT was not used or was not investigated, study in which no Italian RO was in the authors list. Analyzed variables were: publication/year, kind of study, geographic area and age of the first Author. Results The systematic review identified 3291 articles: 1207 papers fulfilled the inclusion criteria. The number of Italian published papers increased during the examined period. Retrospective analyses, prospective Phase I-II trials and literature reviews were 44%, 20% and 14.5% of all published manuscripts, respectively. Randomized trials showed a mild increase from 2000 to 2005, but their absolute number remained low respect to other type of Electronic Poster: Clinical track: Health services research / health economics