ESTRO 38 Abstract book

S892 ESTRO 38

Results The hospital executive decided to transform the oncology hospital to an emergency hospital with the possibility to treat 24/7. In this way, we could treat up to 100 patient a day or more. we also treat on weekends especially palliative patients. Concerning the patient workflow, patients were seen immediately when they arrive at the department, and if medical file is complete and ready to radiation, CT scan simulation was done within a week, countouring, dosimetry, and validation with safety checks were done within 3 days. and finally, when possible, we chose hypo-fractionated regimens (Breast, rectum, single fraction for palliative, etc …). The appointment time started to drop from more than 3 months to almost 2 weeks. Conclusion In developing countries, access to radiotherapy is a real problem. The number of linear accelerators per capita is very low. Therefore delays are very long. This kind of approach, if sufficient human resources, could solve the problem while waiting for a second and maybe other machines. EP-1658 Stereotactic Ablative Body Radiotherapy:UK implementation and current practices.Progress since 2012 G. Distefano 1 , S. Garikipati 2 , H. Grimes 3 , M. Hatton 2 1 University of Surrey, Centre for Vision- Speech and Signal Processing, Guildford, United Kingdom ; 2 Weston Park Hospital, Oncology, Sheffield, United Kingdom ; 3 University College London Hospitals, Radiotherapy Physics, London, United Kingdom Purpose or Objective In 2012 a UK SABR Consortium survey reviewed the implementation of SABR treatment programmes in the UK, obtaining details of practice and varying techniques used in centres with an active treatment programme, evaluating the workload and assessing projected future provision 1 . A second survey was designed and implemented to update those results aiming to continue to drive forwards techniques, aid standardisation and assist in highlighting issues to be addressed within the NHS to improve access to SABR services and trials in the UK. Material and Methods An online questionnaire was sent by the UK SABR Consortium to over 65 UK radiotherapy institutions. The questionnaire covered current service provision and collected data on patient numbers, clinical sites, immobilisation, motion management, CT scanning protocols, target and OAR delineation, treatment planning, image-guidance, treatment protocols, QA methods and expected service development over the next couple of years. Results 48 centres responded to the questionnaire. The number of centres with an active SABR program has doubled since 2012 (36 vs 15) with a further 12 centres indicating the intention of starting SABR in the next couple of years. 28 treating centres deliver SABR to non-lung sites, with 17 centres able to offer the range of sites required for treating oligometastatic disease. The number of patients treated has significantly increased since 2012 with 25 centres now treating above the minimum UK recommended level (25 patients per year).

Results In the base case analysis total cost for the NSAIDs and the radiotherapy, strategies were 258.81€ and 702.01€ respectively. Utilities for the NSAIDs and radiotherapy strategies were 12.42332 QALY and 12.43608 QALY respectively. The ICER of radiotherapy compared to NSAIDs was 65,545€/QALY. The deterministic sensitivity analysis reveals that the incremental cost-effectiveness ratio (ICER) is mainly sensitive to the probability of surgery in case of HO, to the relative risk of HO between NSAIDs and radiotherapy, to the probability of HO following radiotherapy, to the probability of upper digestive bleeding for NSAIDs and to the cost of surgery in case of HO. In the probabilistic sensitivity analysis, the total cost for the NSAIDs and the radiotherapy strategies were 356.87€ and 777.36€ respectively. The utilities related to the NSAIDs and radiotherapy strategies were 14.58905 QALY and 14.59614 QALY respectively. The ICER of radiotherapy compared to NSAIDs was 59,286.17€/QALY. Most of the simulations were in the north-east quarter. For a willingness to pay threshold of 30,000€/QALY, and 100,000€/QALY, the probability of cost-effectiveness of NSAIDs was 87.3%, and 30.8% respectively.

Conclusion We report the results of the first medico-economics evaluation of NSAIDs and radiotherapy in HO prophylaxis. Our analysis suggests that from a French payer perspective, radiotherapy is cost-effective for HO prophylaxis following total hip replacement. EP-1657 Overcoming appointment delay in radiotherapy: a single institution experience M. Ait Erraisse 1 , O. Masbah 1 , T. Bouhafa 1 , K. Hassouni 1 1 CHU Hassan II, Radiothérapie, Fez, Morocco Purpose or Objective Delay to access to radiation therapy in developing countries is challenging and compromising the cancer prognosis. In our department there was one linear accelerator for a whole region in the country. 50 to 60 patient a day were treated and appointments were for more than 3 months. The medical and psychological impact on patients was important. Our objective was to shorten this delay. Material and Methods The radiotherapy department goal was to treat 50 to 60 patients from Monday to Friday as the majority of radiation therapy departments. Treatments started at 8 AM to finish at about 7 to 8 PM. The idea was to treat more patients and efficiently. Therefore, actions were taken on three axes : 1st Before radiotherapy, we had to shorten the time from first consultation to first radiotherapy fraction. 2nd during radiation, we extended treatment period to above 8 PM.and 3rd axe concerns fractionation regimens.