ESTRO 38 Abstract book

S893 ESTRO 38

2017. This excludes research payments and ownership interest. Results Radiation oncologists received 91,804 payments totaling $25.6 million (USD) over the four-year period, representing 0.31% of payments to oncology specialties (46.4 million payments totaling $8.3 billion USD). For radiation oncologists, the number of payments grew 6.9% over the period and the total number of payments grew 9.1%, while these numbers decreased by about 1% for all oncology specialties. Conclusion Industry-physician financial relationships are substantial and have grown over time. Further research is needed to determine the effect of these relationships on physician decision making. EP-1660 Patterns of acute brain metastases related admissions: Opportunity amongst recurring themes R. Bentley 1 , M. O'Cathail 1 , L. Aznar-Garcia 1 , V. Crosby 2 , A. Wilcock 2 , J. Christian 1 1 Nottingham University Hospitals NHS trust, Oncology and Radiotherapy, Nottingham, United Kingdom ; 2 Nottingham University Hospitals NHS trust, Palliative Care, Nottingham, United Kingdom Purpose or Objective Brain metastases (BM) affect up to 40% of patients with metastatic disease. They are associated with a wide range of symptoms and significant morbidity. Though the symptoms are known the health care provider burden is not. We aim to describe the patterns of BM related admissions in a large oncology centre. Material and Methods Over a two year period (1 st Jan 2016 – 31 st Dec 2017), adult patients with a new radiologically confirmed diagnosis of BM were identified by retrieving all MRI and CT head scans that contained the words ‘metastases’, ‘metastasis’ or ‘met’ in the on-line scan report. Only patients with a confirmed primary cancer were included. Information recorded included patient demographics, primary cancer site, treatment received and survival. Number, duration of and reasons for hospital admissions were recorded if they were attributable to BM. Results 236 cases of newly diagnosed BM identified. The median age at diagnosis was 65 years (range 30-87). The median survival across all groups was 115 days (range 1-829). There were more females (58%) than males (42%). Lung cancer represented the most common primary site (49%), followed by breast (20%) and melanoma (13%). Median survival varied by primary site with lung carrying the worst prognosis (95 days) and breast (202 days) the best. Sixty-nine percent of patients had a BM related admission. There were 305 admissions accounting for 2318 bed days. The first diagnosis of BM occurred as a direct result of an admission in 63 patients (27%). The median length of stay was 7 days. The most common reasons for admission were seizures (18%) headaches, (17%) confusion (16%) and weakness (14%). Patients with lung primaries had the longest median stay (12 days) and the largest number of admissions (50% of all admissions) Bed days varied depending on the treatment received. Patients who received Stereotactic Radiosurgery (SRS) had the fewest bed days as a proportion of total follow up days. They had 63 admissions and 491 bed days, which represented 3% of the total follow up days.

The survey indicates that treatment techniques remain reasonably standard across the UK with all centres using 4D-CT and 85% delineating their ITV to contain respiratory- induced tumour motion. The most popular immobilisation devices in the UK remain the wing board, vacuum bag and knee support in use by 70% of centres. 90% use inverse planning solutions together with VMAT delivery and > 80% of treating centres are still performing patient specific QA for all patients.

Documented changes in practice since 2012 include the development of Linac delivered SABR to non-lung sites and notable increase in number of centres using abdominal compression as part of the immobilisation process (14 vs 2 centres). An increase in time spent at some stages of the SABR process (table 1) was also seen which is likely to be a reflection on the increased complexity of cases treated. Conclusion The 2018 survey shows a welcome increase in SABR provision across the UK with an ongoing commitment to Quality Assurance within centres. However, with emerging data it is clear that the UK SABR program need to continue its expansion to ensure that patients with oligometatstic disease have access and SABR for early stage lung is deliverable in all centres. Reference 1 Distefano G, Baker A, Scott AJ, Webster GJ; UK SABR Consortium Quality Assurance Group. Survey of stereotactic ablative body radiotherapy in the UK by the QA group on behalf of the UK SABR Consortium. Br J Radiol. 2014; 87:1037 EP-1659 Trends in industry payments to radiation oncologists from 2014-2017 D. Marshall 1 1 Mount Sinai Hospital, Radiation Oncology, New York, USA Purpose or Objective Physician-industry relationships are common and introduce conflicts of interest. This study investigates recent trends in industry payments to radiation oncologists in a population-based national sample. Material and Methods Open Payments records of general payments to radiation oncologists in the United States were included. We describe the number of payments, total amount of payments and annual percent change over 2014 to