ESTRO 37 Abstract book

ESTRO 37

S567

2 actrec-Tata Memorial Centre, Surgical Oncology, Navi Mumbai, India 3 tata Memorial Hospital, Radiation Oncology, Mumbai, India 4 tata Memorial Hospital, Surgical Oncology, Mumbai, India 5 actrec-Tata Memorial Centre, Statistics, Navi Mumbai, India Purpose or Objective Comparison of subjective and objective assessment methods of cosmetic outcome following multicathetar interstitial brachytherapy implant (MIB) for early breast cancer. Material and Methods 60 patients of early breast cancer who were treated with high dose rate MIB for partial breast irradiation were followed up regularly every 6 months. In this prospective study, all consecutive patients who were 18 to 36 months post brachytherapy were screened and accrued after obtaining informed consent. One time cross-sectional assessment of the breast cosmesis was done by both physician rated subjective method using Harvard scale as well as by objective photographic method using BCCT.Core (version 3.1) software. The correlation between subjective and objective methods for the overall score as well as individual domains was done using Spearman correlation coefficient. Table 1: Summary of correlation statistics comparing subjective with objective domains. Spearman correlation p value

Conclusion Planner’s experience in SBRT prostate is correlated with dosimetric parameters and the modulation index MItotal. Complexity scores and dose distributions depend on specific dosimetric planning requests and replanning improves results in terms of homogeneity between centers whilst keeping the same level of plan complexity (MItotal): DVH sharing could aid in achieving better standardization. These results highlight the importance of training as well as the usefulness of a feedback strategy from multi-institutional comparisons. PO-1013 Using A Decision Board To Evaluate Patient’s Choice Of Either Ebrt Or Multicatheter APBI J. Tang 1 , V. Koh 1 , Y. Leong 1 , S. Buhari 2 1 National Cancer Institute Singapore, Radiation Oncology, Singapore, Singapore 2 National Cancer Institute Singapore, Surgery, Singapore, Singapore Purpose or Objective External Beam Radiotherapy(EBRT) over 42 days or Accelerated Partial Breast Irradiation(APBI) using the multicatheter approach over 5 days are suitable treatment options for early staged breast cancer women post breast conservation surgery. Our aim was to develop a visual aid to help patients select their treatment option and their reasons behind it. Material and Methods A decision board was designed listing the advantages and disadvantages of either modality as a visual aid. Each patient consult was standardized using the decision board as a tool for discussion. Patients were then asked which treatment was their preferred option and the reason/s for choosing that option. Results Of the 221 patients enrolled between August 2008 to August 2017, median age was 58, 70% were left sided tumors, 80% of patients spoke English, 86% were economically active at the time of diagnosis and none had ECOG ³3. Of the 188 patients choosing APBI, 100% of patients chose APBI for shorter fractionation and 92% chose APBI for better side effect profile especially for lower skin toxicity, cardiac toxicity and pulmonary toxicity. Of the 33 patients choosing EBRT, 100% chose EBRT for reasons of needle phobia and 85% for the cheaper cost. All reasons for fractionation choice were consistent with decision-board information, confirming validity. All patients were satisfied and happy to be involved in decision-making. Conclusion We have validated a decision board assisting patient choice of radiotherapy fractionation schedules either with APBI or EBRT for women with early staged breast cancer. All patients indicated that they were satisfied and happy to participate in the decision making process. PO-1014 Comparison of subjective and objective assessment of cosmetic outcome following breast brachytherapy T. Wadasadawala 1 , V. Parmar 2 , S. Sinha 3 , M. Mondal 3 , U. Jain 4 , S. Kannan 5 , R. Pathak 3 , R. Sarin 3 1 actrec-Tata Memorial Centre, Radiation Oncology, Navi Mumbai, India Poster: Brachytherapy: Breast

Overall cosmesis score Excellent-good vs. Fair- poor

0.434

0.001

Nipple

location

(NL) BRA UNR

0.285 0.349 0.449

0.027 0.006 0.000

NL NL

vs. vs.

NL vs. BCE

Breast size (BS) BS vs. BAD BS vs. BOD

-0.246 0.034

0.058 0.797

Breast

Shape

(BSh)

-0.119

0.366

BSh vs. BCD

BRA: Breast retraction score, UNR: Upward nipple retraction, BCE: Breast compliance evaluation, BAD: Breast area difference, BOD: Breast overlap difference, BCD: Breast contour difference. Results Overall, there was 76.6% agreement in the physician rated and objective methods of assessment of cosmesis. However, there was only moderate correlation between the two methods of assessments for the overall score. Among the individual domains, only nipple location correlated moderately with the software defined indices. The results of correlation statistics are summarized in Table 1. There was poor correlation between the two methods for skin colour difference and scar visibility features (results not shown), with spearman correlation coefficient ranging from -0.008 to 0.218 (p value NS) for skin colour and -0.011 to 0.160 (p value NS) for scar visibility.