ESTRO 2020 Abstract book

S1127 ESTRO 2020

therapeutic radiographers. As a consequence, this should improve the quality of compassionate care received by patients and reduce the failings experienced previously in service delivery. PO-1927 Palliative haemostatic radiotherapy in gastro- oesophageal cancer- a single centre experience K. Crowther 1 , J. O'Hare 1 , C. Harrison 1 1 Northern Ireland Cancer Centre, Radiotherapy, Belfast, United Kingdom Purpose or Objective Haemorrhage from unresectable gastric and oesophageal malignancies reduces quality of life and shortens survival. It can be the first symptom of disease or develop later along with disease progression. There is little published literature focusing on haemostatic radiotherapy (RT). 1-6 In the largest available series (n=103), Tey et al found 80.6% patients achieved haemostasis following RT (as defined by not requiring further transfusion). 4 This retrospective study evaluated the efficacy and outcomes of RT in achieving haemostasis in a regional cancer institution. Material and Methods A retrospective analysis was performed of all patients with gastro-oesophageal cancer who received haemostatic RT from January 2017 to September 2019 (incl) using patients’ electronic records. Patient and tumour characteristics, treatment details, overall survival and clinical outcome were collated. Criteria required for inclusion was the diagnosis of bleeding either by endoscopic findings or from clinical symptoms of patients (melaena or haemetemesis) supported by evidence of a low or falling haemoglobin (Hb) level and the requirement for one blood transfusion administered to improve anemia before RT. Results During the study period, haemostatic RT was delivered on 26 occasions to 24 patients with gastro-oesophageal cancer (two patients were retreated). Sixteen patients had a diagnosis of gastric cancer with the remaining eight diagnosed with oesophageal cancer. There were five females and nineteen males with a mean age of 77 (range 60-93). Eastern Cooperative Oncology Group (ECOG) performance status ranged from 1 to 3. Four patients had undergone previous chemotherapy, with one having undergone neo-adjuvant chemotherapy followed by a subtotal gastrectomy. RT dose/fractionation ranged from 8 Gray (Gy)/1 fraction (f) to 30Gy/10f with 58% of patients receiving 20Gy/5f. There were no severe adverse events attributable to RT. Median Hb level before RT was 70g/l and this significantly increased to 102g/l (p<0.0001). Median overall survival was 57 days (range 18-440). There was a trend towards increased survival with increasing RT dose. The exception was one patient who received 12Gy/2f who survived over one year (Figure 1). 17% of patients required further transfusions within one month of completing RT. Death within one month RT also occurred in 17% of patients. Overall, cause of death was bleeding in two patients (8%) and cancer progression without bleeding in 16 patients (67%). Six patients who received RT recently remain alive. These results are comparable to a previous study examining haemostatic RT practices at this cancer institution. 7 Figure 1: Survival period for different treatment doses

factors which allowed us to build-up a relationship of trust with the young patients and their families allowing, in many cases, the treatment without any use of drugs and anesthetics. As a consequence it has also been proved that a better relationship led to minimized the use of drugs and anesthetics during the treatment. The training brochures, the colored thermoplastic masks and an improved relationship with the children allowed to achieve important results for therapy significantly improving the satisfaction for children and adults during the hadrontherapy cycle. PO-1926 Defining compassion in cancer care: a co- production approach A. Taylor 1 , D. Hodgson 1 1 Weston Park Cancer Centre, Radiation Services, Sheffield, United Kingdom Purpose or Objective The importance placed on compassionate care within UK healthcare legislation has amplified since the start of the decade following several high-profile incidents. Inadequate care and compassionate practice have been blamed for reducing quality of life and being the cause of patient deaths. Healthcare legislation can be criticised for its failure to provide meaning or clarity of practical compassionate care. Consequently, this has hindered the ability of NHS Trusts, service delivery managers and individual employees to interpret and implement policy recommendations regarding compassionate practice at a local level. The research aimed to develop a context specific definition of compassion and identify commonly recognised compassionate behaviours. Through a co- production approach we aimed to understand the perspectives of cancer patients and carers and therapeutic radiographers delivering care, to support the implementation of compassionate legislation. Material and Methods Co-production underpinned the methodological approach and design of the research. Eleven focus groups were conducted, five with therapeutic radiographers, three with cancer patients and carers and three with student therapeutic radiographers. On completion of thematic analysis from those groups, three co-production workshops were conducted, integrating the data to ensure the co- produced findings were equally representative of the perspectives of the three participant groups. Results Compassion can be defined as the intention to help, by identifying and understanding the individual with the aim of meeting their needs . Compassion is characterised by unique interaction that promotes connection between individuals and is reflective of a genuine desire to help. An understanding of compassionate display is illustrated through the construction of a conceptual framework. The framework is comprised of four components essential for compassion demonstration and perception of compassionate display; 1) attitude, 2) behaviours, 3) understanding individuality and the appreciation of needs and 4) practices. Collectively these four components enable the therapeutic radiographer to behave in a manner which facilitates a connection with the patient whilst denoting their intent to be compassionate. Consequently, expression of intent enables the patient to perceive the therapeutic radiographer’s practices as compassionate. Conclusion This co-produced definition, which is underpinned by a conceptual understanding of compassionate display, will facilitate the translation of policy into practice. By ensuring NHS Trusts, service delivery managers and individual employees comprehend and promote these key facets of compassion it will aid the development of compassionate practice within the current and future