ESTRO 2020 Abstract book

S308 ESTRO 2020

comprised patients who had RT for BM at the EOL (defined as death within 30 days of commencing RT). The primary outcome was the proportion of patients who received single fraction RT (SFRT) and multi-fraction RT (MFRT). The Cochrane Armitage test for trend was used to evaluate changes in SFRT use over time. Multivariable logistic regression was used to assess factors associated with SFRT use. Results A total of 8,153 patients received 13,947 courses of palliative RT between 2013 and 2016, of which 1,359 courses of RT were delivered at the EOL. Of these, 396 courses of RT (29%) were SFRT and 963 (71%) were MFRT. There was no significant change in the use of SFRT over time from 30% in 2013 to 32% in 2016 (P=0.07). Patients who had SFRT were older (mean age 71.7 who had SFRT vs. 70.1 who had MFRT; P=0.02). There were no differences in SFRT use for different primary cancer type (P=0.9). SFRT were less commonly given to the skull (6%) compared to other body sites e.g. rib (51%) and extremities (52%) (P<0.001). There was higher use of SFRT in patients who had died shortly after commencing RT – 49%, 29% and 25% in patients who died within 7 days, 8-14 days, and 15-30 days of starting RT respectively (P<0.001). There were large institutional provider variations in SFRT use – 34% SFRT use in public compared to 19% in private institutions (P<0.001), and 35% SFRT use in regional compared to 27% in metropolitan centres (P=0.008). In multivariate analyses, the target RT sites, time between starting RT and death, and institutional type (public/ private) were independently associated with SFRT use. Conclusion This large Australian population-based study showed that less than one-third of palliative RT for BM at the EOL was SFRT. There is variation in SFRT use at the EOL depending on the target body sites, and institutional provider factors. Future work is needed to increase uptake of SFRT use especially in cancer patients with limited prognosis who may require palliative RT for symptom management for BM. PH-0524 “TEACHH” model. Our experience in handling. C. Escuin Troncho 1 , A. Miranda Burgos 1 , C. García Aguilera 1 , M. Cerrolaza Pascual 1 , V. Navarro Aznar 1 , A. Campos Bonel 1 , J. Lao 2 , R. Ibañez Carreras 1 1 Hospital universitario Miguel Servet, Radiation Oncology, zaragoza, Spain ; 2 Hospital universitario Miguel Servet, Oncology, zaragoza, Spain Purpose or Objective Radiation therapy is an effective treatment in symptomatic patients (metastatic bone pain, hemorrhages or cerebral edema). A notable percentage of patients who arrive at a radiotherapy oncology service and are planned do not receive treatment due to worsening general condition or death. It is important to estimate the life expectancy in order to adapt the appropriate decision making regarding the treatment with radiotherapy in these patients. OBJECTIVE: To make a scale of assessment of the prognosis that helps us decide on the importance of the indication of palliative radiotherapy and thus reduce the rate of planned patients who do not receive treatment. Material and Methods After reviewing the literature, we adopted the TEACHH model as a support tool for decision making in palliative radiotherapy. The TEACHH model divides patients into three groups according to life expectancy (1.7; 5 and 19.9

Conclusion Wide variation in the use of fractionation in PallRT was demonstrated alongside variation in 30DM. The benefit delivered to those who die very soon after treatment is likely to be very limited. Better understanding of the benefits gained by these very poor prognosis patients, and validated prognostic models, are needed to help inform decision-making. This may help to avoid fractionation in this frail population and, where appropriate, guide use of alternative strategies, such as holistic palliative care. The data quality and ascertainment in the RTDS are improving rapidly and there is now a pressing need for these data to be presented to treating clinicians to allow individuals to better understand how practise within their centre compares to peers. This will support ongoing professional development and improvement of services where appropriate. PH-0523 Palliative radiotherapy for bone metastases at the end of life: an Australian population-based study W.L. Ong 1 , F. Foroudi 1 , R. Milne 2 , J. Millar 3 1 Olivia Newton John Cancer Center, Department of Radiation Oncology, Heidelberg, Australia ; 2 Cancer Council Victoria, Cancer Epidemiology Division, Melbourne, Australia ; 3 Alfred Health, Radiation Oncology Services, Melbourne, Australia Purpose or Objective To evaluate the pattern of use of radiation therapy (RT) for bone metastases (BM) at the end of life (EOL) in Victoria, Australia Material and Methods This is a population-based cohort of cancer patients who received RT for BM between 2013 and 2016, as captured in the statewide Victorian Radiotherapy Minimum Data Set. Data linkage was performed with the Victorian Cancer Registry to capture mortality data. The final cohort