ESTRO 2020 Abstract book

S362 ESTRO 2020

pharyngeal pain and dermatitis assessment were evaluated as ‘good’ agreement (p<0.05) between the HN APRT and ROs while dysphagia and nasogastric tube insertion scored an ‘almost perfect’ agreement (p<0.05). A ‘moderate’ agreement (p<0.05) between the HN APRT and ROs was observed for oral pain and mucositis assessment. A scoring discrepancy of 1 and 2 grades was observed in 19.7% and 0.2% respectively. Conclusion There was high concordance in scoring of acute toxicity between the HN APRT and ROs. This supports the continuous involvement of HN APRT in weekly assessments for NPC patients. OC-0590 Multicentre dual-trial implementation of plan of the day (PoD) adaptive radiotherapy: lessons learnt A. Webster 1 , H. McNair 2,3 , V.N. Hansen 4 , S. Hafeez 2,5 , R. Lewis 6 , C. Griffin 6 , E. Hall 6 , R. Huddart 2,7 1 National Radiotherapy Trials Quality Assurance Group, Mount Vernon Cancer Centre, London, United Kingdom ; 2 The Royal Marsden NHS Foundation Trust, Department of Radiotherapy, London, United Kingdom ; 3 Institute of Cancer Research, Translational Therapeutic Radiography Team, London, United Kingdom ; 4 Odense University Hospital, Department of Radiotherapy Physics, Odense, Denmark ; 5 Institute of Cancer Research, Department of Radiotherapy and Imaging, London, United Kingdom ; 6 Institute of Cancer Research, Clinical Trials and Statistics Unit, London, United Kingdom ; 7 Institute of Cancer Research, Clinical Academic Radiotherapy Team, London, United Kingdom Purpose or Objective This work aimed to assess common operative issues which arose in two multicentre PoD trials: HYBRID (CRUK/12/055) and RAIDER (CRUK/14/016). The purpose was to assemble the lessons learnt from managing these operative issues. Material and Methods Centres were issued radiotherapy planning and delivery guidelines before implementing PoD. Pre-trial and on-trial DICOM data, QA reviews and centre variables were collated from both trials, Figure 1.

Common PoD issues were assessed by the following: 1. Issues were classified into outlining, planning, PoD selection and process groups. 2. An inductive approach was used to develop the common operative issues that arose during PoD implementation. 3. The practical considerations and actions recommended to centres were recorded, to generate the lessons learnt. 4. A secondary analysis was undertaken to test for associations between issues and centre variables. Descriptive statistics were used to characterise the data. Chi-square, Mann-Whitney U and Kruskal Wallis were used to test for associations. Results Pre-trial and on-trial data from 35 centres were reviewed, including 226 outline submissions, 528 plans from 176 submissions, 8,286 PoD selections from 1,339 submissions and 43 process documents.160 operative issues were reported in outlining, 95 in planning, 989 in PoD selections and 51 in the PoD process. Issues were categorised; Table 1.

The most common operative issues were: • OARs were incorrectly outlined •

Larger volumes and plans did not include excursions of smaller volumes and plans Smaller plans were less optimised than larger plans

•

• • •

Incorrect nomenclature

Non-compliant PoD selections

Centres were unable to schedule treatment and imaging for PoD

• There was no difference between issues within groups versus centre variables in all tests except PoD selection. In the PoD selection analysis, the PoD selection compliance decreased from pre-trial to on-trial ( P <.001), Table 1. Therefore additional training including an interactive workshop was introduced. Conclusion