ESTRO 36 Abstract Book

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app are available at aftercare check-ups, while 22.2% (24/108) are not convinced of a benefit of app-based patient documentation. Favorable of an alert function due to data input by patients with the need for further clarification are 64.8% (versus 35.2%), 94.3% are willing to contact the patient after notification. Of all, 93.5% support the idea to use collected data for scientific research and 75.0% believe it could be beneficial for the providing hospital. Conclusion The present work shows a great approval for telemedicine, mHealth and apps in oncology amongst HCPs. Assessing side effects can lead to quicker response and thus lower inconvenience of patients. Clinical data as life quality and treatment satisfaction could be used to evaluate and improve the therapy workflow. Regular input of patient- reported outcome or side effects can be used to early detect and document the disease progression. Overall, this patient data can be used for scientific evaluations. Eventually, a mobile app would enhance the patient relation to his treating department as he has permanent contact using the mobile app - a trend also evolving in the medical field. PO-1020 Re-irradiation of Head and Neck Sarcomas: initial results of Protontherapy Center of Trento, Italy I. Giacomelli 1 , D. Scartoni 1 , M. Cianchetti 1 , F. Dionisi 1 , B. Rombi 1 , M. Amichetti 1 1 Azienda Provinciale per i Servizi Sanitari APSS Trento, U.O. di Protonterapia, Trento, Italy Purpose or Objective Radiotherapy for head and neck (H&N) recurrent sarcomas is usually limited by the dose tolerance of critical structures mainly in the skull base. Re-irradiation of such cases is rarely performed in clinical practice. Numerous dosimetric studies have shown that proton therapy (PT) can spare more healthy tissue than conventional X-ray therapy and it can result in fewer side effects. We report the preliminary results in terms of feasibility and tolerance of re-irradiation with PT for recurrent previously irradiated H&N sarcomas . Material and Methods Between November 2015 and September 2016 four patients (pts) with five recurrent H&N Sarcomas were re- irradiated with PT. Histology of the primary lesions were: pleomorphic sarcoma (1), alveolar rhabdomyosarcoma (2), sclerosing rhabdomyosarcoma (1), radiation-induced spindle cell sarcoma (1). Median age at re-irradiation was 30.0 years (range, 29.0-50.0 years). Karnofsky performance status was 90-100. Median interval time between previous radiotherapy and PT was 55.4 months; the median total dose received at the first radiotherapy course was 54.7 Gy (range, 50.4 – 60.0 Gy). Target definition was based on CT and MR imaging. Median CTV volume was 45.36 cc (range, 10.48-132.2 cc) and median PTV volume was 126.4 cc (range, 35.87-277.8 cc). Patients received a median total dose of 60.0 GyRBE (range, 50.0- 60.0 GyRBE), 1.8–2.0 GyRBE per fraction; two pts received also sequential and one concomitant chemotherapy. All pts were treated with active beam scanning PT using 2-3 fields with single field optimization (SFO) technique. Acute and late toxicities were registered according to Common Terminology Criteria for Adverse Events version 4.0. Patients’ quality of life was assessed using the EORTCEORTC QLQ-C30 questionnaire. Results Treatment was well tolerated: all patients completed PT without breaks. Acute Grade 3 cutaneous erythema occurred in four pts . Registered G2 toxicities were fatigue (1) and soft tissue edema (1). Concerning late toxicities, one patient had persistent G1 pain at the site of previous irradiation and in one pt acute G3 skin erythema became G1 chronic dyschromia. At a median follow-up of 7.4

months (range, 1.4-12.7 months), all pts are alive with controlled local and distant disease Conclusion Our preliminary experience shows that PT re-irradiation of recurrent H&N sarcoma is feasible and safe. Longer follow- up and a larger number of patients are needed to definitively assess efficacy and late toxicity.

Poster: RTT track: Risk management / quality management

PO-1021 An electronically configurable checklist program for quality control of RT treatment planning K.H. Grosser 1 , A.C. Schulte 1 , W. Harms 1 1 St. Claraspital, Radiooncology, Basel, Switzerland Purpose or Objective To asses efficacy of an adaptive checklist program to facilitate plan review for physicists. Material and Methods Pre-treatment plan review is fundamentally important to patient safety and treatment plan quality. A critical control point in this process is the ‘Planning Approval‘ process. To reduce the error rate we developed an adaptive electronical planning approval checklist as part of our quality assurance. We applied this program to more than 600 treatment plans produced with the Eclipse treatment planning system (VARIAN). Because we wanted to optimize the checklist continuously the program was set up to be adaptive with respect to the plan type and to allow the addition of new checklist items. All evaluated cases were documented in a database. The incidence rates of errors and their types are reported. Results The checklist program was introduced into clinical routine in October 2012 and was used in this version until the end of 2015. In total 638 plans were checked. With the help of this checklist program 303 errors in 190 treatment planes were detected. Most errors were classified as minor errors (i.e. incorrect target volume nomenclature). However, 29 dose-related errors have also been found. 13 new checklist items have been gradually added to the existing checklist to account for newly detected error possibilities. The average time to complete the checklist was approximately 3 minutes. The compliance rate was very high. As expected, the acceptance of the “Do-Confirm” strategy was higher than for the “Read-Do” practice. Conclusion A planning approval checklist is a valuable tool to reduce the error rate of treatment plan validation to almost zero. An automated or semi-automated checklist tool with direct access to the database of the treatment planning system would be desirable. PO-1022 Implementation of a paperless workflow in radiotherapy; Reducing transcription O. Shoffren 1 , Y. Tsang 1 , J. Kudhail 1 Purpose or Objective It is well recognised that due to the complexities of the radiotherapy pathway transcription errors are common. As such robust processes are in place throughout the treatment pathway to ensure checking processes are fit for purpose. With the importance on using source data to eliminate this potential for transcription errors to arise, our centre has adopted a paperless workflow allowing access to source data ; from referral to the last fraction of radiotherapy. 1 Mount Vernon Cancer Centre, Radiotherapy Department, borehamwood, United Kingdom