Abstract book - ESTRO meets Asia

S41 ESTRO meets Asia 2018

Medicine, Melbourne, Australia 5 Cancer Council Australia, Cancer Council, Sydney, Australia 6 University of Melbourne, Faculty of Health Sciences, Melbourne, Australia 7 Royal Adelaide Hospital, Radiation Oncology, Adelaide, Australia 8 Genesis Cancer Care, Radiation Oncology, Perth, Australia 9 Sir Charles Gairdner Hospital, Radiation Oncology, Perth, Australia 10 University of Western Australia, Telethon Kids Institute, Perth, Australia 11 Curtin University, School of Public Health, Perth, Australia 12 University of Western Australia, Centre for Health Services Research, Perth, Australia 13 Swinburne University, Department of Psychology, Melbourne, Australia Purpose or Objective Patients often present for radiotherapy with heightened anxiety and distress. The objectives of this study were (1) To determine whether a radiation therapist (RT) led education intervention (RT Prepare) for women with early breast cancer reduced psychological distress, decreased concerns about radiotherapy, increased patient knowledge, improved patient preparedness (2) To determine the intervention’s cost effectiveness; and (3) To explore how this intervention can be implemented into practice. Material and Methods A multiple baseline study was conducted. The RT Prepare intervention comprised two consultations with an RT: prior to planning and on the first day of treatment. RTs focused on providing sensory and procedural information and addressing patients’ pre-treatment anxiety. Measures were collected on four occasions: after consultation with radiation oncologist, prior to planning, treatment commencement and after treatment completion. Outcome measures included psychological distress, patient preparedness, concerns about radiotherapy and patient knowledge. Generalised Linear Mixed Models were used to compare groups. Intervention costs were determined. Results 218 usual care and 190 intervention patients participated. Compared to usual care, intervention participants reported lower psychological distress at treatment commencement (P= 0.01); lower concerns about radiotherapy prior to planning and at treatment commencement (P≤0.01): lower procedural concerns at planning and treatment commencement (P<0.001); lower sensory concerns at planning (P<0.001) and higher patient knowledge at relevant time-points (P<0.001). Intervention costs were $159 per patient, these were estimated to reduce if RT Prepare was provided on an ongoing basis. Costs were estimated for departments/centres of different sizes. Conclusion The RT Prepare intervention reduced breast cancer patients’ psychological distress. Additional research now needs to be conducted to further test this intervention and assist RTs in preparing all patients for radiotherapy. Translating this research into practice may be facilitated by offering radiation therapists with communication skills training focusing on preparing patients for radiotherapy and eliciting and responding to emotional cues. OC-110 Automated atlas-based QA of clinical trial contouring to reduce the greatest uncertainty in RT M.J. Faustino 1,2 , M.G. Jameson 1,2 , J.A. Dowling 3 , K. Cloak 2 , M. Sidhom 1 , J. Martin 4 , J. De Leon 5 , M. Berry 1 , D. Pryor 6 , L.C. Holloway 1,2

to comorbidities and/or advanced age. In the past, part of these patients were treated with conformal radiotherapy (3D-CRT) delivering doses of approximately 55–70 Gy in 4– 7 weeks, but local failures rates as high as 60–70% were observed, probably due to too low doses and/or geographical misses. Other inoperable patients were not treated at all. Stereotactic body radiation therapy (SBRT) was introduced almost two decades ago to treat these patients. SBRT delivers very high radiation doses with great precision in a short period of time (often 60Gy in only three to eight fractions), with local control rates over 90% and a favorable toxicity profile in tumors measuring up to 5cm. The growth of SBRT was possible due to advances in radiotherapy planning and imaging techniques. Breathing-related motion is accounted for through the use of 4-D CT-scans that correlate CT images with respiratory phases. Image guidance using CBCT immediately prior to treatment, confirms that the patient and tumor are positioned correctly. Over the years, the proportion of patients who could have been operated, but preferred to have SBRT has gradually increased. These patients, with fewer comorbidities have better survival rates than the medically operable patients, also after long term follow-up. Various attempts have been made to compare the outcome after SBRT against surgery. Non-randomized comparisons are hampered by the imbalance between groups, In general, survival curves show a benefit of SBRT in the first year (probably due to less treatment related mortality in the SBRT patients) and a benefit of surgery after 12 months (probably related to more comorbidity in the SBRT group). In studies were propensity score matching is used, similar local control and survival rates are seen for surgery and for SBRT. Three randomized trials were closed prematurely due to poor accrual. The pooled results of 58 patients in the ROSEL and STARS trials (Chang/Senan, Lancet Oncol 2015) randomized between SBRT and surgery showed 3 year overall survival rates 95% for SBRT and 79% for surgery patients (p<0.05). Recurrence-free survival at 3 years was 80-86% (not significant). The results of three new randomized trials are awaited. However, accrual to such studies is notably difficult, because patients and physicians may wish to avoid randomization when two treatment arms that are inherently different. In patients with operable STage I NSCLC and "standard operation risks", surgery is still considered the standard of care. However, SBRT should be discussed as an alternative treatment option in patients with higher operation risks. SP-108 Radiation carcinogenesis, prenatal, heritable M. Joiner 1 Wayne State University, Academic Physics, Detroit, USA OC-109 Can we reduce patient distress and implement patient education and support in a cost-effective way? G. Halkett 1 , M. O'Connor 2 , M. Jefford 3,4 , S. Aranda 5,6 , S. Merchant 7 , N. Spry 8,9 , R. Kane 2 , T. Shaw 10 , D. Youens 11 , R. Moorin 11,12 , P. Schofield 3,4,13 1 Curtin University, School of Nursing- Midwifery and Paramedicine, Perth, Australia 2 Curtin University, School of Psychology, Perth, Australia 3 Peter MacCallum Cancer Centre, Cancer Experiences Research, Melbourne, Australia 4 University of Melbourne, Sir Peter MacCallum Department of Oncology- Faculty of Abstract not received Proffered papers: Stimulating topics for discussion (RTT)