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S742
ESTRO 36
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necessarily lead to poorer clinical outcomes. We will
consolidate our search with a forthcoming systematic
review. Consideration of stratified randomization and
treatment sequence evaluations in prospective trials may
clarify this controversial topic and perhaps broaden
patient access to immune checkpoint therapies.
EP-1385 Evaluation of the Spinal Instability Neoplastic
Score for spinal metastases
L. Bollen
1
, K. Groenen
2
, W. Pondaag
3
, C. Van Rijswijk
4
,
M. Fiocco
5
, Y. Van der Linden
6
, S. Dijkstra
7
1
AMC, Radiation Oncology, Amsterdam, The Netherlands
2
Radboud MC, Orthopedic Surgery, Nijmegen, The
Netherlands
3
LUMC, Neurosurgery, Leiden, The Netherlands
4
LUMC, Radiology, Leiden, The Netherlands
5
LUMC, Medical Statistics, Leiden, The Netherlands
6
LUMC, Radiotherapy, Leiden, The Netherlands
7
LUMC, Orthopedic Surgery, Leiden, The Netherlands
Purpose or Objective
To determine the predictive value of the Spinal Instability
Neoplastic Score (SINS) in a cohort of patients treated with
radiotherapy for spinal bone metastases.
Material and Methods
A total of 110 patients were included in this retrospective
study. Time to event was calculated as the difference
between start of radiotherapy and date of occurrence of
an adverse event or last follow-up, with death being
considered a competing event. A competing risk analysis
was performed to estimate the effect of the SINS on the
cumulative incidence of the occurrence of an adverse
event.
Results
Sixteen patients
(15%) experienced an adverse event during follow-up. The
cumulative incidence for the occurrence of an adverse
event at 6 and 12 months was 11.8% (95%CI 5.1%-24.0%)
and 14.5% (95%CI 6.9%-22.2%), respectively. Competing
risk analysis showed that the final SINS classification was
not significantly associated with the cumulative incidence
of an adverse event within the studied population.
Conclusion
The clinical applicability of the SINS as a tool to assess
spinal instability seems limited.
EP-1386 Mobile health technologies for severely-ill and
palliative care patients
G. Theile
1
, V. Klass
2
, G. Tröster
2
, M. Guckenberger
1
1
University Hospital Zürich, Department of Radiation-
Oncology, Zurich, Switzerland
2
ETH Zurich, Wearable Computing Laboratory, Zurich,
Switzerland
Purpose or Objective
Purpose:
One of the critical phases in severely-ill
patients’ trajectories is demission from hospital care. Due
to a lack of pro-active and low-threshold interventions in
the home-care setting, a relevant number of avoidable
emergency visits is observed. The idea of this
collaboration project of the Clinic of Radiation-Oncology
(CRO) USZ and ETH Zurich is an early detection of changes
in crucial symptoms by using wireless activity tracking
technology. This allows for non-invasive, objective
measures; additionally, subjective parameters recorded
by questionnaire apps will be captured. Aims of the study
are to evaluate and optimize patients’ acceptance
regarding the supply with a tracking bracelet and a
smartphone in order to monitor objective and subjective
health data and to evaluate correlations between patient-
specific activity patterns and the subjective patients’
ratings of pain, distress and quality of life (QoL).
Material and Methods
Methods
: Explorative, descriptive design. Recruitment of
30 participants on the different wards of the CRO
(radiation-oncology,
palliative).
Application
of
semiquantitative questionnaires and guideline interviews
to evaluate patients’ usage and acceptance of technical
devices. Extraction of sensor data (body motion, social
features, heart rate, speech) using signal processing
methods from smartphone und wristband. Capturing of
subjective health data via electronical version of VAS-pain
(daily), of NCCN Distress Thermometer (daily) and EORTC
– QLQ C30 (paper version, weekly). First pre-studies on (a)
semi-qualitative evaluation of device, app and study
acceptance and (b) optimization of patient inclusion
criteria and estimation of recruitment as well as (c) a pilot
of wireless tracking in three patients have been conducted
at time of abstract submission.
Results
Results
: According to the pre-studies severely-ill and
palliative patients are willing and able to use smartphones
and wristbands and have a positive attitude towards the
proposed monitoring systems. Sixty percent of eligible
patients declared potential interest to participate.
Preliminary data analysis from the pilot support our
hypothesis that it is possible to receive exploitable data
from mobile devices carried by discharged patients. In May
2017, then having started the main study, we will present
more of quantitative evaluation data as well as first data
extracted from the activity trackers (smartphone and
bracelet).
Conclusion
Conclusion:
Our project will deliver relevant data on
patients’ acceptance of wireless tracking, as well as
correlation between subjective symptom assessment and
objective activity data. The study is meant to be
preparatory work for an intervention study to test the
effect of wireless monitoring on early symptom relief,
quality of life and prevention of avoidable hospitalization
in the group of the severely-ill and palliative care
patients.
EP-1387 Time Trends In Opioid Use In Cancer Patients
with Pain: Observations from Administrative Data
L. Barbera
1
, C. DeAngelis
2
, C. Earle
3
, C. Atzema
4
, D.
Dudgeon
5
, D. Howell
6
, A. Husain
7
, M.A. O'Brien
8
, H.
Seow
9
, J. Sussman
10
, R. Sutradhar
11
, A. Chu
11
, Y. Liu
11
1
Odette Cancer Centre - Sunnybrook Health Sciences
Centre, Radiation Oncology, North York- Toronto,
Canada
2
Odette Cancer Centre - Sunnybrook Health Sciences
Centre, Pharmacy, North York- Toronto, Canada
3
Sunnybrook Health Sciences Centre, Medicine, North
York- Toronto, Canada
4
Sunnybrook Health Sciences Centre, Medicine, Toronto,
Canada
5
Queen's University, Medicine and Oncology, Kingston,
Canada
6
University Health Network, Oncology Nursing, Toronto,
Canada
7
Mount Sinai Hospital, Temmy Latner Centre for
Palliative Care, North York- Toronto, Canada
8
University of Toronto, Family and Community Medicine,
Toronto, Canada
9
McMaster University, Oncology, Hamilton, Canada
10
Juravinski Cancer Centre, Radiation Oncology,
Hamilton, Canada
11
Institute of Clinical Evaluative Sciences, Cancer
Research, Toronto, Canada
Purpose or Objective
Objective: Previous work in Ontario demonstrated that
33% of cancer patients with severe pain (7-10/10) did not
receive opioids at the time of their pain assessment. The