ESTRO 36 Abstract Book

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S757 ESTRO 36
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circumstances. Psychosocial counselling however had the
largest evidentiary base for most of the outcomes.
Conclusion
Conclusion: To our knowledge this is the first evidence
based guideline to comprehensively evaluate
interventions to improve sexual problems in people with
cancer. The guideline will be a valuable resource to
support practitioners and clinics in addressing this
important aspect of being human.
EP-1416 A new model of care to improve clinical trial
participation in radiation oncology
M. Grand 1,2,3, M. Berry1,3,4, D. Forstner1,3,4, S. Gillman1,3,
P. Phan1,3, K. Wong1,4,5, S. Vinod 1,4,6
1 Liverpool Hospital, Cancer Therapy Centre, Liverpool,
Australia
2 Ingham Institute for Applied Medical Research, Clinical
Trials, Liverpool- NSW, Australia
3 Campbelltown Hospital, Cancer Therapy Centre,
Campbelltown- NSW, Australia
4 University of NSW, South Western Sydney Clinical
School, NSW, Australia
5 Ingham Institute for Applied Medical Research, CCORE,
Liverpool- NSW, Australia
6 Western Sydney University, Clinical School, NSW,
Australia
Purpose or Objective
Clinical trial participation is becoming increasingly
recognised as an indicator of quality of care in
oncology. Previously, Radiation Oncology (RO) clinical
trials at Liverpool and Macarthur Cancer Therapy Centres,
Sydney, Australia were managed by a general oncology
clinical trials unit. The focus was largely on
pharmaceutical and large collaborative group trials, and
less on investigator initiated studies. This model was
heavily reliant on individual clinicians remembering to
screen and recruit patients. Recognising our low rates of
participation in clinical trials, we decided to develop and
implement a new model of care to support clinical trials
in RO.
Material and Methods
A new team dedicated to RO clinical trials with specific
skill sets in nursing, radiation therapy and clinical
research, was formed in December 2014. Strategies
were devised to improve performance which included
development of standard operating procedures, Good
Clinical Practice (GCP) training, and active education and
communication. Work processes were changed to be less
reliant on clinicians, with more co-ordination by the RO
clinical trials team. Active screening was conducted
through attendance at multidisciplinary team meetings,
screening clinic lists and development of a MOSAIQ
screening tool for clinicians. The model involved regular
auditing and feedback to clinicians to identify poor
recruiters or poorly recruiting trials, and provide clinical
trials support to improve this.
Results
Across both Liverpool and Macarthur Cancer Therapy
Centres, screening activity increased from 51 patients
screened in 2014, to 339 in 2015, and to 487 up to August
2016. Participation in clinical trials, as a percentage of
new patients seen in RO clinics, increased from 2.6% in
2014, to 12.4% as of August 2016 (Fig 1). The number of
RO clinical trials that were open in 2014 was 20, and in
2016, it was 33. Among these studies, the number of
investigator initiated studies that were open in 2014 was
8, compared to 15 in 2016. In 2016, the MOSAIQ screening
assessment has been completed for 36.6% of new patients
across both sites. Completion of GCP certification by all
radiation oncology staff involved with clinical trials has
reached 100%. The quality of data submission has
improved through accurate collection of data at the
required time points.
Conclusion
This new model of care, tailored to the specific needs of
RO, has resulted in increased clinical trial screening and
participation. The RO clinical trials department has
become the chosen model of care across the local health
district.
Figure 1: Percentage of patients on clinical trials
EP-1417 Clinical evaluation of a fully automatic body
delineation algorithm for radiotherapy
T. Fechter1,2, J. Dolz3, U. Nestle2,4, D. Baltas1,2
1Medical Center - University of Freiburg, Medical Physics
- Department of Radiation Oncology, Freiburg, Germany
2German Cancer Consortium DKTK, Partner Site Freiburg-
Germany, Freiburg, Germany
3École de technologie supérieure, Laboratory for
Imagery- Vision and Artificial Intelligence, Montréal,
Canada
4Medical Center - University of Freiburg, Department of
Radiation Oncology, Freiburg, Germany
Purpose or Objective
The aim of radiotherapy is to deliver the highest possible
dose to the tumour and spare surrounding healthy tissue.
For high efficacy an accurate delineation of the body
outline on planning CT is crucial. On the one hand for dose
calculation, on the other hand to reduce the delivered
dose to the skin. However, depending on the tumour and
treatment type, positioning markers, catheters, breathing
belt, fixation mattress, table and/or blankets are directly
adjacent to the patient’ skin. Algorithms currently
employed in clinical settings cannot often distinguish
those devices from the patient’s body. Consequently,
these devices are included in the body segmentation
which requires tedious manual corrections. In this work, a
fully automatic algorithm for body delineation that can
handle structures adjacent to the patient is clinically
evaluated for various cancer cases.
Material and Methods
The presented approach is based on a series of threshold
and morphology operations, and it was implement ed using
MITK platform. For evaluation purposes , segm entation
was performed on the planning CT of overall 30 patients:
10 lung cancer patients, 10 patients with a prostatic lesion
and 10 rectum carcinoma patients. CT scans were
acquired on different scanners and with different image
resolutions. Body delineations used for real treatment
planning served as reference contours. Similarity between
reference and generated contours was assessed by
computing the volume ratio (VR), Dice's coefficient (DC)
and Hausdorff distance (HD) to evaluate differences with
respect to volume, overlap and shape, respectively.
Results
The mean VR obtained was 0.99 with a standard deviation
(SD) of 0.006. The average amount of false ly classified