ESTRO 36 Abstract Book

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S998 ESTRO 36 2017
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H. Hansen 1, M. Skovhus Thomsen 2
1 Aarhus University Hospital, Clinic for Radiotherapy and
Radiation Oncology, Aarhus C, Denmark
2 Aarhus University Hospital, Department of Medical
Physics, Aarhus C, Denmark
Purpose or Objective
In our department all appointments are booked when the
referral is received, i.e. a 100% pre-booking is performed.
In 2014-15 every 7th treatment course for patients
referred and booked to palliative treatment in our
department was cancelled before the planned start of
radiotherapy. This study investigated the reasons for
cancellations of palliative treatment courses prior to start
of radiotherapy as well as possible common denominators
among the cancelled patients .
Material and Methods
A retrospective exploratory study of reasons for cancelling
planned palliative radiotherapy treatment was
established. Patients were included if they had been
booked for palliative radiotherapy treatment between
1January 2015 and 30 June 2015. Two sets of data were
collected. Firstly, data on age, gender and diagnosis was
collected on all planned palliative radiotherapy
treatments (n =787). Secondly, data on all patients who
had been cancelled before planned start of treatment
(n=105) was obtained. Data on cancelled patients included
demographic and clinical data as well as other relevant
data recorded in the time between referral to palliative
radiotherapy and cancellation. If a patient had been
cancelled more than once during the study period data
was only collected on the first cancellation.
Results
Of the 787 planned radiotherapy courses, 106 (13 %)
courses were cancelled before planned start of treatment.
Of the 106 courses cancelled, one patient accounted for
two cancelled treatments. The median time between
referral and planned start of treatment for the cancelled
courses was 14 days, showing that the majority of
cancelled patients were planned to start radiotherapy
much earlier than the maximum time limit of 28 days
specified in the Danish legislation.
Results of data collected on all planned palliative
radiotherapy treatments showed that patients' age,
gender and diagnosis did not differ between the courses
cancelled before planned start and courses started.
Main reasons for cancellation were death before start of
treatment, the patient being too weak to start treatment
or treatment was no longer relevant. Five of the 33
patients cancelled because they were too weak to receive
palliative radiotherapy, died in the time interval between
cancellation and the day they were supposed to start
treatment. The total number of patients who died before
planned start of treatment was 29 (28 %) (Table1).
Conclusion
The main reasons for cancelling palliative radiotherapy
were the patient either being too weak to receive
treatment/ dying before beginning of treatment or
because treatment was no longer relevant. The other data
collected could not explain the number of patients being
cancelled. More knowledge is needed about the
differences between patients starting palliative
radiotherapy treatment and patients being cancelled
before start of treatment.
EP-1852 A research interventional clinic within the NHS
to enable participation in prostate clinical trials
K. Crowther1, A. O'Neill1,2, S. Murray 3, J. Cousins3, O.
Stewart 3, G. Totten3, S. Hynds3, K. Parsons3, P. Shiels1, C.
Logan1, D. Mitchell1, C. Lyons1, S. Jain1,2
1Cancer Centre- Belfast City Hospital, Radiotherapy,
Belfast, United Kingdom
2Centre for Cancer Research and Cell Biology, Queen's
University, Belfast, United Kingdom
3Belfast City Hospital, Northern Ireland Cancer Trials
Network, Belfast, United Kingdom
Purpose or Objective
Within prostate cancer clinical trials there has been an
increasing move towards hypo-fractionated and
Stereotactic Ablative Radiotherapy (SABR) regimes. This
has led to an increased requirement for Image-Guided
Radiotherapy (IGRT). At our centre, it was therefore
necessary to implement a service to facilitate the
implanting of fiducial markers (FM) and other
interventional procedures to enable our participation in
such clinical trials.
Material and Methods
Funding for this service was secured from a research
grant. A multi-disciplinary working group of Consultant
Clinical Oncologists, Radiographers, Hospital
Management, Nurses, Clinical Trials team and Clinical
Research Fellows was formed. This group ensured the
service was introduced in a safe and controlled manner by
meeting at regular intervals throughout the set-up
process, writing protocols and work instructions, and
designing and implementing a competency-based training
programme for staff undertaking and assisting
with the procedures. This service is now a prerequisite for
three clinical trials at our centre. Procedures include;
prostate FM insertion under Trans Rectal Ultrasound
(TRUS) guidance, collection of prostate tissue for research
purposes and the insertion of a prostate hydrogel spacer.
Results
Since December 2015, there have been 34 patients
through this clinic. All patients received FMs and three
patients also had prostate biopsies taken and insertion of
the hydrogel spacer. As part of service evaluation for the
first five months, patients attending this clinic received a
post-procedure phone call 72 hours after FM insertion by
the Clinical Research Radiographer to monitor for any
complications. 11 patients who had attended the clinic for
FM insertion received this call; seven patients reported no
issues, two reported loose bowels/diarrhoea, one patient
reported haematuria and one case of possible prostatitis
was also reported.
Conclusion
This service has been a significant development in
facilitating participation in local and national prostate
cancer radiotherapy trials. Patient-reported acute side
effects and toxicity resulting from the procedures
undertaken would indicate they are well tolerated with
minimal complications reported. Demand for this service
continues to grow with the opening of further clinical
trials. Performance and efficiency of this clinic demands
an ongoing collaborative approach by a large multi-
disciplinary group working across professional,
departmental and institutional boundaries .