ESTRO 36 Abstract Book

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S22 ESTRO 36 2017
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as salvage treatment in 16 patients (41.6%) while the rest
(58.4%) received adjuvant proton therapy. In skull base
tumours, 15 patients (39.5%) were treated in salvage
setting, 22 (57.9%) in adjuvant while 1 (2.6%) patient had
definite proton therapy. The median administered dose
was 74 Gy (RBE) (range 62 – 76 Gy (RBE)).
Results
Following a median follow up of 68 months (range 11.5 –
189.8 months), of those patients treated for a skull base
tumour, all recurred locally except for one who presented
a 'skip metastasis”. The median time to local recurrence
in these patients was 31 months (range 4.4 to 152 months).
In patients with skull base disease, half (N=19) were
further treated with surgery, 4 patients (21%) of which had
adjuvant chemotherapy, most commonly imatinib and one
patient received further adjuvant radiotherapy. Of those
patients who were not operated, they either received
chemotherapy only (N=12), radiotherapy only (N=1) or no
treatment at all (N=4) or there was no information of the
treatment provided (N=3).
Of those patients treated for an extra-cranial chordoma,
13 patients (33%) presented with a distant failure and 38
patients (97%) had a local recurrence. The median time to
local recurrence was 36.9 months (range 4.8 – 146.7
months). Half of these patients (N=19) were treated
surgically, one of which had adjuvant chemotherapy and
two radiotherapy. Of the patients who were not operated,
5 received chemotherapy only, 10 no treatment at all or
there was lack of information (N=4).
Following PBS proton therapy in skull base and extra-
cranial chordoma, 5-year actuarial local control (LC),
distant disease free survival and overall survival (OS)
following proton therapy were 19.5% (95%CI 10.7 – 28.3%),
75% (95%CI 64 – 75.1%) and 66.3% (95%CI 55.5 – 77.1%)
respectively. The OS was not different if the patients were
treated in the adjuvant or salvage setting, 68.6% (95%CI
54.9 – 82.3%) and 63% (95%CI 45.7 – 80.5%) respectively (p=
0.96). The median time from the first recurrence after
PBS proton therapy to the death was 24 months (range 0.7
– 142.3 months).
Conclusion
This data shows that patients diagnosed with a recurrence
following spot scanning proton therapy for a skull base or
extra-cranial chordoma can still have other treatment
options available although once a recurrence is diagnosed
the outcome is poor.
PV-0050 A randomised controlled study of decision aids
to improve clinical trial decisions &recruitment
P. Sundaresan1,2, B. Ager3, P. Butow3, S. Tesson3, A.
Kneebone2,4, D. Costa3, H. Woo2, M. Pearse5, I.
Juraskova3, S. Turner2
1 Crown Princess Mary Cancer Center- Westmead
Hospital, Radiation Oncology, Sydney- NSW, Australia
2 The University of Sydney, Sydney Medical School,
Sydney, Australia
3 The University of Sydney, Psycho-Oncology Co-operative
Group PoCoG- School of Psychology-, Sydney, Australia
4 Royal North Shore Hospital, Northern Sydey Cancer
Centre, Sydney, Australia
5 Auckland Hospital, Radiation Oncology, Auckland, New
Zealand
Purpose or Objective
Randomised controlled clinical trials are considered the
‘gold-standard’ for evaluating medical treatments.
However, recruitment to clinical trials is low overall, with
both patients and clinicians reporting difficulties with the
consent process. Decision Aids (DAs) may improve this
process by ensuring patients weigh up the pros and cons
of all their options and make informed value-sensitive
decisions. DAs have demonstrated efficacy in improving
knowledge and reducing decisional conflict during
decision making about medical treatments. We aimed to
evaluate the utility of a DA for potential participants of a
clinical trial (Trans-Tasman Radiation Oncology Group’s
RAVES 08.03), in reducing decisional conflict, improving
knowledge and potentially improving informed trial
recruitment.
Material and Methods
Potential participants for RAVES were identified by their
urologist or radiation oncologist (RO) and invited to
participate in the DA study. Participants received a pre-
randomised package containing the standard RAVES
participant information sheet and either the custom
developed DA or a blank notebook. The packages were
identical in appearance and both participant and
recruiting clinician were blinded to the intervention.
Questionnaire measures of decisional conflict and
knowledge (including RAVES knowledge) were
administered at baseline, one and six months. The primary
outcome measure was decisional conflict. Secondary
outcomes measured included knowledge about clinical
trials and RAVES as well as recruitment to RAVES.
Results
127 men (median age = 63 years) were recruited through
urologists (n = 91) and radiation oncologists (n = 36). 61
men were randomised to the DA arm and 66 to the control
arm. Decisional conflict was significantly lower (p =
0.0476) and knowledge regarding RAVES was significantly
higher (p = 0.033) in the DA arm. 18% of the DA arm (11 of
61) and 9% of the control arm (6 of 66) were recruited to
RAVES. This difference did not reach statistical
significance. Of the 5 men from the urologist sample who
subsequently entered RAVES (5.5%), all 5 were from the
DA arm (p=0.017). Of the 11 men from the RO sample who
subsequently entered RAVES (30.5%), there was no
significant difference in recruitment by the DA
intervention (5 from DA arm vs from 6 control arm).
Conclusion
This study is the first to demonstrate the utility of a DA in
reducing decisional conflict and improving trial knowledge
in those with cancer making decisions regarding clinical
trial participation. The DA also improved trial
recruitmentin a sub-group of patients.
Proffered Papers: Joint Clinical - GEC ESTRO on cervix
cancer
OC-0051 Fatigue, insomnia, hot flashes (CTCAE) after
definitive RCHT+IGABT for cervical cancer (EMBRACE)
S. Smet1, D. Najjari-Jamal1, N. BK Jensen2, L. Fokdal2,
J.C. Lindegaard2, C. Kirisits3, C. Haie-Meder4, U.
Mahantshetty5, I.M. Jürgenliemk-Schulz6, E. Van
Limbergen7, B. Segedin8, P. Hoskin9, K. Tanderup2, R.
Pötter1, K. Kirchheiner1
1Medical University of Vienna / Vienna General Hospital,
Department of Radiation Oncology- Comprehensive
Cancer Center, Vienna, Austria
2Aarhus University Hospital, Department of Oncology,
Aarhus, Denmark
3Vienna General Hospital, Department of Radiation
Oncology- Comprehensive Cancer Center- Medical
University of Vienna, Vienna, Austria
4Gustave-Roussy, Department of Radiotherapy, Villejuif,
France
5Tata Memorial Hospital, Department of Radiation
Oncology, Mumbai, India
6University Medical Centre Utrecht, Department of
Radiation Oncology, Utrecht, The Netherlands
7UZ Leuven, Department of Radiation Oncology, Leuven,
Belgium
8Institute of Oncology Ljubljana, Department of
Radiotherapy, Ljubljana, Slovenia
9Mount Vernon Hospital, Cancer Centre, London, United
Kingdom