ESTRO 36 Abstract Book

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S743 ESTRO 36 2017
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their initial RAPC consultation. We calculated the 30-day
mortality of patients who received treatment.
We then compared the data from the initial 3 months
when the clinic was active from 1st September to 30th
November 2014 against a 3 month period from 1st May to
31st July, 2016 inclusive, when there was no clinic due to
staffing shortages.
Results
During the initial 3 month period where the RAPC was
active, the number of cases seen in consultation was 129.
Patient’s ages ranged from 28.4 to 96 years with a mean
age of 69.1 years. Most common primary tumour sites were
Genitourinary and Lung accounting for 25% and 21% of the
patient population. Most common indication for PRT was
bone pain accounting for 69% of patients seen in the clinic.
Of the 122 patients who received PRT, 57 patients (46.7%)
received single fraction PRT whilst 65 patients (53.2%)
received fractionated PRT. 98% were seen within 2 weeks
of referral (87% within 1 week). The 30-day mortality rate
was 13.95%.
When comparing the 2 periods the overall median interval
from referral to consultation was 3.9 days with RAPC vs
3.7 days with no RAPC. The median time from
consultation to simulation was 0.9 days with RAPC vs 2.7
days with no RAPC. 74% were simulated on the day of their
initial consultation with RAPC vs 31.4% with no RAPC. 35%
started their PRT treatment on the day of their
consultation visit with RAPC vs 23% with no RAPC.
Conclusion
The comparison between the initial 3 months of the RAPC
vs the 3 months with no RAPC showed the median time
from consultation to simulation tripled, the percentage of
patients who were simulated on the day of consultation
fell by half and only 23% received same day treatment.
The 30-day mortality rate is consistent with UK studies and
suggests appropriate patient selection. Running a
dedicated palliative clinic decreased waiting times,
reduced the number of visits to the Regional Cancer
Centre and provided prompt PRT to symptomatic patients
in the terminal phase of their illness. The RAPC is
therefore meeting our objectives.
EP-1406 Improvement in cancer pain management: the
value of a joint approach in a single prospective series
V. Masiello1, S. Mafrida1 , F. Cellini1, F. Rodolà2, G.
Cannelli2, S. Longo 1, L. Polidori2, M. Balducci1, M. Rossi2,
V. Valentini1
1 Policlinico Universitario Agostino Gemelli- Catholic
University, Department of Radiation Oncology – Gemelli-
ART, Roma, Italy
2 Policlinico Universitario Agostino Gemelli- Catholic
University, Department of Anesthesiology and Intensive
Care Agostino Gemelli Hospital, Roma, Italy
Purpose or Objective
Pain management in cancer is a multifactorial challenge
for clinicians. Multidisciplinary approach can improve
survival and quality of life. In our center we applied a
multidisciplinary integrated approach to pain
management for outpatients. Purpose of this study was to
detect a benefit in terms of quality of life with this
approach.
Material and Methods
A team represented by radiation oncologist and
anesthetist offered a weekly outpatient ambulatory. We
enrolled patients (pts) with cancer pain from primitive
tumor or metastases. Intervention included RT and/or
drug modification/prescription after discussion of both
clinicians. Timing of treatment administration was also
case-by-case defined. For all the patients we collect
performance status (PS), Numeric Rating Scale (NRS), Pain
Management Index (PMI) value and Morphine Equivalent
Dose (MED) at baseline and after a month of therapy. A
complete pain response to radiotherapy was defined as:
NRS 0 and no modification in baseline drugs.
Results
From November 2015 to April 2016 we evaluated 85 pts for
a total of 122 sites of cancer pain referred. Of this pts,
10% came from consultations, 40% were send from care
provider and 50% were on regular follow up. Twenty/85
pts (23.5%) presented cancer pain by primitive tumor.
Sixty/85 pts (70.5%) presented bone metastases. At
baseline: median PFS: 60% (30-80%); median NRS: 5 (3-10);
median PMI: 0 (+1/-3). At first contact 31.8% pts had PMI
between -1 and -3 (i.e.: pain not adequately controlled).
Moreover, 13% of pts at the baseline didn’t assume any
therapy and 31.7% assumed only FANS. Pts with a previous
cancer pain therapy assumed a median MeQ of 150.5 mg
(1-300 mg).
All pts with bone metastases (60/85), underwent
palliative RT for a total of 120 irradiated CTVs, as follows:
34/120 (%): 8 Gy/1 fx; 1/120 (%) 4 Gy x 2, 8/120 30 Gy/10
fr, 77/120 CTV with 20Gy/5fr.
After 4 weeks, all the 85 baseline pts was
visited/contacted. Median PFS was 60% (40-90), median
NRS was 4.5 (0-9) (Figure 1), median PMI was 2 (-1/3). At
the first follow up only 2 pts presented a negative PMI (-
1) due to pain progression. Complete pain responders were
36%; 5.7% of pts continued to assume FANS only if
required and the rest of pts presented a median MED of
150.5 mg (1-300 mg).
Conclusion
In a patient reported outcome era, a joint approach at
cancer pain can improve self-report symptoms.
Particularly, the non-controlled pain seems to be avoided.
Larger series and QoL are required to confirm these
results.
Electronic Poster: Clinical track: Elderly
EP-1407 Are future radiation oncologists equipped with
the knowledge to manage elderly cancer patients?
L. Morris1, N. Thiruthaneeswaran2, M. Lehman3, G.
Hasselburg3, S. Turner1
1Crown Princess Mary Cancer Centre, Radiation
Oncology, Westmead, Australia
2Peter MacCallum - Bendigo Radiotherapy Centre,
Radiation Oncology, Bendigo, Australia
3Royal Australian and New Zealand College of
Radiologists, Faculty of Radiation Oncology, Sydney,
Australia
Purpose or Objective
The management of elderly patients with cancer is a
significant global challenge as a result of an increasing
aging population. Education of future radiation oncologists
in geriatric oncology is fundamental to ensuring elderly
cancer patients receive appropriate care. This study aims
to assess radiation oncology (RO) trainee knowledge,
perception and clinical practice in geriatric oncology.
Material and Methods