ESTRO 36 Abstract Book

S22 ESTRO 36 2017 _______________________________________________________________________________________________

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. Sundaresan 1,2 , B. Ager 3 , P. Butow 3 , S. Tesson 3 , A. Kneebone 2,4 , D. Costa 3 , H. Woo 2 , M. Pearse 5 , I. Juraskova 3 , S. Turner 2 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. OC-0051 Fatigue, insomnia, hot flashes (CTCAE) after definitive RCHT+IGABT for cervical cancer (EMBRACE) S. Smet 1 , D. Najjari-Jamal 1 , N. BK Jensen 2 , L. Fokdal 2 , J.C. Lindegaard 2 , C. Kirisits 3 , C. Haie-Meder 4 , U. Mahantshetty 5 , I.M. Jürgenliemk-Schulz 6 , E. Van Limbergen 7 , B. Segedin 8 , P. Hoskin 9 , K. Tanderup 2 , R. Pötter 1 , K. Kirchheiner 1 1 Medical University of Vienna / Vienna General Hospital, Department of Radiation Oncology- Comprehensive Cancer Center, Vienna, Austria 2 Aarhus University Hospital, Department of Oncology, Aarhus, Denmark 3 Vienna General Hospital, Department of Radiation Oncology- Comprehensive Cancer Center- Medical University of Vienna, Vienna, Austria 4 Gustave-Roussy, Department of Radiotherapy, Villejuif, France 5 Tata Memorial Hospital, Department of Radiation Oncology, Mumbai, India 6 University Medical Centre Utrecht, Department of Radiation Oncology, Utrecht, The Netherlands 7 UZ Leuven, Department of Radiation Oncology, Leuven, Belgium 8 Institute of Oncology Ljubljana, Department of Radiotherapy, Ljubljana, Slovenia 9 Mount Vernon Hospital, Cancer Centre, London, United Kingdom Proffered Papers: Joint Clinical - GEC ESTRO on cervix cancer