ESTRO 37 Abstract book

Purpose or Objective To evaluate the impact of break in treatment for nonmedical reasons, as suspension or delay in scheduling BRT boost, on survival in gynaecological cancer. We estimated the Overall Treatment Days (OTD) (including no treatment days) of each patient. Material and Methods By November 2008 to April 2012 95 endometrial cancer pts. (no recurrences) treated in adjuvant according to this treatment schedule: EBRT (50 Gy/5 weeks) plus BRT boost 18 Gy in 3 fractions before or after the same EBRT. For patients of our Center we performed the boost before according our guidelines, for patients from nearby centers the boost was performed after. Generally OTD was longer in patients who performed boost after EBRT (for management problems pts. of nearby centers were often sent for boost at the end of the EBRT). We recorded the gap after EBRT and the result was a median delay of 35 days (range 7-134). We evaluated this factor in comparison of survival curves with Kaplan Meier method of entire population of the study. Results Median follow-up 6,35 years (range 1,13-8,33). In the evaluation of survival according the value of OTD the cut-off result is ≥ 70 days. So we recorded two groups Median-55 (range 40-68) of 70 pts. vs Median-96 (range 72-159) of 25 pts. In Median-55: age 66 (range 36-84); stage distribution was pT1b 16 pts., pT1c 41, pT2 9, other stages 4; grading distribution G1 19 pts., G2 43, G3 8; lymph node status performed in 58 pts. (N0=53, N1=5) in other 12 NX. In Median-96: age 58 (range 31-79); stage distribution was pT1b 6 pts., pT1c 15, pT2 3, other stages 1; grading distribution G1 10 pts., G2 13, G3 2; lymph node status performed in 23 pts. (N0=22, N1=1) in other 2 NX. The late toxicity as G3- G4 was 4 pts. (5%) in Median-55 group and 2 (8%) in Median-96 population. Only relapse recorded in 1 (alive) of group Median-55. Survival comparison that considered Median-55 vs Median-96 resulted favourable to first group and more significant, median 5,67 vs. 4,79 years (P=0,21). Conclusion Reduce to the minimum the entire treatment time is mandatory. For a better quality management of the scheduling of entire treatment (avoiding treatment suspension for nonmedical reasons) we need to increase the collaboration with nearby centers to be more effective in gynaecological cancers (scheduling BRT simulation before the EBRT at own center). Patients who have ended the EBRT often come for BRT simulation to our center with problems of acute toxicity in progress so to perform boost is very difficult. Because of the pain that can be caused during the CT simulation it is possible to have a missing target, to avoid this problem pts. of our center have the simulation CT at the same time of EBRT simulation. By increasing quality management the survival increases. EP-2403 Title: Implementation of brain HFSRT in a French public and non-academic hospital N.H. Hau Desbat 1 , E. Berland 1 , M. Romanet 1 , M.L. Neyret 1 , N. Pisano 1 , M. Parry 1 , P. Fourneret 1 1 Centre Hospitalier Chambery, Radiation therapy, Chambery, France Purpose or Objective To describe the multidisciplinary frame built before the first brain HFSRT in a French public and non-academic hospital, in order to guarantee its efficiency and safety. Material and Methods The quality department and radiation oncology department of Metropole de Savoie Hospital are involved in a process of continuous improvement in radiation treatments. In November 2014, a national expert working

A review of the simulation checklist was performed between April and June 2016. The following data was analyzed: the checklist completed correctly rate; the number of incidents detected by the checklist referred to the pre-simulation phase and the number of incidences registered in our Safety Information System (ROSIS). Results A total of 311 checklists were analyzed, in which 303 (97.43%) were completed correctly. The number of incidents detected by the checklist was 52 (16.7%) and were referred to: 3 an incorrect registry on our database, 13 an incorrect assignment of the pathway simulation, 7 incorrect appointment, 11 incorrect simulation orders and 18 patient information consent incompleted. The number of incidents related to simulation and OARs delineation during this was 24 (7.7%) and were related to network 6, radiotherapy pathway 1, image acquisition 1, resimulation 7, vac-lok cushions 2 and OARs delimitations 7. (Fig. 2)

Derived from the analysis of incidents recorded we made a series of changes: we modified the general protocol of positioning at the CT room, and improvement action was generated (standardization of OARs delimitation); a new resource was generated in the RT network to facilitate communication between the administrative staff and the CT room RTT (on issues of registration and/or clinical pathway of patient safety) or clinical pathway of patient safety). Globally, the actions taken to improve communication between professionals include: set an appointment via RT database to MD if informed consent is missing; follow- up of the safety pathway by RTTs; if no reproductibility in positioning is achieved no further proceeding with the simulation process. Conclusion Completing a checklist helps us to not forget any of the specific points of the simulation process and perform them in an well established order. It serves as a record for subsequent analysis incidents, generated actions for improvement and/or revision/ modification of radiotherapy simulation protocols. EP-2402 How much treatment suspension or scheduling delay in treating gynecological cancer affects survival? F. Piro 1 , A. Martilotta 1 , A. Massenzo 1 , U. Piro 1 , D. Cosentino 1 , L. Marafioti 1 1 Ospedale Mariano Santo, radioterapia oncologica, Cosenza, Italy