Whole Brain Radiotherapy Versus Stereotactic Radiosurgery in Poor-Prognosis Patients with One to 10 Brain Metastases: A Randomised Feasibility Study.

Aims: A significant proportion of patients with brain metastases have a poor prognosis, with a life expectancy of 3-6 months. To determine the optimal radiotherapeutic strategy for brain metastases in this population, we conducted a randomised feasibility study of whole brain radiotherapy (WBRT) versus stereotactic radiosurgery (SRS).

Materials And Methods: Patients with a life expectancy of 3-6 months and between one and 10 brain metastases with a diameter ≤4 cm were enrolled at six Canadian cancer centres.

Development and validation of a clinical prediction-score model for distant metastases in major salivary gland carcinoma.

Background: The most common pattern of failure in major salivary gland carcinoma (SGC) is development of distant metastases (DMs). The objective of this study was to develop and validate a prediction score for DM in SGC.

Patients And Methods: Patients with SGC treated curatively at four tertiary cancer centers were divided into discovery (n = 619) and validation cohorts (n = 416).

Healthcare system barriers to long-term follow-up for adult survivors of childhood cancer in British Columbia, Canada: a qualitative study.

Purpose: Risk-stratified life-long follow-up care is recommended for adult childhood cancer survivors (CCS) to ensure appropriate prevention, screening, and management of late effects. The identification of barriers to long-term follow-up (LTFU), particularly in varying healthcare service contexts, is essential to develop and refine services that are responsive to survivor needs. We aimed to explore CCS and healthcare professionals (HCP) perspectives of healthcare system factors that function as barriers to LTFU in British Columbia, Canada.

Neoadjuvant systemic therapy in breast cancer: use and trends in radiotherapy practice.

Background: The use of neoadjuvant systemic therapy (nast) in the treatment of breast cancer is increasing, and the role of adjuvant radiation therapy (rt) in that setting is uncertain. We sought to review and report the use of nast, its trends over time, and its relationship with the prescribing patterns of locoregional rt in a provincial cancer system.

Methods: Patients with stages i-iii breast cancer diagnosed during 2007-2012 were identified using a provincial database.

Population-Based Study of Stereotactic Radiosurgery or Fractionated Stereotactic Radiation Therapy for Vestibular Schwannoma: Long-Term Outcomes and Toxicities.

Purpose: To examine long-term local control of vestibular schwannoma and side effects in patients treated with stereotactic radiosurgery (SRS) and fractionated stereotactic radiation therapy (SRT) in British Columbia.

Methods And Materials: From August 1998 to May 2009, 207 patients were treated with radiation therapy (RT) at British Columbia Cancer Agency. 136 (66%) received SRS, and 71 (34%) received SRT.

Patient-reported outcome use in oncology: a systematic review of the impact on patient-clinician communication.

Purpose: Patient-reported outcomes (PROs) are an increasingly popular tool to optimize care and bridge the gap between patient experience and clinician understanding. The aim of this review was to identify mechanisms through which PROs facilitate patient-clinician communication in the adult oncology population.

Methods: We conducted a systematic review of the published literature using the following data sources: MEDLINE, EMBASE, CINAHL, PsycINFO, Cab Direct, and CDSR.

Examining Lifestyle Information Sources, Needs, and Preferences among Breast Cancer Survivors in Northern British Columbia.

Purpose: Little is known about the lifestyle (e.g., physical activity, nutrition) information needs among breast cancer survivors living in nonurban settings.

Utilization of palliative radiotherapy for bone metastases near end of life in a population-based cohort.

Background: Palliative radiotherapy (PRT) can significantly improve quality of life for patients dying of cancer with bone metastases. However, an aggressive cancer treatment near end of life is an indicator of poor-quality care. But the optimal rate of overall palliative RT use near the end of life is still unknown.

Incidence of distal bone metastases in patients treated for palliative radiotherapy and associations with primary tumour types.

Purpose: This study assesses the incidence of distal bone metastases in palliative radiotherapy (RT) patients.

Material And Methods: All courses of RT for bone metastases from 2007-2011 for patient living in British Columbia (BC) were identified in a provincial RT programme. Treated bone metastases (BoM) were categorized as distal if the BoM was located within or distal to the elbow or knee.

Palliative radiotherapy fractionation schedules prescribed are dependent on the distance a patient travels to receive treatment.

This study assessed the impact of the distance a patient travelled to the treatment centre on the use of single fraction RT for bone metastases. There was significant variability in the prescription of SFRT by distance at which the patient lives from a cancer centre (p<0.001).

Incidence and treatment patterns of complicated bone metastases in a population-based radiotherapy program.

Introduction: There is abundant evidence in support of single fraction (SF) radiation therapy (RT) for uncomplicated bone metastases (BoM). We sought to determine the proportion of BoM that is complicated in a population-based RT program in order to act as a potential guide for assessing SFRT utilization rates.

Materials And Methods: A total of 3200 RT courses were prescribed to 1880 consecutive patients diagnosed with BoM in 2013.

Impact of Using Audit Data to Improve the Evidence-Based Use of Single-Fraction Radiation Therapy for Bone Metastases in British Columbia.

Purpose: To assess the impact of a population-based intervention to increase the consistency and use of single-fraction radiation therapy (SFRT) for bone metastases.

Methods And Materials: In 2012, an audit of radiation therapy prescriptions for bone metastases in British Columbia identified significant interphysician and -center (26%-73%) variation in the use of SFRT. Anonymous physician-level and identifiable regional cancer center SFRT use data were presented to all radiation oncologists, together with published guidelines, meta-analyses, and recommendations from practice leaders.

Use of single- versus multiple-fraction palliative radiation therapy for bone metastases: population-based analysis of 16,898 courses in a Canadian province.

Purpose: There is abundant evidence that a single fraction (SF) of palliative radiation therapy (RT) for bone metastases is equivalent to more protracted and costly multiple fraction courses. Despite this, there is low utilization of SFRT internationally. We sought to determine the utilization of SFRT in a population-based, publicly funded health care system.

Prospective evaluation of unmet needs of rural and aboriginal cancer survivors in Northern British Columbia.

Background: The unmet needs of cancer survivors in rural, remote, and aboriginal communities are largely unexplored. We explored potential differences between rural survivors (rss) in 4 general population (gp) and 4 First Nations (fn) communities.

Methods: We approached 4 gp and 4 fn rs communities to participate in a mixed-methods project.

Poster - Thur Eve - 71: Improved dose accuracy for plan checking IMRT breast plans.

Dose verification as part of plan checking is a critical component of high quality patient care. IMSure QA is a software platform used at the BC Cancer Agency that facilitates dose verification for both conformal and IMRT plans. We have recently initiated treating breast tangents using IMRT at the Fraser Valley Centre and noted increased dose discrepancies (mean difference of -3%) between Eclipse and IMSure's QA module.