S37 _________________________________________________________________________________________________________ specificity: 98.1%), the risk of failure is 9.8% (8/82) for patients not having received ADT. For patients who received ADT, the predictive factors of failure are PSA-60 (OR:53.9 p < 0.0001) and T-Stage (OR:0.25 p = 0.0008). Using this model and a PSA-60 cutoff of 0.1 ng/mL (sensitivity: 85%, specificity: 92.9%), the predicted risk of BF in the rising PSA group is 53.7% (36/56). Taking into account the two predictive models, the anticipated cure rate for the entire cohort is 89.7%. Conclusions: Patients treated with LDR-PB monotherapy and whose PSA-60 is ≤ 0.3 ng/mL are highly likely to be cured even if they experienced a slight PSA rise. However, for patients who also received ADT, a stricter cut-off of 0.1 ng/mL may be appropriate.

Purpose: To describe the case mix, intervention efficacy and prognosis of patients with advanced lung cancer attending a Fast Track Lung (FTL) clinic that was established to improve timeliness of access to palliative RT.Methods and Materials: Pre-treatment and treatment information was prospectively collected on FTL patients seen from January 2014 to December 2015.Palliative RT use was decided based on clinical/radiologic information suggesting that one or more specific symptoms were reasonably likely to be helped.Phone follow up by a nurse 1-2 months later assessed the effect of RT on each index symptom.Results: Two hundred and fourteen patients were assessed a total of 310 times, a mean of 1.5 times per patient (range 1-8).Eighty-six percent had non-small cell histologies (71% adenocarcinoma, 22% squamous cell carcinoma).Most were ECOG 2 (30%) or 3 (46%) at the time of first presentation.Median survival from initial FTL consult was 3.2 months (95% CI 2.2 -3.6) for the entire group; for ECOG 0 -1, it was 12.3 months (95% CI 7.4 -16.2) and for ECOG 3 -4, 1.8 months (95% CI 1.5 -2.2).EGFR mutation positive patients had a median survival of 12.5 months (95% CI 4.3 -39.8).224 of the 310 clinic visits resulted in palliative RT to at least one site, of which 161 (72%) had phone follow up.Three hundred and ninety courses of RT were delivered, a mean of 1.8 per patient, (range 0 -13).Forty-nine percent of RT courses were delivered to bony sites other than ribs, 22% to the chest, 14% to the chest wall/ribs and 10% to the brain.Thirty-once percent were single fractions and 92% were < 5 fractions.Median dose was 20 Gy and the median number of fractions was 5.Among patients receiving RT to one or more concurrent site(s), 80% reported some benefit.Seventy-seven percent of patients receiving RT to the chest reported improvement in at least one index symptom.This varied by symptom (e.g.dysphagia 33%, cough 82%, hemoptysis 100%).Eighty percent of treated bone mets became less painful.If one assumes that every patient without follow up information had no benefit, still 59% were helped.Conclusions: Palliative RT, generally with 5 or fewer fractions, helped most patients with clinically or radiologically targetable symptoms who attended a dedicated Fast Track Lung clinic.Phone follow up is a feasible way to obtain patient or family reported outcome information.Median survival was short, although considerably longer in patients with good performance status and/or an EGFR mutation, in whom the potential benefits of more intensified palliative RT should be investigated.

A new ambulatory consultative clinic with integrated assessments by palliative care, radiation oncology, and allied health professionals was introduced to (1) assess patients with brain metastases at a regional comprehensive cancer center and (2) inform and guide patients on management strategies, including palliative radiotherapy, symptom control, and end-of-life care issues. We conducted a quality assurance study to inform clinical program development.