S879
Clinical - Mixed sites & palliation
ESTRO 2026
or how often it is actually performed in real-world practice. This study aimed to clarify how often response assessments are performed after palliative RT and to identify the characteristics of patients who remained unevaluated. Material/Methods: We retrospectively reviewed patients treated with palliative RT between September 2018 and March 2019. Medical records were reviewed to determine whether any radiation oncologist-authored chart entry existed within 16 weeks after RT. The presence of such documentation was classified by a simple binary definition, as evidence of follow-up (“response assessment performed”). Patients who survived >60 days without hospital transfer were considered evaluable. Those without any radiation oncologist- authored entry were defined as “Evaluable but Not Evaluated” (EBNE). Follow-up duration by primary physician and radiation oncologist was compared. Results: Among 309 patients (median age 64.5 years), 199 (64.4%) received documented evaluation by radiation oncologists. Median follow-up was shorter for radiation oncologists (75 days) than for primary physicians (110.5 days; p < 0.0001). Sixty-three patients (20.4%) survived >60 days without hospital transfer, but had no documented assessment (EBNE cohort). EBNE cases most frequently involved bone metastases (n=16), whole-brain RT (n=9), and brain stereotactic radiosurgery (n=5). Conclusion: More than one-fifth of patients receiving palliative RT survived longer than 60 days but remained unevaluated—a measurable blind spot in care delivery. The EBNE framework is based on a simple binary definition. It clearly identifies this structural gap and provides a reproducible measure of follow-up quality. As a quantifiable quality indicator, it can support the standardization of post-RT evaluation workflows and promote quality improvement in palliative oncology. “Evaluable but Not Evaluated (EBNE)” defines a reproducible and auditable indicator of follow-up quality in palliative radiotherapy, bridging the gap between treatment delivery and verification of benefit. References: 1. Rades D, Schild SE, Abrahm JL. Treatment of painful bone metastases. Nat Rev Clin Oncol 2010;7(4):220- 229.2. Chow E, Hoskin P, Mitera G, Zeng L, Lutz S, Roos D, et al. Update of the international consensus on palliative radiotherapy endpoints for future clinical trials in bone metastases. Int J Radiat Oncol Biol Phys 2012;82(5):1730-1737.3. Rades D, Š egedin B, Conde- Moreno AJ, Garcia R, Perpar A, Metz M, et al. Radiotherapy with 4 Gy × 5 versus 3 Gy × 10 for
months; symptomatic RN in one case (25%).
Conclusion: This study represents the first UK series reporting lesion-level outcomes for linac-based SRS in BSM. Single-fraction SRS delivered at a median dose of 16Gy to the PTV demonstrated high local control with relatively rare toxicity including symptomatic radionecrosis. These results support single-fraction SRS as an effective and safe treatment option in appropriately selected patients with BSM. Keywords: Brainstem metastases, Stereotactic, Radiosurgery Identifying “Evaluable but Not Evaluated (EBNE)” Patients After Palliative Radiotherapy: A Real- World Gap in Follow-up Hiroshi Tanaka 1,2 , Soichiro Abe 3 , Kohei Wakabayashi 4 , Risei Miyauchi 5 , Yutaro Koide 2 , Hiroyuki Tachibana 2 , Takeshi Kodaira 2 1 Gamma knife center, Shiokawa hospital, Suzuka, Japan. 2 Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan. 3 Department of Radiation Oncology, Aichi Medical University Digital Poster 1965 Hospital, Nagakute, Japan. 4 Department of Radiation Oncology, Hamamatsu University School of Medicine, Hamamatsu, Japan. 5 Department of Radiation Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan Purpose/Objective: With expanding systemic therapy options, the role of palliative radiotherapy (RT) has increased. Although many studies have examined pain or symptom response after palliative RT, no studies have systematically evaluated how follow-up is structured
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