S911
Clinical - Mixed sites & palliation
ESTRO 2026
palliative radiotherapy during the first three months of 2025. Data were extracted from CT scheduling logs and the MOSAIQ® system. For each patient, we recorded attendance at simulation, treatment delivery, and reasons for non-attendance (e.g., death, poor condition, treatment elsewhere, or loss to follow-up). For treated patients, the interval between CT simulation and treatment initiation was calculated to assess workflow efficiency and timeliness. Results: Between January 2 and March 31, 2025, 98 palliative radiotherapy (RT) appointments were scheduled during departmental staff meetings for previously treated patients and new referrals. CT simulation sessions were held mainly on Saturdays for palliative RT. Indications included whole brain metastasis irradiation (EIT) in 48% of patients, analgesic RT in 34%, decompressive RT for spinal cord compression in 11%, decompressive RT for superior vena cava syndrome in 4%, and hemostatic RT in 3%. The median age was 62 years , and the median distance from patient residence to the center was 67 km , with 23% living more than 60 km away. Of the 98 scheduled simulations, only 45 (46%) were performed, and 40 patients received treatment. Fifty-four percent of missed scans (n=29) were due to patient death. Other reasons for missed scans included patients being unreachable or absent (17%), postponements due to fatigue or poor tolerance of the required position (15%), scans already performed due to earlier rescheduling of the appointment (11%) and treatment in private centers (4%). The mean interval between CT simulation and treatment initiation was 18 days, although urgent cases could be treated the same day. The departmental agenda is continuously updated before each staff meeting to reflect changes in patient condition and treatment priorities. Conclusion: In a middle-income country, the audit shows that palliative radiotherapy—which represents a significant proportion of the department’s workload—is well organized, though workflow and access can be improved. Better selection, earlier referrals, and stronger support may enhance timely care and outcomes. Keywords: audit, palliative, workflow Digital Poster Highlight 4205 Early Seizure Risk after Stereotactic Radiosurgery for Brain Metastases: a Multicenter Analysis Isacco Desideri 1 , Orlando Maria Malanga 2 , Daniela Greto 1 , Guido Pecchioli 3 , Mario Levis 4 , Alessio Gastino 4 , Erica Maria Cuffini 4 , Umberto Ricardi 4 , Roberta Rudà 5 ,
incidences of grade ≥ 2 AAEs were 27% versus 24% (p = 0.84), and grade ≥ 3 AEs were 4% versus 3% (p = 1), with no significant differences. On univariable analysis, age ≥ 90 years was not significantly associated with poorer OS (p = 0.37). Conclusion: Age ≥ 90 years was not associated with worse prognosis or increased toxicity after RT. To our knowledge, this is the first PSM-based comparison of the effectiveness and safety of RT between nonagenarians and YOA. These findings may assist clinicians in treatment decision-making for patients in their 90s. References: [1] Sprave T, Rühle A, Stoian R, Weber A, Zamboglou C, Nieder C, et al. Radiotherapy for nonagenarians: the value of biological versus chronological age. Radiat Oncol. 2020 May 19;15(1):113. doi: 10.1186/s13014- 020-01563-x.[2] Kocik L, Geinitz H, Track C, Geier M, Nieder C. Feasibility of radiotherapy in nonagenarian patients: a retrospective study. Strahlenther Onkol. 2019 Jan;195(1):62-68. English. doi: 10.1007/s00066- 018-1355-6.[3] Thompson A, Cone R, Gao H, Hammond E, Fraser D, Back MF. Is advanced age a barrier to effective cancer treatment? The experience of nonagenarians receiving radiation therapy. Asia Pac J Clin Oncol. 2012 Sep;8(3):255-9. doi: 10.1111/j.1743- 7563.2011.01497.x. Keywords: elderly, nonagenarian, radiotherapy Digital Poster 4138 Optimizing palliative radiotherapy delivery: Insights from a Tunisian center audit Ghada Abdessatar, Mouna Ben Rejeb, Lilia Ghorbel, Lotfi Kochbati Radiation Oncology, Abderahmane Mami Hospital, Ariana, Tunisia Purpose/Objective: Palliative radiotherapy (RT) is essential for improving quality of life by managing pain, neurological complications, bleeding, and other distressing symptoms. These urgent interventions often involve patients with complex medical and psychosocial needs, making timely delivery challenging. To address increasing demand, our center audited the workflow from staff discussion to treatment initiation to identify opportunities to improve efficiency, optimize patient selection, and provide more patient-centered care Material/Methods: This audit was conducted in the Radiation Oncology Department of Abderrahmane Mami Hospital, Tunisia, including all patients scheduled for CT simulation for
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