(P103) Preoperative Versus Postoperative Radiotherapy in Localized ...

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Response by post-graduate year (PGY) was 26.3% PGY-2, 26.8%. PGY-3, 21.5% .... University of Cincinnati Barrett Cancer Center, 2Division of Oncology at.
Volume 98  Number 2S  Supplement 2017 Methods: A nationwide survey was sent to all U.S. radiation oncology program directors and coordinators as published by the Association of Residents in Radiation Oncology. The survey included the Maslach Burnout Index (MBI)-Human Services Survey, a validated and widely accepted burnout assessment questionnaire, as well as demographic and program-specific questions tailored to radiation oncology residents. Primary endpoints included rates of emotional exhaustion, depersonalization, and personal achievement as measured on MBI subscale scores. Results: Overall, 205 residents responded, representing 28.0% of the 733 radiation oncology residents nationwide. Of the respondents, 31.2% were women. Response by post-graduate year (PGY) was 26.3% PGY-2, 26.8% PGY-3, 21.5% PGY-4, and 25.4% PGY-5. High levels of emotional exhaustion and depersonalization were reported in 28.3% and 17.1%, respectively; 33.1% experienced a high burnout level on at least one of these MBI subscales. Furthermore, 12% had low rates of perceived personal achievement. Twelve residents (5.9%) reported feeling “at the end of my rope” on a weekly basis or more. Conclusions: Approximately one third of radiation oncology residents have high levels of burnout symptoms. Particularly concerning was that more than one in twenty felt at the end of their rope on a weekly basis or more. Steps should be taken to identify program or resident-specific factors associated with burnout, followed by targeted interventions aimed at addressing modifiable factors to prevent the negative consequences of burnout. (P102) Survival After Chemotherapy and Stem Cell Transplant Followed by Delayed Craniospinal Irradiation Is Comparable to Upfront Craniospinal Irradiation in Pediatric Embryonal Brain Tumor Patients David R. Raleigh, MD, PhD,1 Bryan Tomlin, PhD,2 Benedict Del Buono,1 Erika Roddy,1 Katherine Sear,1 Lennox Byer,1 Erin Felton,1 Anu Banerjee, MD,1 Joseph Torkildson, MD,3 David Samuel, MD,4 Biljana Horn, MD,1 Steve E. Braunstein, MD, PhD,1 and Daphne A. Haas-Kogan, MD5; 1UCSF, 2California State University Channel Islands, 3UCSF Benioff Children’s Hospital Oakland, 4Valley Medical Oncology, 5Dana Farber Institute Background: Pediatric embryonal brain tumor patients treated with craniospinal irradiation (CSI) are at risk for adverse effects, with greater severity in younger patients. Here we compare outcomes of CSI versus high-dose chemotherapy (HD), stem cell transplant (SCT) and delayed CSI in newly diagnosed patients. Methods: Two hundred one consecutive patients treated for medulloblastoma (72%), supratentorial primitive neuroectodermal tumor (sPNET; 18%) or pineoblastoma (10%) at 2 institutions between 1988 and 2014 were retrospectively identified. Progression free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method and compared by log-rank tests. Results: Adjuvant CSI regimens were used for 56% of patients (upfrontCSI), and HD/SCT regimens were used in 32% of patients. HD/SCT patients were significantly younger than those receiving upfront-CSI (2.9 vs 7.8 years; P60 miles), receipt of chemotherapy, tumor originating in extremities, >5 cm tumors, and certain histologies, such as myxoid, pleomorphic, and dedifferentiated liposarcomas, and malignant peripheral nerve sheath tumor. OS analysis revealed no difference between the two treatment cohorts, HR 1.05, 95% confidence interval: 0.95-1.16. Conclusions: Postop RT is utilized much more commonly than preop RT in localized STS. However, preop RT use has increased in recent years. Multiple demographic and clinicopathologic factors were predictive of preop RT use. Consistent with randomized phase 3 data, there was no difference in OS. (P104) Radiation and Subsequent Reirradiation Outcomes in the Treatment of Diffuse Intrinsic Pontine Glioma and a Systematic Review of the Reirradiation Literature Chris Freese, MD,1 Vinita Takiar, MD, PhD,1 Maryam Fouladi, MD, MS,2 Ralph Vatner, MD, PhD,1 Mariko DeWire, MD,2 John Breneman, MD,1 and Luke Pater, MD1; 1Departments of Radiation Oncology at the University of Cincinnati Barrett Cancer Center, 2Division of Oncology at the Cincinnati Children’s Hospital Medical Center Purpose: Diffuse Intrinsic Pontine Glioma (DIPG) is a devastating pediatric disease, with a median survival of