Despite this is being a small retrospective study, survival figures and toxicity profiles of low dose weekly cisplatin are comparable to historical controls using high-dose regimens, hence justifying our approach. In addition, radiotherapy interruptions are minimized and cisplatin is easy to administer in outpatient settings. Future three-arm studies could include this regimen as the basis of treatment combined with targeted therapies.

the experience in clinical trials. Method: We purposefully employed a soft-launch of our lung cancer screening program with low-dose CT (LDCT) so we could rapidly evaluate our experience through audit and feedback. The program began in January 2015 and included several key implementation components: 1) guideline review supporting lung cancer screening; 2) continuing medical education to physicians regarding implementation; 3) Epic-registry build to account for eligible members, orders for LDCT, completion of LDCT, and radiologic results; 4) Nurse care coordinator to follow-up with screen positive members to return for imaging; 5) Development of a shared decision making tool for patient/provider discussions. LDCT is read by radiologists using American College of Radiology Lung-RADS TM grading system. We describe the uptake of LDCT in an age-and smoking-eligible population and alignment of Lung-RADS TM with expected population estimates overall among exams conducted from 2015-2018. Negative screen is defined as Lung-RADS TM 1 or 2. Positive screen includes Lung-RADS TM 3 and 4. Result: With an estimated 15,000 adults eligible for lung cancer screening, about 1,800 annual visits have a documented shared decision-making. While the majority of patients (89%) opt-in to screening, about 26% of those patients cancel or do not show up for their LDCT exam. As of March 2018, KPWA completed 3,092 LDCT exams: 2,104 initial screens and 988 subsequent screens. Among all initial LDCT performed, 84.6% screened negative; the proportion increased slightly to 88.6% on subsequent LDCT exams. On initial LDCT, the proportion of positive exams were as follows: Lung-RADS TM 3 (7.8%); Lung-RADS TM 4A (3.3%), and Lung-RADS TM 4B, C, X (2.4%). On subsequent LDCT exams, these proportion decreased slightly to 5.2% and 2.2% for Lung-RADS TM 3 and 4A, respectively. Conclusion: Overall implementation of KPWA lung cancer screening suggests an ability to identify eligible patients, engage in shared decision-making, appropriate referral and uptake of LDCT, appropriate use of Lung-RADS TM assessment, and patients who return for follow-up and subsequent annual screening. Opportunities remain for improvement in acceptance of LDCT based on patient needs and further adoption within our system.

using "breast cancer" and "national cancer database" and another using "lung cancer" and "national cancer database." The data was combined to determine each variables' association with journal impact factor using both univariate and multivariate analyses. P< 0.05 was considered as statistically significant. Results: A total of 191 published studies were identified. We found that a journal impact factor > 5 was associated with a publication year prior to 2017 (univariate analysis OR 2.68, 95% CI 1.38-5.21, p-value 0.004 and multivariate analysis OR 3.47, 95% CI 1.62-7.42, p-value 0.001) and a sample size > 10,000 (univariate analysis OR 3.27, 95% CI 1.43-7.50, p-value 0.005 and multivariate analysis OR 4.68, 95% CI 1.89-11.6, p-value 0.0008). Variables such as number of authors (5 vs. >5), region (US vs. non-US), cancer type (lung vs. breast), stage (including vs. excluding stage IV), treatment outcome (yes vs. no) and treatment incidence (yes vs. no) were not significant for an association with an impact factor > 5. Conclusion: Based on our data, studies published after 2017 using the NCDB were associated with a lower impact factor. This could suggest that the quality of the NCDB data may be declining over time. References:

ProblemAvailability of advanced radiotherapy technology to treat cancer is limited in regional Australia. At Central West Cancer Care Centre, the utilisation rate of intensity‐modulated radiotherapy and volumetric modulated arc therapy was significantly lower compared to other NSW public health services. Stereotactic ablative body radiotherapy treatment was not available at Central West Cancer Care Centre.DesignTo increase the intensity‐modulated radiotherapy/volumetric modulated arc therapy utilisation rate and to make stereotactic ablative body radiotherapy treatment available through quality improvement projects with multi‐disciplinary collaboration.SettingCentral West Cancer Care Centre is part of Western NSW Local health District. Central West Cancer Care Centre has two linear accelerators for delivering intensity‐modulated radiotherapy, volumetric modulated arc therapy and stereotactic ablative body radiotherapy treatments, and a computed tomography simulator with 4D computed tomography capability.Key measures for improvement Intensity‐modulated radiotherapy/volumetric modulated arc therapy utilisation rate increases to > 65% Stereotactic ablative body radiotherapy available to Central West Cancer Care Centre patients Strategy for changeA multi‐disciplinary active of team radiation oncologists, medical physics specialists and radiation therapists developed an implementation plan for each treatment technique.Effect of changeThere was a significant increase in use of advanced techniques. The impact on patients included the following: Fewer side effects and improved control of disease as the advanced techniques directed the dose to the tumour and reduced the radiation dose to organ at risk. Treatment completed sooner than conventional radiotherapy, as the required dose required fewer trips to the hospital. Rural and remote patients were not required to travel to a metropolitan centre to have stereotactic ablative body radiotherapy treatment. Lessons learntStrong commitment from a trained team and a collaborative approach is important for the implementation of advanced technology in regional centres.