S484 I. J. Radiation Oncology d Biology d Physics Volume 72, Number 1, Supplement, 2008

Results: Both Formative (process) and Summative (outcomes/impact) evaluations demonstrated improvements during the 3-yearprogram. We noted more than 40 Formative observations that positively influenced program development and 4 events with neg-ative impacts, the most significant of those 44 total observations were improvements in facilities by the hospital, audiovisual/con-ferencing support and placement of support staff for Patient Navigation and protocol coordination for clinical trials by our NIHCDRP Disparities Grant and a program expansion to co-emphasize a Thoracic Tumor Conference. Summative outcomes all indi-cated significant improvements: For Physician participation (CME credit issued), numbers increased with most 6-month incre-ments reported from 2004 baseline through 2007: 120 to 156.286.382.644.628.405; (TOTAL: 2,501). The total staffattendance at 6 month intervals were from a base of 178 to 300.500.624.995.732.620; (TOTAL: 3471) Cases presentedranged from a base of 34 per 6 months to 49.66.66.84.99.103; (TOTAL: 467). We also detail both longitudinal activitysummaries and statistical analyses for case mix and duration, trending analyses and projections by quarterly intervals for all mea-sured endpoints. Most importantly we also summarize a participant Satisfaction Survey measuring 6 vital components. Resultssuggested specific quality improvements.

Conclusions: Although many factors, such as TEAMWORK, planning and evidence based case reviews contribute to the growthof Tumor Board, we suggest that multidisciplinary contributions from all oncologic specialty areas are central. The complexities ofmulti-modality treatments, newer diagnostic and visualization approaches require an inclusive team willing to evaluate, learn, andevolve.

Author Disclosure: S.M. Rakfal, M.D, FACRO, None; S. Palepu, M.D., FACS, None; L.L. Schenken, Ph.D., None; E.M. Ricci,PhD, None.

2705 High Incidence of Larynx Cancers in Vietnamese Population in the Bay Area

D. D. Huang1, E. J. Filion1, E. Chang2, A. D. Colevas1, M. J. Kaplan1, Q. Le1

1Stanford University School of Medicine, Stanford, CA, 2Northern California Cancer Center, Fremont, CA

Purpose/Objective(s): Agent Orange exposure has been implicated in the development of laryngeal cancers in Vietnam (VN) Warveterans. We hypothesize that Vietnamese immigrants were also exposed to Agent Orange and similarly prone to developinglaryngeal cancers. This study’s objective is to compare the incidence of laryngeal cancers and of other non-Agent Orange relatedhead and neck (HN) cancers in the VN population in California to that in other Asian ethnicities in the same state as well as to non-Asians in the country.

Materials/Methods: Data from the U.S. Surveillance Epidemiology and End Results (SEER) and the California Cancer Registrydatabases were analyzed for the period between 1988 and 2006. 57,592,725 Asians and 548,807,029 non-Asians formed the studygroups. Incidence rates of HN cancers were analyzed based on primary tumor site (oral cavity, oropharynx, larynx, hypopharynxand nasopharynx), time period (1988-1993, 1994-1999, 2000-2006), ethnicity (Vietnamese, Chinese, Japanese, Filipino, Korean,Asian Indian and non-Asian) and gender (male, female). The statistical analyses were conducted with SEER*Stat (http://seer.cancer.gov/seerstat/).

Results: VN males had the highest incidence rate of laryngeal cancers, mainly squamous cell carcinomas, among all Asian males inCalifornia. The incidence rate was 5.1-10 per 100,000 person-years for VN, 2.7-3.8 for Chinese, 1.8-3.3 for Japanese, 2.7-3.1 forFilipino, 3.8-6.8 for Korean, 2.2-6.2 for Asian Indian and 5.5-8.4 for non-Asian males. The difference was statistically significantbetween VN males and other Asian male subgroups except for the Korean males for all time periods evaluated. There was no sig-nificant difference in the incidence of laryngeal cancers among different female groups evaluated. For other HN cancer sites listed,there was no significant difference in the incidence rate between VN population and other Asian ethnicities, except for nasopha-ryngeal cancer, where the VN group had the 2nd highest incidence (5.7-8.2 for VN males and 2.4-3.7 in VN females), just behindthe Chinese, and they were statistically significantly higher than the non-Asian population and other non-Chinese Asian groups forall analyzed time periods.

Conclusions: The incidence of laryngeal cancer is higher in VN males compared to other Asian subgroups in California. This maybe related to the combination of Agent Orange exposure and smoking habits. Further work is needed to establish the link betweenAgent Orange and laryngeal cancer in VN patients.

Author Disclosure: D.D. Huang, None; E.J. Filion, None; E. Chang, None; A.D. Colevas, None; M.J. Kaplan, None; Q. Le, None.

2706 Outcomes of Patients Treated but not Cured by Prostate Brachytherapy

J. B. Houk, W. L. Barrett

University of Cincinnati, Cincinnati, OH

Purpose/Objective(s): Brachytherapy is a widely used and very effective therapy for the treatment of localized prostate cancer. Itsuse increased from 4% of diagnosed patients in 1995 to 22% in 2000. The purpose of this study is to analyze the outcomes of pa-tients treated but not cured of prostate cancer by brachytherapy.

Materials/Methods: We conducted a retrospective analysis of 437 consecutive patients treated with brachytherapy as the soletreatment or as a component of their treatment at the University of Cincinnati from 1995 to 2008. We assessed that the treatmentfailed in 43 patients according to the most recent ASTRO guidelines which define a biochemical failure as a PSA rise by 2 ng/mL ormore above the nadir PSA. The 43 patients who failed therapy had clinical stage T1 or T2 disease at diagnosis. Median pre-treat-ment PSA for the group was 6.7 ng/mL with a range of 2.18-28 ng/mL. The median Gleason score at diagnosis was 7, range 4-10.Of the 43 treatment failures, 10 have died since treatment. Patients who failed brachytherapy were analyzed with respect to age atdiagnosis and survival status following biochemical failure.

Results: The 43 patients who have experienced biochemical failure after brachytherapy represent 9.8% of the entire study popu-lation. The median age of these patients at the time of their implant was 69 with a range of 48-77 years. The patients experiencingbiochemical failure are currently at a median follow-up time from treatment of 7.5 years, range 0.5-12.5 years. Of those 43 there are33 patients still living (76.7%) with a median post treatment time of 7.5 years, range 3.5-12.5 years. The remaining 10 (23.3%) are

Proceedings of the 50th Annual ASTRO Meeting S485

deceased with a median time from treatment to death of 7.75 years, range 0.5-12.0 years. Of the deceased patients, 8 died of prostatecancer (80%) with median time from treatment to death of 7.75 years, range 0.5-12.0 years. One patient died from lung cancer andone from intercurrent disease.

Conclusions: In our center 437 patients have been treated with brachytherapy as a component of or as the sole treatment for theircancer of the prostate. 43 (9.8%) patients have experienced biochemical recurrence by ASTRO criteria. 10 of those patients havedied. 8 of the 10 deceased patients died from prostate cancer. These patients had a median time from treatment to death of 7.75 yearswith a range of 0.5-12.0 years. The entire study population has a median follow-up of 6.83 years and a range of 1 month to 12.5years. Currently there is no significant difference in median follow-up time or range of follow-up time between the patients whodied from prostate cancer and those that are still living but experienced biochemical failure. This finding is best explained by theindolent nature of prostate cancer. Continued follow-up studies will be needed to assess long term mortality of patients receivingbut failing brachytherapy.

Author Disclosure: J.B. Houk, None; W.L. Barrett, None.

2707 The Role of Physician Assistants in Radiation Oncology

M. Polansky, A. C. Ross, M. S. Gould, P. A. Parker, J. L. Palmer

UT MD Anderson Cancer Center, Houston, TX

Purpose/Objective(s): Recent predictions of a US shortage in healthcare personnel have led to discussions regarding how to meetthe demands of an aging population, particularly in the field of oncology. In 2002, ASTRO conducted a workforce study that fore-casted a shortfall of personnel across all team positions within the specialty. Physician Assistants (PA) may be particularly suited tohelp fill the deficit of skilled healthcare workers by virtue of their generalist training and adaptability.

Materials/Methods: A descriptive study was conducted using a web based survey from 11/7 - 12/14/07 to characterize the role ofPAs in oncology. Invited participants included all PAs listed in the national PA database (855) listing practice in med onc, hem/onc,rad onc (XRT), surg onc, ped onc or ped hem/onc and all PAs at M.D. Anderson Cancer Center (159). Ten letters were undeliver-able, resulting in 1,004 PAs contacted.

Results: Of 301 respondents (30% participation rate), 36 (12%) reported working in XRT, 35 providing patient (pt) care. Of thesePAs, 72.2% were female; median age 44. Median time as a PA was 8 years, 4 years in oncology. Only 8.3% of respondents reportedparticipating in a XRT elective during PA school, although 42% had some type of oncology elective. Most had experience withcancer pts during internal medicine and general surgery rotations. Direct mentorship of supervising physicians (88.9%- very im-portant) and self study (97.2%- important or very important) were deemed the most important factors in acquiring their knowledgebase in oncology. Most of the respondents (75%) felt it took 6 months to 2 years to be ‘‘fully competent’’ in their practice. 67%routinely work with 1-2 physicians. All PAs indicated routinely providing care to outpts, while 56% occasionally provide care toinpts. Median time providing direct pt care was 70% and 15% of time providing indirect pt services. With new pts, those on activetreatment and long-term follow-up pts, most perform history and physicals (82%, 86%, 91.4%), determine the assessment and plan(41%, 74%, 77%), break bad news (53%, 65.7%, 71.4%), provide pt education (88%, 91.4%, 88.6%), and obtain informed consent(70.6%, 68.6%, 60%). 88.6% reported involvement in delivery of XRT. Of those PAs, 87% were involved in simulation, 41.9%draw target volumes, 48% write XRT prescriptions for physician signature, 35.5% verify pt setup, 29% review and approve portfilms for signature, 41.9% present plans for QI peer review, 80.6% document external beam summaries. Additional data regardingclinical duties, research and teaching was collected.

Conclusions: Current PAs in XRT are well utilized in clinical management of pts and by participating in the XRT planning pro-cess. As technology and the complexity of XRT planning advances, the PA role may become even more diversified as they help tofill the needs of our aging population.

Author Disclosure: M. Polansky, None; A.C. Ross, None; M.S. Gould, None; P.A. Parker, None; J.L. Palmer, None.

2708 Results of the ASTRO 2006 Diversity Survey

O. E. Streeter1, M. Abdel-Wahab2, Y. Bains3, D. Dorman4, F. Govern5, D. Heron6, R. Miller7, J. Oh8, P. Wallner9, D. G. Petereit10

1Keck School of Medicine of USC, Los Angeles, CA, 2Miller School of Medicine, Univ. of Miami, Miami, FL, 3Cancer PhysiciansAssociated, P.A., College Station, TX, 4Sarasota Oncology Center, Sarasota, FL, 5Radiation Oncology Sciences Program, NCI,Bethesda, MD, 6University of Pittsburgh Medical Center Cancer Pavilion, Pittsburgh, PA, 7Radiation Oncology Services,Riverdale, GA, 8M.D. Anderson Cancer Center, Houston, TX, 921st Century Oncology, Moorestown, NJ, 10John T. VucurevichCancer Care Institute/Rapid City General Hospital, Rapid City, SD

Purpose/Objective(s): Survey the ASTRO membership on their opinion of the need to increase minority participation in radiationoncology.

Materials/Methods: The survey was conducted through an online questionnaire. The sample population included all ASTROmembers with valid e-mail addresses. The online survey procedure included an announcement e-mail asking for their responseto the questionnaire with a link to facilitate response. The survey data were collected and analyzed by the Plexus Consulting Groupand provided to the authors in a formal report.

Results: A total of 490 respondents completed at least a portion of the survey. Most respondents work in a non-academic com-munity hospital (30.2%). Almost one of five respondents practice in an academic science center (19.1%) or a freestanding clinic(19.6%). Most respondents are in small single-specialty practices (43.2%). Most of the respondents practice in the Midwest, South-east, or Northeast. The fewest numbers of respondents practice in the Mid-Atlantic area. The majority of respondents have been outof medical school for 16 years or more (59%). Respondents indicated that most of their medical school colleagues were white(93.7%), while 8.8% were black, 8.3% Hispanic, 18.5% Asian/Pacific Islander, and 25.2% Other. Only one out of five respondents(19.9%) said their practice or facility makes special attempts to recruit minority staff. The respondents indicated their patient base is