ESTRO 2020 Abstract book

S707 ESTRO 2020

WBRT (HR: 0.575). On multivariabele analysis both low dose dexamethasone (0-7 mg) (HR: 1.038) and the possibility of treatment options after WBRT (HR: 1.303) were significant. The existence of paraplegia prior to WBRT was nearly significant (p=0.064). Age, gender, time to development of brain metastases, time from the first metastases to WBRT, the presence of leptomeningeal, liver and lung metastases were not significant on univariate analysis. Conclusion WBRT is effective in a selected group of patients: 38% of the patients surviving 2 months reported benefit from the treatment resulting in a significant increased survival for this group. However, 27% of the patients died within 2 months. Prognostic factors for an increased survival were low dose dexamethasone use (0-7mg) prior to WBRT and additional treatment options after WBRT. PO-1252 Early palliative care in advanced-stage cancer patients: A retrospective cross-sectional study N. Thakur 1 1 Post Graduate Institute of Medical Education and Research, Radiotherapy and Oncology, Chandigarh, India Purpose or Objective While treating patients with the advanced disease it becomes very challenging for the clinicians to decide as to when the active treatment is justified and when should palliative care be introduced in patient's treatment. American Society of Clinical Oncology (ASCO) suggested that patients with advanced cancer, regardless of patient or outpatient, should receive dedicated palliative care services, early in the disease course, simultaneous with active treatment. Similar recommendations have been proposed by the European Society of Medical Oncology (ESMO). Keeping in view this background, we aimed to study the impact of the introduction of early palliative care into routine oncological management on patient's survival. Material and Methods This retrospective cross-sectional study is based on hospital data for patients who died in the hospice between the year 2017 and 2018. The complete information including age, gender, date of death, diagnosis, procedures, and medical interventions, as well as the date of documentation, was obtained of each patient. Results A total of 27 patients were enrolled in this study. The mean age at presentation was 50.3 years. 11 (40.7%) patients received oncological treatment integrated with palliative care in the last month of life. The median duration of survival from diagnosis till death was 7 months in the patients who received only palliative care and 10 months in patients who received integrated onco-palliative care in the last month of life (P=0.452). 14 (51.8%) patients received early palliative care. The median survival of the patients who received early palliative care and of those who were offered palliative care towards the end of life was 8.5 months and 7 months respectively (P=0.040). Conclusion Based on our results, we strongly believe that early palliative care when integrated into standard oncological treatment in advance stage cancer patients can prolong patient's survival. PO-1253 Stereotactic Ablative Radiotherapy for spinal metastases: Experience at a Brazilian Institution G. Marta 1 , F. Miranda 1 , A. Silva 1 , S. Hanna 1 , W. Neves Jr 1 , F. De Arruda 1 , A. Mancini 1 , R. Gadia 1 , F. Moraes 2 1 Hospital Sírio-Libanês, Radiation Oncology, Sao Paulo, Brazil ; 2 Kingston Health Sciences Center- Queen's University, Radiation Oncology, Kingston, Canada

In the last decade, stereotactic ablative radiotherapy (SABR) has arisen as an optimal treatment option for either oligometastatic and oligoprogressing patients with spine metastases. SABR allows the delivery of high-dose radiation to the specific target volume while sparing nearby organs at risk and increases the therapeutic ratio. This study aims to assess the clinical outcomes (local control and pain control, adverse events and overall survival) of patients with spine metastases who underwent SABR as part of their treatment scheme at a Between November 2010 and September 2018, we reviewed patients with spine metastasis treated with SABR in our department (Hospital Sírio- Libanês, Sao Paulo, Brazil). Spine SABR was performed in patients with oligometastases in different settings: radical (SABR only), postoperative (after decompression and/or fixation surgery) and reirradiation. We considered gastrointestinal, renal, sarcoma, melanoma and thyroid metastases as radioresistant tumors. Demographic, clinical and imaging data were obtained from the electronic medical records. Adverse events and local and pain control (failures) were defined as per available guidelines. Results 97 patients with spine metastases were included. The median age was 59 years (range 23 to 91). Most patients (82.3%, n=80) received SABR as the first local bone treatment while 12 patients (12%) underwent fixation and/or decompression surgery prior to SABR. Most common used SABR dose were 1x18Gy (24.5%) and 1x16Gy (20.2%). Fifty patients (51.6%) presented with radioresistant tumors. Two-year overall survival rate was 74.1% and median survival was 19 months. The local control rate at 2-year was 72.3%. In regards to pain control, 83.3% of patients had a complete response; 12.1%, partial response. Only 8.5% of patients developed failure pain during the clinical follow-up. Logistic regression for pain control at last follow-up did not demonstrate statistically significant differences among variables (ECOG-PS, tumor type, clinical settings and paraspinal mass, treatment dose). Vertebral compression fractures occurred in 10 patients (10.3%), of which, 5 cases in the reirradiation setting. Radiculopathy and myelopathy were not observed. Similarly, no grades III or IV toxicities This is the first study presenting a Brazilian experience with spine SABR and the results confirm its feasibility and safety. SABR was shown to produce good local and pain control rates with low adverse events rates. PO-1254 Palliative QUAD shots with chemotherapy in advanced Head and Neck Cancer: Is it the way to go? P. Tejaswi 1 , S. Sunkappa Dayashankara 2 , J. Kunigal Puttaswamy 2 , T. Boraiah 2 , N. Ramanand 2 , A. Katke 2 1 Mysore Medical College and Research Institute, Department of Radiation Oncology, Mysore, India ; 2 Kidwai Memorial Institute of Oncology, Department of Radiation Oncology, Bangalore, India Purpose or Objective To evaluate the feasibility and outcome of optimal response for palliation of symptoms, quality of life and toxicity using quad shots along with chemotherapy in advanced head and neck cancer patients who are not fit This study included 65 patients of Stage IV histologically proven squamous cell carcinoma of head and neck after multidisciplinary committee approval. Informed consent is taken from all patients for this study. On day 1, baseline symptoms and quality of life is documented followed by which concurrent radiosensitising agent Carboplatin (AUC2) administered only on day 1 and within 2-4 hours of Brazilian Institution. Material and Methods were seen. Conclusion for radical treatment. Material and Methods

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