ESTRO 2020 Abstract book

S715 ESTRO 2020

PO-1268 Survival prediction in geriatric patients after radiotherapy of spinal bone metastases T. Bostel 1,2 , T. Sprave 3 , R. Förster 4 , I. Schlampp 5 , S. Akbaba 5 , D. Wollschläger 6 , J. Debus 2,5 , A. Mayer 1 , H. Schmidberger 1 , H. Rief 7 , N.H. Nicolay 2,3 1 University Medical Center Mainz, Radiation Oncology, Mainz, Germany ; 2 German Cancer Research Center DKFZ, Clinical Cooperation Unit Radiation Oncology, Heidelberg, Germany ; 3 Medical Center – University of Freiburg, Radiation Oncology, Freiburg, Germany ; 4 Zurich University Hospital, Radiation Oncology, Zurich, Switzerland ; 5 Heidelberg University Hospital, Radiation Oncology, Heidelberg, Germany ; 6 University Medical Center Mainz, Institute of Medical Biostatistics- Epidemiology and Informatics IMBEI, Mainz, Germany ; 7 Radiotherapy Bonn-Rhein-Sieg BRS, Practice site Bonn, Bonn, Germany Purpose or Objective To date, no reliable score has been established to predict survival in elderly populations with bone metastases. The aim of this retrospective study was to analyze the transferability of established predictive survival scores in geriatric patients after palliative radiotherapy (RT) of spinal bone metastases (SBM). Material and Methods A total of 318 patients 70 years and older (median age 75 years, range 70 - 88) with osteolytic SBM who were irradiated at the University Hospitals of Heidelberg and Mainz as well as at the German Cancer Research Center were included in this large multicenter study. Patients were assigned to one of a total of 4 categories (A - D) according to the definition of the established Bollen score. The required prognostic factors (Karnofsky performance index, primary tumor, presence of cerebral or visceral metastases) were taken from the medical records. The stratification of the study patients into one of the four categories was initially based on a classification of the primary tumors according to their clinical profile (i.e., favorable, moderate or unfavorable) and performance status (i.e., Karnofsky performance score 80-100% vs. < 80%); for patients with a favourable clinical profile, a further subdivision was made depending on the presence or absence of cerebral or visceral metastases. Statistical analysis included Kaplan-Meier survival estimation, log- rank test, and Wilcoxon test. Results The most common tumor entities were NSCLC (n = 117; 37%), renal cell (n = 53; 17%), breast (n = 46; 15%) and colorectal cancer (n = 33; 10%). Median survival and 6- month survival for the total patient population after RT were 5.5 months (95% CI 4.4 - 7.2 months) and 49%, respectively. Median survival in category A was 15.1 months (95% CI 10.0 - 26.5 months), in category B 9.9 months (95% CI 7.3 - 15.3 months), in category C 7.2 months (95% CI 5.8 - 12.3 months) and in category D 3.0 months (95% CI 2.7 - 3.8 months) (p < 0.001, log-rank test). The median survival times of the reference cohort (see Bollen et al., Neuro Oncol. 2014) were 31.2 months, 15.4 months, 4.8 months, and 1.6 months for categories A, B, C, and D. In the Cox regression analysis, significant differences in survival were found in our cohort when comparing category A patients with other groups. Conclusion The current multicenter analysis showed that the established Bollen score for SBM allows a reliable estimation of life expectancy for geriatric patients as well. Therefore, especially for patients with a very poor prognosis (Bollen category D), the use of strongly hypofractionated irradiation protocols is recommended to shorten the duration of hospitalization, since pain control and quality of life are the main therapeutic goals.

(3.1%) registered, eventually solved by Argon Plasma applications, and 1 G3 urinary stenosis (3.1%), solved with temporary catheterization. Late G2 toxicity were 15.6% (5 pts) for urinary tract and 6.2% (2 pts) for the rectum. Fifteen pts were dead at the last follow up, only 5 due to prostate cancer progression. Seven pts experienced biochemical and clinical relapse (2 intermediate, 3 high and 2 very high risk), while 25 pts are free from biochemical progression. The median biochemical relapse- free survival (bRFS) and distant progression-free survival (calculated from the last day of RT) were 64.5 and 70.3 months respectively. Conclusion Radical radiotherapy with a curative intent even in elderly pts shows very good results in terms of both biochemical control and progression-free survival, with a good toxicity profile. In our opinion, radical treatment in elderly pts could improve their life expectation and quality of life. PO-1267 Radiotherapy in octogenarian and nonagenarian gynecologic patients: a monoinstitutional experience C. .T. Delle Curti 1 , B. Pappalardi 2 , F. Piccolo 2 , C. Fallai 2 , A. Cerrotta 2 1 University Milano-Bicocca, Radiotherapy, Monza, Italy ; 2 Fondazione IRCCS Istituo Nazionale dei Tumori, Radiotherapy 2, Milan, Italy Purpose or Objective The objective of this retrospective study was to evaluate the feasibility of radiotherapy (RT) in elderly patients with We retrospectively reviewed the outcomes of 30 consecutive ≥ 79 years old patients with gynecologic cancer (15 uterine cancers, 13 vulvar cancers and 2 vaginal cancers) who were consecutively treated with RT in our institution. All patients were evaluated using the G8 screening tool. Results Overall, patient median age was 84.2 years (range: 79- 98, DS: 5.47) and patient median Karnofsky performance status (KPS) was 70 ( range: 50- 90, DS: 10.1) with a G8 score ranged from 4.5 to 12.5 ( median 9.8, DS 2.0). External beam RT was performed in a palliative setting (n = 17; 57%), with a volumetric arc therapy (VMAT). The mainly VMAT schedule was 39 Gy/13 fractions that provides effective and efficient palliation of symptoms with an overall response rate for bleeding of 100% during the treatment and an overall response of pain and itch of 100% after 2 months from the end of RT. Early treatment interruptions were needed in 2 patients for cognitive and clinical deterioration. 13 patients underwent to brachytherapy (BT) for curative, palliative and adjuvant purpose with a median dose of 21 Gy (range: 14-42 Gy, DS: 7.2) and a median number of fractions of 3 (range: 2-7). Interruption of BT treatment was needed for a women affected by vaginal adenocarcinoma due to surgical wound dehiscence. Overall, both for VMAT and BT were reported infrequent major acute toxicities (