ESTRO 2020 Abstract book

S733 ESTRO 2020

yrs)].Brain tumor,GI tumor,oligo-metastasis,lung cancer and GU tumor were 207(56%),61(17%), 65(18%),9(3%) and 9(3%) pt respectively.Amongst brain tumors,47(13%) were meningioma,42(11%) AN,35(9%) AVM and 33(9%)brain metastasis.50(14%) was HCC,11(3%) glomus tumor and only 9(3%) were prostate cancer pt. Amongst rare tumors,7(2%) were brainstem cavernoma, 2 cases each of eye tumors, cholangiocarcinoma, pancreatic cancer.AVM dose18- 24Gy/1fr, meningioma & AN 12Gy/1fr. Lung cancer dose 45Gy/3fr, HCC 45Gy/5fr, prostate 36.25Gy/5fr. Results Among 35 AVMs, 2 had acute edema requiring admission and supportive care, 6 pts required steroids for >1 month.In AN pts, 4 required steroid >3 months. 1 pituitary tumor pt had acute steroid insufficency.9 of 213(4%) of brain tumor pts required admission after CK. No treatment related death or permanent neurodeficit.Among 34 brain metastasis,15(44%) had controlled disease at last follow up [Estimated OS 284 days (95%CI: 234-328; SEM: 22.5); >6 month actuarial OS 89%].29.4%(10/34) had intra-cranial progression,18%(6/34) pts had new lesions and 12%(4/34) had recurrence within high dose region.Among,41 HCC with PVT accrued in the study till date [mean age 61.4 yrs (38-76 yrs),98% male;Child Pugh A 61%,B 34%;BCLC C 95% & D 5%; PS0-1:71%, KPS>80: 83%; co-morbidities 39%; infective 15%, Alcohol intake 24%].Pts presented with abdominal pain (39%), ascitis (17%), fatigue(7%), and melena(7%).Mean follow up was 30.8 weeks(SD 25.8; range 2-107 weeks).Mean actuarial OS was 52.1 wks(95%CI: 38.4- 65.5 wks).6 month & 12 months actuarial OS 65% and 48% respectively.At last follow up,22/41(54%) were alive and 19/41(46%) expired with disease progression.Among 34 pts evaluable for response assessment, 18(45%) had complete PVT.At last follow up, among 22 pts alive 9 (22%) had stable disease and 13(32%) had progressive disease.Among 19 pts expired,15(85%) due to local progression,4 (15%) due to metastasis.No death due to classical RILD.19/41(46%) patients had radiologically confirmed re- canalization[18 in PVT & 1 in IVC]..Mild GI toxicities (Gr-1- II) in 12(29%), fatigue(Gr II-III) in 20(48%) and grade III GI toxicity in 2(5%) patient.2(5%) pt had decompensation(<4wk) after treatment.108 fiducials were placed in 36 pts. Post-fiducial pain score 0-1 in 26(72%) and score 3-4 in 2(6%).5(14%) admitted in 'day-care'(2 mild pneumothorax, 3 pain).1 pt(3%) admitted for hemothorax and died. Conclusion Early symptomatic toxicities after CK <5%.Post-CK edema requiring long-term steroid is in 8% and admission required in 4% pts.Recurrence rate after brain metastasis SRS is 29% at 6 month follow up.HCC with PVT response is 40% at 2 month post-CK assessment. PO-1299 Prospective clinical evaluation of feasibility and patient acceptance of MR-guided radiotherapy S. Klüter 1 , S. Katayama 1 , C.K. Spindeldreier 1 , S.A. Koerber 1 , G. Major 1 , M. Alber 1 , J. Debus 1 , J. Hörner- Rieber 1 1 University Hospital Heidelberg, Radiation Oncology, Heidelberg, Germany Purpose or Objective MR-guided radiotherapy (MRgRT) has recently been introduced in our institution. As, compared to standard treatment techniques, MRgRT requires high patient compliance and can be associated with prolonged treatment times, feasibility and patient tolerance were prospectively assessed using patient-reported outcome Forty-three patients were enrolled in a prospective observational study and treated with MRgRT on a low-field MR-Linac between April 2018 and April 2019. For assistance in gated breath-hold delivery using cine-MRI, a video feedback system was installed. PRO-Qs consisted of questionnaires (PRO-Q). Material and Methods

country since the onset of the Syrian Civil War in 2011. Turkey, which shares a large land border with Syria, is hosting 3.6 million of these registered refugees, far more than any other country. While a number of prior studies reported different healthcare outcomes in this population, there has been no comprehensive study focusing on cancer care. The purpose of this study was to evaluate baseline characteristics of Syrian refugees living in Turkey who are diagnosed with cancer and assess rates of radiotherapy utilization and compliance. Material and Methods We performed a retrospective review of 12 institutional databases to identify Syrian refugee patients in Turkey with a cancer diagnosis from 2015 to 2018. We then identified those patients treated with radiation therapy (RT) and surveyed the demographic data, clinical outcomes, and treatment compliance rates. Patients younger than 18 years old were excluded. Treatment centers were organized by geographic location (e.g. Syrian border cities or elsewhere), and patients were categorized by residence (e.g. refugee camp or house). Patients who missed 2 or more scheduled RT appointments (excluding planned treatment breaks) were deemed “noncompliant.” Chi-squared and Fisher’s exact tests were used to compare variables. Results We identified 18,115 Syrian refugee patients diagnosed with cancer during the study period. A total of 811 of these patients (4.5%) were treated with RT. Median age was 49 years (range, 19 – 94), and 54% of patients were female. Median follow-up was 5.9 months (range, 0 – 36). Forty- two percent of patients were living in a refugee camp and 58% in a house. The most common cancer types were breast (31%), lung (14%), and brain (12%). The majority of patients were diagnosed at an advanced stage (66% Stage III-IV). Concurrent chemoradiotherapy was delivered in 22% of the patients. The majority of patients (83%) were treated in regions in the south and southeast of Turkey closer to the Syrian border. Grade ≥3 acute toxicity was reported in 18% of the patients. In total, 20.3% of patients were deemed “noncompliant”. A statistically significant association was found between noncompliance and residence in a refugee camp (P<0.001), advanced stage (P<0.001), and administration of concurrent chemoradiotherapy (P<0.001); whereas no association was found between noncompliance and treatment length (P=595), Grade ≥3 acute toxicity (P=0.06), history of surgery (P=0.996), gender (P=0.819), and age (P=0.386). Conclusion Although Syrian refugees have access to free cancer screening and treatment, the majority of patients are diagnosed at an advanced stage. Only a small percentage (4.5%) of patients receive RT, with a high rate (20.3%) of noncompliance. Several demographic and clinical factors were significantly associated with noncompliance. These findings may inform future strategies to improve adherence to prescribed therapy. PO-1298 Early outcome & toxicity of 450 consecutive patients treated with CyberKnife: Indian experience A. Gupte 1 , R. Madhavan 1 , H. Nair 1 , A. Sasidharan 1 , S. K 1 , A. R Nair 1 , P. K u 1 , B. Kunheri 1 , R. Holla 2 , D. Dutta 1 1 Amrita Institute of Medical Sciences, Department of Radiation Oncology, Kochi, India ; 2 Amrita Institute of Medical Sciences, Department of Medical Physics, Kochi, India Purpose or Objective Demographic profile, patient parameters, early toxicity and response to treatment assessment of all consecutive patients treated with CyberKnife radiosurgery. Material and Methods 450 consecutive pts treated with CK in an Indian dedicated radiosurgery unit were accrued. 368 pts were evaluable for analysis [male 213(52%), mean age 57(range 4-87