Abstract Book

ESTRO 37

S370

areas beyond contrast enhancement on MRI, [ 18 F]GE-180 PET represents a promising tool for HGG delineation with a potential influence on radiotherapy planning. As differently pronounced changes of the tumoral TSPO expression could be observed after radiotherapy (up to a nearly complete remission of tumoral TSPO expression), the assessment of TSPO expression with [ 18 F]GE-180 PET might serve as a new imaging biomarker for response assessment in HGG and its impact on patient’s outcome is under investigation in the current study. PO-0724 Brain tumor patients’ psychological profile during RT and its relationship with MRI response L. Dinapoli 1 , S. Chiesa 1 , R. Gatta 1 , S. Bracci 1 , F. Beghella Bartoli 1 , A. Tenore 1 , M.Z. Sanfilippo 1 , M. Massaccesi 1 , V. Valentini 1 , M. Balducci 1 1 Fondazione Policlinico Universitario Agostino Gemelli, Radiation Oncology Department Gemelli-ART, Roma, Italy Purpose or Objective The prevalence rates for depression and anxiety have been found to be as high as 62.5% in adults with brain tumor (BT) and 52% of BT patients experience a significant distress. Radiotherapy has an impact on psychological functioning, immediately and over time. Moreover, non-depressed glioblastoma patients show longer survival than depressed patients. Aim of this study is to evaluate BT patients’ psychological profile, its evolution during/after RT and its relationship with MRI response. Material and Methods Consecutive patients with BT who underwent RT with radical intent were included. Distress Thermometer (DT), Hospital Anxiety and Depression Scale (HADS) and Functional Assessment of Cancer Therapy (FACT-Br) were used to evaluate emotional distress, mood and quality of life, respectively. The tests were self-administered at the beginning (T0), middle (T1), end (T2) of RT course and three months after the end of RT (T3). We also evaluated patients’ MRI after three cycles of adjuvant TMZ. Statistical analysis of tests’ scores was performed by means of Wilcoxon test for paired samples; psychological profile and its relationship with MRI was evaluated by Fisher’s Exact test. Results We recruited 50 patients (27 male 23 female, median age 55, range years 20-79) between January 2016 and April 2017. Radiotherapy was post-operative in all patients and was delivered up to a median total dose of 60 Gy (range 50-66). Thirty-six out of fifty (72%) patients received concurrent chemotherapy with Temozolomide (TMZ). All patients underwent the T0, T1 and T2 evaluation. Tests after three months (T3) are available for 43 (86%) patients. In patients with 'psychological wellbeing” at T0 (DT<4;HADS<14) there is no significant statistical evidence of any change over time. In patients who were distressed and anxious/depressed ('uneasy” patients)(DT≥4 and/or HADS≥14)(N=30) we found a statistically significant improvement in DT when comparing T0 vs T3 and T1 vs T3 (p<0.001)(Figure1). Even emotional and functional wellbeing subscales of FACT-Br improved over time (T0 Vs T3) (p<0.001). Analyzing MRI after three cycles of adjuvant TMZ we found that most patients with 'psychological wellbeing” at T0 had a good response at MRI (15 Stable Disease-SD, No Evident Disease-NED, or Partial Response–PR vs 1 Disease Progression-DP). On the other hand 'uneasy” patients were balanced (9 SD, NED, or PR vs 10 DP). Distributions were analyzed by means of Fisher’s Exact test (p<0.004) (Figure 2).

Conclusion In this series of BT patients, 'uneasy” patients improved over time in DT scores and functional/emotional wellbeing, whereas patients with 'psychological wellbeing” remained stable over time. Moreover, almost all these patients have good MRI response after three cycles of TMZ, when compared with "uneasy" patients. These results encourage the implementation and validation of a psychological support during RT in BT patients. PO-0725 Neutrophil-to-lymphocyte ratio as a predictor of overall survival in brain metastases following SRS M. Chowdhary 1 , J. Switchenko 2 , R. Abrams 1 , D. Wang 1 , G. Marwaha 1 , P. Blumenfeld 1 , R. Press 2 , J. Jhaveri 2 , J. Olson 2 , H.K. Shu 2 , W. Curran 2 , K. Patel 3 1 Rush University Medical Center, Radiation Oncology, Chicago, USA 2 Emory University School of Medicine, Radiation Oncology, Atlanta, USA 3 Yale School of Medicine, Therapeutic Radiology, New Haven, USA Purpose or Objective Systemic inflammation is known to play an important role in the progression of cancer. Specifically, an increase in the neutrophil-to-lymphocyte ratio (NLR) has been associated with shorter survival in patients with various malignancies, though its effect has not been fully elucidated in brain metastases (BM). Tumors treated with stereotactic radiosurgery (SRS) can result in a leukocyte predominant inflammatory response. The aim of this study is to investigate if NLR is associated with outcomes in patients with BM who are treated with SRS. Material and Methods After IRB approval, patients (pts) with BM from any histology treated with SRS from 2003-2015 were retrospectively identified. NLR was calculated from the most recent full blood counts obtained following SRS. Overall survival (OS) and intracranial outcomes were