Abstract Book

S687

ESTRO 37

The grade of oral mucositis was scored on the WHO scale. The pain was scored using the NRS scale. The need for IV opioids was recorded (yes/no). The median number of days the patients used enteral and/or parental nutrition (patients could use both on the same day), and the median number of days from BMT to discharge from hospital, was recorded. The statistical significance was determined with the N-1 chi-squared test for the use of IV opioids and the Mann- Whitney test for the other parameters. Results Results are listed for the TBI3/TBI6 patients. The average mucositis grade of mucositis is shown in figure 1. Figure 1: Mucositis grade in the 21 days following bone marrow transplant for the patients who received 12 Gy TBI in 3 days in 3 (n=32) or 6 (n=33) fractions. The median oral mucositis grades were 2.0/1.3, p =0.01. The median pain scores were 4.8 /3.8, p=0.01. IV morphine was required for 68% of the TBI3 patients and 41% of the TBI6 patients, p=0.03. The median number of days for which the patients required enteral nutrition were 13.0/21.0 days, p=0.01. The median number of days for which the patients required parenteral nutrition were 15.0/9.5 days, p=0.01. The median days to discharge week 28/25, with a p-value of 0.02. Conclusion Patients given 6 rather than 3 fractions of TBI, delivering the same overall dose in the same overall time, had a statistically significantly lower grade of oral mucositis, less pain and less need for IV opioids. They required parenteral nutrition for statistically significantly fewer days, and enteral nutrition for more. The number of days from BMT to discharge from hospital was statistically significantly less. The use of 6 fractions rather than 3 statistically significantly reduces the early toxicity in TBI patients. EP-1241 Assessment of Quality of Life in Elderly and young DLBCL: Risk Parameters and clinical outcomes V. Pareek 1 , R. Bhalavat 1 , M. Chandra 1 , L. Nellore 1 , K. George 1 , D. Borade 1 , K. Kalariya 1 , Z. Moosa 1 , R. Navaneeth 1 , S. Amrita 1 , A. Kapoor 1 , C. Bakshi 2 1 Jupiter Hospital, Radiation Oncology, Mumbai, India 2 Jupiter Hospital, Medical Oncology, Mumbai, India Purpose or Objective DLBCL is the most common type of aggressive B cell NHL. The objective of this study was to compare health related quality of life (HRQOL) between diffuse large B cell lymphoma (DLBCL) survivors of different age categories and to compare their HRQOL with an age- and sex- matched normative population. Material and Methods From the medical records of Jupiter Hospital, all patients diagnosed with DLBCL from 2009 to 2016 were enrolled for the evaluation. Patients (n = 175) were invited to complete the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) questionnaire. Data from an age- and sex-matched normative population (n = 155) were used for comparison. Results After a median follow up of 40 months, DLBCL survivors aged 18–59 years scored better on physical functioning, quality of life, appetite loss and gastrointestinal functioning than survivors of 76– 85 years old (p < 0.005). Financial problems more often occurred in survivors aged 18–59 years compared to survivors of 76–85 years old (p < 0.01). Compared to the normative population, DLBCL survivors aged 18–59 years showed worse scores on cognitive and social functioning and on dyspnea and financial problems (p <0.01). In survivors of the other age

categories, only differences with trivial or small-size effects were found. Conclusion There was significant difference in the affected quality of life in younger population compared to the normative population. The younger DLBCL survivors have better HRQOL than older survivors. DLBCL has a greater impact on younger than older survivors and that the worse HRQOL observed is caused by age and the disease impact on the quality outcome is minimal. EP-1242 Prognostic role of PET/CT in DLBCL - assessment of Deauville criteria and SUV max V. Pareek 1 , R. Bhalavat 1 , M. Chandra 1 , C. Bakshi 2 , R. Kanbur 3 1 Jupiter Hospital, Radiation Oncology, Mumbai, India 2 Jupiter Hospital, Medical Oncology, Mumbai, India 3 Jupiter Hospital, Nuclear Medicine, Mumbai, India Purpose or Objective PET/CT role as therapeutic strategies in diffuse large B- cell lymphoma (DLBCL) is controversial as the interpretation may vary between the observer across various centers. This study aims to assess the prognostic value of PET/CT using the Deauville criteria and ΔSUVmax. Material and Methods Between 2013 and 2016, 38 patients were evaluated with newly diagnosed DLBCL treated with a rituximab- containing regimen. These patients underwent ¹ ⁸ F- FDG PET/CT at baseline (PET0) and after three cycles (PET3), with no therapy change based on the latter scan. These scans were interpreted by three observers using the Deauville five-point scale and ΔSUVmax between PET0 and PET3 was calculated. Interpretations were evaluated for interobserver agreement and for progression-free survival (PFS) prediction. Results Median follow-up was 18 months. PET/CT was predictive of outcome when interpreted with the Deauville criteria and ΔSUVmax. Using the five-point scale, the overall kappa value was 0.72 with the reference background set in the liver (score ≥4) and interobserver agreement was even better using a 68% ΔSUVmax cut-off (κ = 0.81). Moreover, the prognostic value of interim PET was slightly inferior when using a Deauville score ≥4 than when using a 66% ΔSUVmax cut-off: for the Deauville score the 3-year PFS estimate was 65% (50- 78%) in PET3-positive patients vs. 80% (73-89%) in PET3- negative patients (P = 0.002); for the 66% ΔSUVmax cut- off the 3-year PFS estimate was 48% (36-64%) in PET3- positive patients vs. 77% (68-86%) in PET3-negative patients (P = 0.001). Conclusion The Deauville criteria are validated as assessment tool for prognostic value in DLBCL, the role of SUV max cannot be undermined. The SUV max can lead to better performance and reproducibility and should be preferred in cases where baseline PET/ CT scans are available. EP-1243 DIBH and IMRT for gastric MALToma: Dosimetric evaluation using comprehensive plan quality index S.H. Choi 1 , S.H. Park 1 , J.J.B. Lee 1 , J.G. Baek 1 , J.S. Kim 1 , H.I. Yoon 1 1 Yonsei University, Radiation Oncology, SEOUL, Korea Republic of Purpose or Objective Although there are many attempts to raise the therapeutic ratio of radiotherapy in Gastric Mucosa- Associated Lymphoid Tissue lymphoma (MALToma), only a few planning studies reported about the modern