Abstract Book

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ESTRO 37

was reported as valuable, medical oncologists were frequently not open to giving radiation oncologists autonomy in providing an independent assessment of end- of-life care options. A proposed model of integrated palliative care consultation at the time of palliative radiation was met with skepticism given concern over the lack of medical oncology input into involvement of this additional service. Radiation oncologists’ fear of upsetting medical oncologists was felt to be justified if radiation oncologists discussed end-of-life planning without prior communication or alignment with the medical oncologists’ end-of-life care plan.

Palliation of cancer-related symptoms and toxicity were prospectively evaluated according to CTCAEv4 criteria. Results From July 2015 to October 2017, 19 patients were treated by the reported schedule. Median age was 85 (63- 89). Stage of cancer were: 38% stage IIB, 15% stage IIIA. 15% stage IIIB and 32% stage IIIC. All patients were able to complete the entire hypofractionated radiotherapy schedule. Median follow up was 6 months (1-18), local control was 86% and palliation of cancer-related symptoms was 100%. 5 patients (26%) had grade I acute gastrointestinal toxicity and 4 patients (21%) grade II. No toxicities Grade ≥ 3 were described. Conclusion Preliminary data shows that this radiotherapy schedule is a clinically viable option for unresectable tumours of the esophagogastric junction or gastric adenocarcinoma to achieve significant palliation of the main presenting symptoms like bleeding and dysphagia. EP-1653 Prognostic factors in stereotactic body radiotherapy to bony oligometastatses from solid tumors. W.H. Mui 1 , S.F. Nyaw 1 , M.Y.P. Wong 1 , R.W.K. Leung 1 , F.C.S. Wong 1 1 Tuen Mun Hospital, Clinical Oncology, New Territories, Hong Kong SAR China Purpose or Objective There is robust data showing promising treatment results in terms of local control, progression free survival and overall survival by the use of Stereotactic Body Radiotherapy(SBRT) as ablative therapy for oligometastatic disease in general. However prognostic factors are less well studied in treating oligometastatic bony disease not only limited to the spine by SBRT. Material and Methods A retrospective review of the treatment outcomes of patients who received SBRT to bony oligometastatic sites in our department since 2005 is conducted. Local, systemic disease control and their survival were assessed against different prognostic factors including age, performance status, synchronous or metachronous metastasis, immediate systemic therapy (including chemotherapy, targeted or hormonal therapy), bone only disease or others, whether all disease sites were treated by ablative therapy, PTV volume and various planning parameters including higher D95(BED10> 51.3Gy = 27Gy/3Frs for non-spinal lesion), achievable V100≥ 90% and D90≥ 99%. Results The treatment outcome of 25 patients and 28 lesions was studied. 23(92%) patients had follow-up imaging with CT, PET, MRI or bone scan. The performance status (ECOG) of 22(88%) patients was 1, 5(20%) patients had other sites of disease apart from bone, 8 (28.6%) lesions were non- spinal lesions. Altogether, 20 (80%) patients received ablative therapy, including SBRT, to all involved disease sites, 21(84%) patients received immediate systemic therapy before or after SBRT, treatment was mostly well tolerated. The median D95 was 24.3Gy (prescribed dose range: 18Gy –50Gy, in 3 -5Frs); V100≥ 90% and D90≥ 99% were achievable in 89.3% of the patients, Fig 1. Over a median follow-up of 16.3 months, the median overall survival and median local progression free survival(PFS) were not yet reached, whereas the median systemic progression free survival was 25.5 months. The local control and systemic control were 89.3% and 52% respectively, Fig 2. Concerning local control after SBRT,

Conclusion Participation of radiation oncologists in end-of-life care planning was viewed with skepticism by medical oncologists. Radiation oncologists who endeavor to routinely incorporate end-of-life care planning in their practice should focus on open communication with medical oncologists and developing trust around their ability to prognosticate and counsel patients regarding end-of-life options. EP-1652 Moderately hypofractionated radiotherapy for unresectable esophagus-gastric carcinoma. F. Lopez-Campos 1 , E. Carrasco 1 , C. De la Pinta 1 , M. Martín-Martín 1 , M. Martín-Sanchez 1 , J. Domínguez 1 , A. Hervás 1 1 Hospital Ramon y Cajal, Oncología Radioterápica, Madrid, Spain Purpose or Objective A moderately hypofractionated radiotherapy schedule for unresectable esophagus-gastric carcinoma was prospectively evaluated in terms of efficacy, palliation of cancer-related symptoms and acute toxicities. Material and Methods Patients with clinically unresectable tumours of the esophagogastric junction or gastric adenocarcinoma who were not candidates for treatment with chemotherapy were enrolled in this study. The radiation dose was 37,5Gy/15 fractions administered with a three- dimensional conformal radiation technique. The primary endpoint was palliation of cancer-related symptoms. Secondary endpoints included local control and toxicity.