Abstract Book

S895

ESTRO 37

modality treatment or in combination with surgery and/or chemotherapy. Irradiation was delivered by megavoltage external-beam RT with conventional fractionation, hypofractionated RT based on stereotactic technique, or proton therapy. RT dose ranged between 22 and 70 Gy (median 50 Gy) and was delivered to different targets depending on tumor and treatment aim and setting. Treatment-related severe (G ≥ 3) toxicity was reported in 4 out of 9 studies (total number of patients: 109) with 24 cases of acute toxicity (22.0%) and 3 cases of late toxicity (2.8%). When considering outcome in all patient group, overall survival ranged from 6.4 to 69 months (median 22.6 months) in patients who received radiation treatment, and from 14.3 to 31.3 months (median 24.2 months) in patients who were not radio- treated. Median 2-years survival rates were 49% (range 6.6-75.5%) and 50.4% (range 31-58%) respectively. Anyway, considering only studies comparing RT-treated and non-RT-treated patients, median survival and 2-years survival were 28.3 months (range 22.6-69), and 56% (range 49-75.5%) respectively in treated patients versus 24.2 months (range 14.3-31.2, p=0.200) and 50.4% (range 31-58%, p=0.486) in non-treated patients Conclusion RT of upper GI tumors in elderly patients seems to be tolerable and safe, particularly in terms of late toxicity, both alone or combined with other treatment modalities. It may contribute to prolong survival even when other therapies are excluded because of age and/or comorbidities. Further analyses and prospective trials enrolling elderly patients are needed to better define the risk/benefit ratio in this relevant group of neoplasms EP-1665 Protontherapy for intracranical and skull base tumors in elderly patients D. Scartoni 1 , D. Amelio 1 , S. Lorentini 1 , L. Widesott 1 , R. Righetto 1 , I. Giacomelli 1 , M. Cianchetti 1 , M. Schwarz 1 , M. Amichetti 1 1 Centro di Protonterapia, Protontherapy, Trento, Italy Purpose or Objective To report preliminary results of active beam scanning proton therapy (PT) for intracranical and skull base tumors in elderly patients (pts). Material and Methods Twenty-six elderly patients (age: ≥ 70 years) were treated with PT between January 2015 and February 2017. Median age was 76 years (range, 70-87) while KPS ranged between 60 and 100 (median, 90); 14 were female (53%) and 12 were male (47%). Fifteen (61%) patients were treated for a meningioma; three (12%) pts for a high grade glioma; three (12%) pts for a chordoma; one pts (3%) for a low grade glioma; one (3%) pts for a well- differentiated neuroendocrine carcinoma; one (3%) pts for a paragaglioma; one (3%) pts for a vestibular schwannoma and one (3%) pts for an anaplastic hemangioperycitoma. All the treatments were delivered at 1.8-2 GyRBE per fraction with a median total dose of 54 GyRBE (range 50-72 GyRBE). All pts were treated with active beam scanning PT using 3-4 fields with single field optimization technique. Treatment planning was based on morphological magnetic resonance imaging (MRI) with contrast enhancement medium administration, CT and PET images. Toxicity was assessed according to Common Terminology Criteria for Adverse Events version 4.0. Mean follow-up time was 8 months (range, 3-25). Results All pts completed the treatment without breaks. One pts discontinued the treatment because of tumor

progression. Registered acute side effects include grade 1 (12%) and grade 2 (50%) skin erythema, grade 1 (3%) and grade 2 (50%) alopecia, grade 1 (42%) fatigue, grade 1 (12%) and grade 2 (7%) conjunctivitis, grade 1 (3%) and grade 2 (38%) pain, grade 1 (7%) and grade 2 (20%) headache, grade 1 (7%) and grade 2 (7%) skin hyperpigmentation. There were no grade 3 or higher acute toxicities. Registered late side effects include grade 1 (7%) and grade 2 (46%) alopecia, grade 1 (15%) fatigue, grade 1 (12%) headache, and grade 1 (3%) skin hyperpigmentation. There were no grade 3 or higher late toxicities. Conclusion PT is feasible and safe treatment for elderly pts with intracranical and skull base tumors. Longer follow-up is necessary to assess definitive efficacy. EP-1666 Elderly patients with head and neck cancer and the benefit of curative-intent treatment M. Núñez Fernández 1 , A. Folgar Torres 2 , E. Mur Restoy 1 , M. Galdeano Rubio 2 , M. Bonet Beltrán 3 , J.M. Solé Monné 1 1 Consorci Sanitari de Terrassa. Hospital de Terrassa, Radiation Oncology Department, Terrassa, Spain 2 Consorci Sanitari de Terrassa. Hospital Sant Joan de Dèu de Manresa, Radiation Oncology Department, Manresa, Spain 3 Hospital Universitari Sant Joan de Reus, Radiation Oncology Department, Reus, Spain Purpose or Objective To assess the tolerability, feasibility and response of radical or postoperative radiation therapy in elderly patients diagnosed with head and neck cancer. Material and Methods Retrospective analysis of patients 70 years or older, diagnosed with head and neck squamous cell carcinoma (HNSCC) who were treated in a single institution between May 2013 and December 2016 with radiotherapy (RT), chemo-radiotherapy (CRT) or cetuximab-radiotherapy (bioRT) in radical or postoperative setting. Acute toxicity was assessed by the Common Terminology Criteria for Adverse Events version 4.0 scale and the overall survival (OS) were compared using the log-rank test. Results 81 patients with a mean age of 78 years were included with a median follow-up of 15 months. The most frequent primary site were larynx (44%), followed by oral cavity (17%) and salivary glands (11%). 75% were stage III or IV M0 as defined by American Joint Committee on Cancer criteria version 7. 53% were treated with radical intent and 47% postoperatively. 65% received RT, 19% CRT and 16% bioRT. The most frequent total dose for patients treated with radical intent was 69,96-70 Gy/33-35 daily fractions (79%) and 60-66 Gy/30-33 daily fractions (80%) in the postoperative setting. The 75% of patients were treated with 3D-conformal RT and the image-guided RT were cone-beam-CT with or without Hexapod system in 57% of patients. There were no G4 or G5 toxicity. The most frequent acute toxicities were G1-2 and G3 toxicities were oral mucositis (17%), dermatitis (9%), dysphagia (6%), skin pain (4%), oral pain (3%) and cheilitis (1%). At last follow-up, 55 patients (68%) were alive and 26 (32%) died. In terms of disease control, 83% of patients had no evidence or stable disease, however 16% had progression. In subgroup of patients treated with radical intent, 74% had a complete response and 9% had a stable disease.