Abstract Book

S897

ESTRO 37

EP-1669 Radiochemotherapy in locally advanced pancreatic cancer: an aged-based analysis C. Rinaldi 1 , M. Fiore 1 , B. Floreno 1 , P. Trecca 1 , R. Coppola 1 , L. Trodella 1 , R.M. D'Angelillo 1 , S. Ramella 1 1 Campus Biomedico University, Department of Radiation Oncology, Roma, Italy Purpose or Objective The purpose of this analysis is to evaluate the feasibility and efficacy of concurrent radiochemotherapy (RCT) with or without induction chemotherapy for elderly patients with locally advanced pancreatic cancer (LAPC). Material and Methods A total of 52 patients enrolled in mono-institutional prospective studies were included. All patients were treated with gemcitabine-based RCT. Of these, 31 patients were treated with induction chemotherapy (GemOx or FOLFIRINOX). The radiation therapy total dose was 54-59.4 Gy with conventional fractionation. We stratified population into two groups: the first included patients aged <70 years, the second one those aged ≥70 years. Overall survival (OS), progression-free survival (PFS), local control (LC) and toxicity rates were recorded. Results Thirty-seven patients aged <70 years (mean age 61 years) and 15 patients aged ≥70 years (mean age 74 years) were evaluated. Nineteen patients (51%) of the first group underwent radical surgery compared with five patients (33.3%) of the second group. Only 11 patients (57.9%) aged <70 years were treated with adjuvant chemotherapy. Median OS and 1-yr OS were 21.5 months and 83% in patients <70 years and 11.5 months and 40% in those ≥70 years (p<0.01). Median PFS was significantly higher in the younger group (19.4 months vs 9.9 months; p<0.05). LC was high in both groups (1-yr LC 87% vs 88%). For the entire cohort, the treatment protocol was well tolerated with no significant difference in grade 3 or 4 acute toxicities between the groups. Conclusion These data suggest that RCT has a role in the management of elderly patients with LAPC. Nevertheless, strategies to optimize local control and patients’ selection for the combined approach may play an increasing role in improving outcomes. EP-1670 Feasibility of High Dose Hypofractionated Radiotherapy in Older Patients with Gynaecological Cancer G. Imseeh 1 , A. Taylor 1 1 Royal Marsden Hospital Trust & Institute of Cancer Research, Department of Imaging and Radiotherapy, London, United Kingdom Purpose or Objective Locally advanced and recurrent gynaecological cancers are a frequent cause of pelvic morbidity including bleeding and pain. For some patients, radical treatment is inappropriate due to frailty or patient choice. Attending hospital daily can be difficult and alternative regimens may be more acceptable to patients. The aim of this retrospective study is to assess the tolerability and efficacy of high dose hypofractionated palliative radiotherapy in treating gynaecological cancers. Material and Methods Using electronic patient records, we retrospectively identified patients who received palliative radiotherapy for a primary or locally recurrent gynaecological malignancy between July 2011 and December 2016.

Analysis was restricted to patients who were aged ≥ 65 and planned to receive a total radiation dose of >25 Gy in >4 Gy per fraction. Data was collected and analysed on patient outcomes including symptom control, toxicity and survival. Results 25 patients were included in our analysis with a median age of 83 (range 67 – 101). Treated tumours by subsite were 12 endometrial, 6 cervical, 5 vaginal and 2 vulval. 1 patient had distant disease at time of treatment. The commonest presenting symptom was post menopausal bleeding (84%) followed by pain (8%). 7 patients (28%) had a baseline performance status (PS) of 1 and 15 patients (60%) had a PS 2. Radiotherapy was planned and delivered conformally in 23 patients (92%). The most frequent fractionation regime was 30Gy in 6 fractions delivered twice a week over 3 weeks (84%) with a median delivered dose of 30Gy (27 – 30). 23 patients (92%) completed their treatment as planned. 68% of patients experienced grade 1 - 2 toxicities, mainly diarrhoea (48%). Only 2 patients (8%) experienced grade 3 – 4 toxicities; both were grade 3 diarrhoea where 1 was managed conservatively and completed treatment and another discontinued treatment as a result. 23 patients (92%) had documented symptomatic relief at follow up with resolution of bleeding and/or reduction in pain. 3 patients were lost to follow up and two patients were still alive at time of analysis. Although not all patients had further imaging later in their disease course, 18 had a documented progression date with a median progression free survival of 9.0 months (0.2 – 22.9). Estimated median overall survival was 14.8 months (0.1 – 31.6). Conclusion High dose hypofractionated palliative radiotherapy provides an effective and convenient treatment option for patients who are not suitable for radical therapy. It is effective at symptom control, is well tolerated and can potentially provide durable disease control. EP-1671 Inappropriate Radiologic Staging Examinations in Early-Stage Breast Cancer: A cost assessment T. Hijal 1 , H. Habibullah 2 , S. Rahman 2 , H. Almarzouki 2 , C. Freeman 1 , B. Gallix 3 1 Cedars Cancer Centre - McGill University Health Centre, Radiation Oncology, Montréal, Canada 2 McGill University, Radiation Oncology, Montréal, Canada 3 McGill University, Radiology, Montréal, Canada Purpose or Objective Cancer staging is essential before the initiation of therapy. A sizeable proportion of patients undergoes unnecessary staging tests, which are costly. This study seeks to quantify the cost of such unnecessary tests in patients with early-stage breast cancer in the province of Québec, Canada. Material and Methods All patients diagnosed with breast cancer between 2012 and 2014 at the McGill University Health Centre were included in this retrospective study. For each patient, the type and number of unnecessary staging tests, as per national guidelines, was extracted from the medical chart. The cost of each was obtained from Quebec Electronic Poster: Clinical track: Health services research / health economics