Abstract Book

S915

ESTRO 37

Purpose or Objective Efficacy of low-dose radiotherapy for painful osteo- articular degenerative diseases has been largely probed. We present our results with this approach in a large series of patients. Material and Methods From April 2015 to June 2017, 90 patients (150 different treatments) were enrolled on our protocol. We included 76 women (84%) and 14 men (16%), with a median age of 63 y/o (range 30-89 y/o). Most patients presented with degenerative osteoarthritis (54%), inflammatory bursitis (40%), plantar fasciitis (4%) and dystrophic calcification (2%). Anatomic location was inferior limb in 58% of the patients, being trochanters, knees and feet the most frequent spots (32, 23 and 16 treatments respectively) and superior limb in 42% of the patients, mainly hands in 46 cases, shoulders in 29 cases and elbows in 4 cases. Treatment comprised low-dose radiation up to a total dose of 6Gy (1Gy/fraction) each two days. All patients underwent CT-based simulation. Planning target volume (PTV) contoured on CT scan included painful joint and surrounding periarticular soft tissues. Treatment was delivered in a LINAC and daily verified with orthogonal X- ray. If less than major response was achieved, a second course was delivered after 6-8 weeks. Pre-treatment and post-treatment evaluation of the pain was based on visual analogue pain scale (VAS), requirements of oral analgesic intake and the modified von Pannewitz pain score (MVPPS). Clinical response was evaluated at 6 weeks after treatment and each 3 months thereafter. Results Before treatment, 88% of the patients referred VAS > 6, while only 18% of the patients maintained this VAS after treatment. A second course of radiotherapy when mayor response wasn’t achieved was required in 42% of the cases, and 86% of them achieved VAS < 4 after this second course. The median follow-up was 98 days (range 12-519), and 23% of the patients were monitored for more than 6 months. In these cases, 94% maintained VAS < 5 after long follow-up. Regarding functionality, 59% of the cases referred MVPPS 1-3 and 15% MVPPS 4, but without increasing intake of analgesia. Conclusion Low-dose radiotherapy is an effective and well-tolerated approach for painful degenerative arthropaties, achieving acceptable rates of pain control that seem to be maintained during follow-up and thus contributing to improve the quality of life of these patients. Further follow-up is required for ensuring these promising results. EP-1706 Does hyperlactaemia predict prognosis in cancer patients with sepsis? A retrospective review. S. Raby 1 , J. Weaver 2 , T. Cooksley 3 1 The Christie NHS Foundation Trust, Department of Clincal Oncology, Manchester, United Kingdom 2 The Christie NHS Foundation Trust, Department of Medical Oncology, Manchester, United Kingdom 3 The Christie NHS Foundation Trust, Department of Acute Medicine and Critical Care, Manchester, United Kingdom Purpose or Objective In Emergency Oncology, fever and sepsis is a common presentation. Lactate as a marker of severity and prognosis in sepsis is widely established with even a mild elevation in lactate associated with increased mortality. Measurement of lactate has been incorporated into the recent NICE Sepsis guidelines 2016 as an indicator for risk

stratification. However, the extent to which this is true in patients with malignancies is unknown as baseline lactate may be raised independently of sepsis. There is therefore doubt as to whether lactate is a useful diagnostic and prognostic marker. We sought to analyse if there was a trend between lactate level and mortality in a large UK cancer institute Material and Methods We conducted an audit of oncology patients with an episode of sepsis (neutropenic or non-neutropenic) during admission to a large tertiary referral oncology centre between September 2014 and September 2017. Patients with sepsis were identified on the basis of ICD-10 code. Venous or arterial Lactate levels were collected at time of diagnosis. Patients were divided into groups based on lactate level < 2mmolL -1 , between 2mmolL -1 and 4 mmolL - 1 or ≥ 4mmolL -1 . Lactate levels were correlated to 7-day and 30-day mortality. Fishers exact test was used to compare mortality between groups. Results There were a total of 389 individual patients with a single episode of sepsis between September 2014 and September 2017. 12 patients had a lactate ≥ 4mmolL -1 , 72 patients had a lactate between 2mmolL -1 and 4 mmolL -1 and 305 patients had a lactate < 2mmolL -1 . Mean lactate was 1.2 mmolL -1 , 2.7 mmolL -1 and 6.3 mmolL -1 in each of the respective groups. Baseline characteristics were similar between study populations. Mortality at 7-days and 30 days significantly increased across groups (30 days; 15.3% versus 26.4% versus 66.7%, 7-day; 3.9% versus 12.5% versus 50.0%, admission lactate, < 2mmolL -1 versus between 2mmolL -1 and 4 mmolL -1 versus ≥ 4mmolL -1 ; p < 0.05 for all between group comparisons). Conclusion Hyperlactaemia appears to be a marker of poor prognosis in cancer patients presenting with sepsis. Further analysis of lactate measurement for risk stratification is required. EP-1707 An insight into Bone health in cancer survivors from a developing nation A. Sharma 1 , M. Sharma 2 , M. Upadhyay 1 , M. Surya 3 , S. Sharma 3 , R. Seam 1 1 Indira Gandhi Medical college, Department of Radiotherapy & Oncology, Shimla, India 2 Kamla Nehru Hospital- Indira Gandhi Medical college, Department of Obstetrics & Gynecology, Shimla, India 3 Indira Gandhi Medical college, Department of Radiodiagnosis, Shimla, India Purpose or Objective Cancer and its treatments can have profound effects on bone health. The purpose of our study was evaluated incidence and factors associated with impaired bone health in cancer survivors. Material and Methods A total of 140 cancer survivors enrolled in prospective study evaluating bone health were included. Fracture risk of was evaluated by dual-energy x-ray absorptiometry densitometry (DEXA) scan. Parameters evaluated included T score, Z score, Bone mineral density (BMD) and Bone mineral content (BMC). Risk of fracture was analyzed by age, height, body mass index, weight, type of cancer, treatment by chemotherapy, radiotherapy, hormonal therapy, exercise, performance status and ability to perform house hold activities. Pearson's chi-squared test was use to evaluate factors effecting osteoporosis. A p value of ≤ 0.05 was considered significant. All analyses were performed using the IBM