ESTRO 2020 Abstract Book

S628 ESTRO 2020

Corsini 15 , L. Livi 16 , E. Garibaldi 17 , M. Tartarelli 1 , C.L. Deatoni 18 , A. Baiguini 1 , F. Bertoni 2 , S.M. Magrini 1 1 University and Spedali Civili di Brescia, Radiotherapy Unit, Brescia, Italy ; 2 University of Modena – AOU Policlinico di Modena, Radiation Oncology Department, Modena, Italy ; 3 San Donato Hospital, Radiation Oncology Department, Arezzo, Italy ; 4 ASST, Spedali Civili, Brescia, Italy ; 5 ARNAS Civico Hospital, adiation Oncology Unit, Palermo, Italy ; 6 Ospedale San Jacopo, Department of Radiation Oncology, Pistoia, Italy ; 7 Policlinico Umberto I- Sapienza University of Rome, Radiation Oncology, Roma, Italy ; 8 S. Andrea Hospital- Sapienza University of Rome, Radiation Oncology, Roma, Italy ; 9 IRCCS MultiMedica, IRCCS MultiMedica, Sesto San Giovanni, Italy ; 10 Ospedale Sant’Anna, Department of Radiotherapy, Como, Italy ; 11 Azienda USL Toscana- Centro- Ospedale S. Maria Annunziata, Department of Radiation Oncology, Firenza, Italy ; 12 Fondazione Policlinico Universitario A. Gemelli – UCSC, Radiation Oncology, Roma, Italy ; 13 Istituto Clinico Humanitas- Humanitas Cancer Center, Radiation Oncology, Milano, Italy ; 14 Istituto Nazionale Tumori-IRCCS-G. Pascale Foundation, Radiation Oncology, Napoli, Italy ; 15 AUSL6, Radioterapia, Livorno, Italy ; 16 AUO Careggi, DAI Oncologia, Firenze, Italy ; 17 IRCCS Candiolo, Radiation Oncology, Torino, Italy ; 18 IRCCS San Raffaele Scientific Institute, Department of Radiation Oncology, Milano, Italy Purpose or Objective To describe early results of the analysis of the tolerability of elective pelvic node irradiation (ENI) with or without androgen deprivation therapy (ADT) in patients (pts) with intermediate/high/very high-risk prostate cancer (PC) enrolled in the PRO-EPI study Material and Methods This is a prospective, multicenter, observational cohort study. Data on consecutive pts with intermediate/high/very high-risk PC planned to receive radical or post-operative prostate radiotherapy (RT) with or without ENI and ADT were recorded in a web-based database. Case Report Form (CRF) with demographic, disease and staging information, quality of life (QoL) and symptoms were compiled. Decision making was based on standard practice. Very preliminary QoL data are presented , analyzing both pre-treatment and 1 month (1m) after treatment questioners. Differences were evaluated with T-Test and Anova in relation with the different variables (SPSS®) The data at presentation and the inherent biases of the dataset at this stage of the study are presented in detail in a companion abstract Results From February 2017 to May 2019, 2112 PC pts were registered and 915 enrolled in 44 Italian RT Centers. Features of the series: ENI 41.8%; mean age 73 yrs; familial PC risk 18.8%; baseline hemoglobin levels ≤10 g/dl 26.5%; locally advanced PC 32.9%; nodal involvement 11%; mean PSA 13,7 ng/ml; Gleason Grade Group 1 in 12.3%, 2 in 22.9%, 3 in 23.1%, 4 in 24.4%, 5 in 17.2%; baseline comorbidity index ≥3 (CIRS) in 19.4%; mean severity index 1.32. Mean pre-treatment physical and mental QoL perception (SF-12) were 49.2 and 49.65, respectively. High mean points in physical and mental QoL (SF12) have been registered. The points do not vary a lot between baseline and 1m after RT (PCS p=0,308; MCS p=0,085), although ENI (PCS p=0,023; MCS p=0,927) and ADT (PCS p=0,026; MCS p=0,331) seem to induce slightly worsening of mean physical QoL values . Baseline mean perceived QoL score for urinary function 77.88, bowel function 88.41, sexual issue 21.97 (UCLA-PCI Italian version). Mean UCLA urinary and bowel points slightly worse after the treatment (p=0.000), in particular mean 1m points are

different in patients submitted to post-operative RT and ENI. Very low UCLA sexual points decrease further after the treatment (p=0.000) (basal vs 1m); ADT and surgery induce lower 1m points. Acute (CTCAE 4.0) G3-4 grades were absent. G1-2 rectal and bowel toxicity is lower than 30%, G1-2 urinary is 62% (G1=46.5%; G2=16%). No differences have been observed according the treated volume, but a slightly more frequent G2 bowel toxicity in the ENI group Conclusion The study is still recruiting (till February 2020). These preliminary data show an elderly, relatively healthy population. RT seems to be well tolerated at the 1m follow up interval, in both ENI and no-ENI cases. Longer follow up data are needed before drawing any conclusion, being as important as treatment data PO-1193 18F-CHOLINE PET/68Ga-PSMA PET SBRT in oligorecurrent prostate cancer: comparative analysis R. Mazzola 1 , G. Napoli 1 , G. Francolini 2 , L. Triggiani 3 , L. Nicosia 1 , V. Figlia 1 , N. Giaj-Levra 1 , F. Ricchetti 1 , M. Rigo 1 , F. Cuccia 1 , L. Livi 2 , S.M. Magrini 3 , M. Salgarello 4 , F. Alongi 1 1 Sacro Cuore Don Calabria Cancer Care Center, Advanced Radiation Oncology, Negrar, Italy ; 2 A.O.U. Careggi- University of Florence, Radiation Oncology, Florence, Italy ; 3 ASST Spedali Civili di Brescia - Brescia University- , Radiation Oncology, Brescia, Italy ; 4 Sacro Cuore Don Calabria Cancer Care Center, Nuclear Medicine, Negrar, Italy Purpose or Objective Aim of the present analysis is to compare the impact of 18F-Choline and 68Ga-PSMA PET-CT guided metastases directed therapies (MDT) in a cohort of patients affected by castration sensitive oligorecurrent prostate cancer (PC). Material and Methods The present study is a retrospective multicenter analysis conducted at three Italian Academic Centers. Inclusion criteria of the present analysis were: i) histologically confirmed diagnosis of prostate carcinoma, ii) patients affected by biochemical relapse after primary tumor treatment (radical prostatectomy or radical radiotherapy), iii) oligorecurrent PC, defined as the presence of 1-3 hypermetabolic lesions detected by means of 18F-Choline or 68Ga-PSMA PET-CT, iv) 18F-Choline and 68Ga-PSMA PET- CT performed in a single Nuclear Medicine, v) patients treated with upfront SBRT without hormonal therapies, vi) SBRT delivered with a dose of at least 5 Gy per fraction to a biological effective dose (BED) of at least 80 Gy using an α/β ratio of 2 Gy. In case of oligoprogression after MTD, a second-course of SBRT was generally proposed if less than of ≤3 new lesions were diagnosed, outside the previous irradiated field. In the remaining cases, androgen deprivation therapy was administered. The primary endpoint was the distant progression free survival (DPFS) after SBRT, defined as the interval between the end of SBRT and the detection of a new metastasis outside the field of irradiation. Secondary endpoints were: overall survival (OS, local control (LC) and ADT-free survival. Results 118 lesions in 88 patients were analyzed. Forty-four (50%) patients underwent SBRT by means of 68Ga-PSMA PET/CT whereas the remaining 50% by 18F-choline PET/CT. The median follow-up was 25 months (range 5-87). For the entire population of study, OS and LC were 100%. In 48 patients (54.5%) a distant progression occurred. The DPFS was 22.8 months (range, 14.4-28.8 months). Median PSA value before SBRT was 2.07 ng/ml in the Choline PET cohort, and 0.6 ng/ml in the PSMA-PET arm.