ESTRO 2021 Abstract Book

S1010

ESTRO 2021

PO-1220 Prospective evaluation of Child Pugh score as a tool for assessment of acute toxicity in liver SBRT Y. Sreenija 1 , S. K 1 , H. Nair 1 , A. Sasidharan 1 , S.G. Pottayil 2 , A. E H 3 , S. Sadasivan 4 , S. S 5 , D. Dutta 1 1 Amrita Institute of Medical Sciences, Radiation Oncology, Kochi, India; 2 Amrita Institute of Medical Sciences, Radiology, Kochi, India; 3 Amrita Institute of Medical Sciences, Medical Physics, Kochi, India; 4 Amrita Institute of Medical Sciences, Gastroenterology, Kochi, India; 5 Amrita Institute of Medical Sciences, Gastrointestinal Surgery, Kochi, India Purpose or Objective Prospective evaluation of Child Pugh (CP) scoring system in evaluating radiation induced liver injury in an objective method. Materials and Methods The present analysis is from a single institutional prospective study evaluating the response and toxicity outcome in liver tumours treated with CyberKnife Radiosurgery (CK). CK treatment was done as per protocol (three fiducials, Dosage: 20-50Gy/5fr; 800 cc normal liver <8Gy, Duodenal max <24Gy). Hepatocellular carcinoma (HCC) and portal vein thrombosis (PVT) with good liver function (CP Score upto B7, PS 0-1), oligo liver metastasis that progressed on systemic therapy and recurrent cholangiocarcinoma were accrued in the study. Baseline CP score, liver function before CK and at 8-10 wks post-CK evaluation was done. At follow up (8-10 wks) response to treatment, events after CK, unplanned admissions and interventions, radiation induced toxicity (classic & non-classic RILD) and change in CP scores were documented and analysed. Results Between Jan 2017 to Dec 2020, 120 patients (pt) were accrued [male 115(96%), CP A 66%, CP B 30%, mean age 61.3 years (38-77yrs), CLIP 0-2: 43 (39%), CLIP 3 35 (31%), CLIP 4-5 (29%), infective etiology 13%,PS0-1 83%], among them 100 had HCC and PVT, 14 had only HCC, 4 had liver metastasis and 2 had cholangiocarcinoma. Among 120 accrued pt, CK was done in 114 (95%) and in 6 pt (5%) treatment was abandoned after fiducial placement(1 pt had MI, 3 had bleed requiring intervention and 2 had post-fiducial liver decompensation).28 (23%) pt required ‘unplanned’ admission within 3 months of CK. Among them 27 (22%) had severe ascites requiring intervention. 14 (50%) required therapeutic peritoneal fluid drainage, 7(25%) required albumin infusion, and 3 pts were admitted for conservative management. 4 (3%) pt had variceal bleed requiring active interventional (banding). 10 (8%) pts had moderate pain requiring medication after fiducial placement. Among 114 treated pts, 11 (10%) expired within 3 months after CK due to disease progression, 9 pts were alive but have not reached 2 month evaluation and 94 (78%) pt had two month post-CK evaluation. Among these 94 evaluable pts, 18 pt (15%) had RILD [7 (6%) had Classic RILD & 11 (9%) had non-classic RILD]. In CP score assessment at 2 month follow up, 46 (38%) had no change in CP score. Decline of 1, 2 & 3 point CP score from baseline was in 16 (17%), 10 (10%), 13 (14%)pts. Improvement in CP score of 1 & 2 point from baseline was in 8 (9%) and 1 (1%)pt respectively. No CP Grade change in 64 (68%) pts. Decline from Grade A to B in 20 (21%) and C in 2 (2%). Decline from grade B to C in 4 (5%). Only 3 pt (4%) had improved Child Pugh grade after CK. Decline in CP score was only in HCC pts. Conclusion RILD was seen in 18% and CP score change was in 17% pts. CP score change after SBRT correlates with the classic and non-classic RILD and post RT acute toxicities. Hence, CP score change is an objective scoring system to evaluate the radiation induced liver injury after SBRT treatment. PO-1221 Proton beam radiotherapy in pancreatic cancer: a systematic review L. Cavallini 1,2 , A. Arcelli 1,2 , A. Guido 2 , M. Buwenge 1,2 , B. Rombi 3 , F. Bertini 3 , L. Strigari 4 , S. Strolin 4 , C. Bellarosa 1,2 , C.M. Donati 1,2 , S. Bisello 1,2 , E. Scirocco 1,2 , M. Ferioli 1,2 , G. Macchia 5 , D. Pezzulla 5 , M. Amichetti 3 , A.G. Morganti 1,2 , S. Cammelli 1,2 1 Department of Experimental, Diagnostic and Specialty Medicine – DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy; 2 Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 3 Proton Therapy Center, Santa Chiara Hospital - Trento, Italy, Trento, Italy; 4 Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 5 Radiation Oncology Unit, Gemelli Molise