ESTRO 2021 Abstract Book

S1012

ESTRO 2021

Teresa, Gastrohepathology, Tirana, Albania

Purpose or Objective The aim of the study was to identify the prognostic factors related to survival outcome in Albanian gastric cancer patients. Materials and Methods Demographic, histopathological, treatment and follow up data of 180 nonmetastatic stage IB-III gastric cancer treated in our center during 2016-2019 were retrospectively analyzed, to identify prognostic factor correlated to disease free survival (DFS) and overall survival (OS). Pearson's correlations, logistic regression and age-adjusted models were conducted. Statistical analysis was done using SPSS version 26 (SPSS, Chicago, IL). Results Patients’mean age was 58.9± 9.8 years (range 26-80 years). Male to female rate was 3.2:1. Median follow up was 36± 13 months. Four patients (2.2%) had a family history of gastric cancer. Subtotal gastrectomy was performed in 57.8% of the patients, total gastrectomy in 33.9% and 8.3% were considered inoperable. R1 resection was present in 16 patients (8.9%). Incomplete node dissection was performed in 46.1% of the patients, D1 dissection in 6.1% and D2 dissection in 39.4%. The most frequent tumor locations were: 25.6% in antro-pyloric region, 22.2% in antrum, 15% in corpus and 5% in cardia. The main histopathology types were adenocarcinoma 94.4% and signet ring cell carcinoma 5.6%. Grade 3 tumor was present in 63.9% of patients. According to Lauren classification, intestinal type was present in 20% of the patients, diffuse type in 24.4% and mixed type in 55.6%. Fifty five percent of the patients were stage III, 38.4 % stage II and 6.5% stage Ib. Patients had adjuvant treatment in 88.3%, neoadjuvant treatment 8.9%, palliative treatment 1.1% and 35% were treated with adjuvant chemoradiotherapy (CRT). On the close-out date 66.7% were still alive and local control (LC) was 93.3%. DFS was 11.5 ± 11.9 months. No significant correlation was found according age and gender related to OS and DFS, but female patients had a higher risk for progressive disease (PD) compared with male (OR=1.3, 95% CI=0.76-2.4), p=0.3. Upon age-adjusted and multivariable adjustment for all covariates, factors influencing the risk for local recurrence (LR) were vascular invasion (p=0.04) and N stage (p=0.046). Significant correlation was found between the LR and PD (p=0.003). Prognostic factors related to OS and DFS were found: T stage (p=0.006), node stage (p=0.012), vascular invasion (p=0.04), perineural invasion (p=0.03), type of surgery and node dissection, (p<0.001 respectively) and presence of R1 resection (p=0.02). Adjuvant treatment was also an important factor affecting OS and DFS, p=0.032. According to the role of adjuvant RT a positive correlation was observed (OR=3.4, 95%CI=1.1-5.1), p=0.02. Conclusion Different prognostic factors are defined for gastric cancer and our findings were in concordance with the literature. Longer follow up and further sub analysis are needed to determine a panel of prognostic factors, in order to improve gastric cancer management and promote a personalized treatment, according to their risk category. PO-1224 SBRT as a part of the multimodal management of intermediate and advanced hepatocellular carcinoma A.A. Mohamed 1 , K. Gester 2 , M. Eble 3 1 RWTH Aachen University , Radiation Oncology department, Aachen, Germany; 2 RWTH Aachen University , Radiation Oncology department , Aachen, Germany; 3 RWTH Aachen University, Radiation Oncology department, Aachen, Germany Purpose or Objective Hepatocellular carcinoma (HCC) is a challenging disease with poor outcomes for patients who are not amenable to transplant, however, local therapy could alter the worse prognosis of the disease. We did a single-center retrospective study to analyze the role of stereotactic body radiotherapy (SBRT) as a part of the multimodal management of intermediate and advanced HCC. Materials and Methods We identified 20 Patients with intermediate and advanced HCC (BCLC B&C) in our register who were discussed in the multidisciplinary tumor board (MDT) and received SBRT of the liver in the course of their management between March 2013- December 2020. 19 Patients had complete blood labs before and after SBRT. 13 Patients were BCLC B and 7 patients were BCLC C (Portal vein invasion only). Child-Pugh (CP) score was as follows: 9 Patients CP-A, 8 Patients CP-B & 2 Patients CP-C. The median prescribed dose was 37.5 Gy, number of fractions was 3-12, with dose per fraction 5-12.5 Gy. The median prescribed dose of the PTV as EQD2 α∕β10 : 70.3Gy, Median D2% of the PTV as EQD2 α∕β10 : 104.1 Gy. Results Eight patients (40%) received other liver-directed therapies (RFA, TACE and SIRT) or TKI safely after SBRT, 5 patients (25%) received liver-directed therapies before SBRT. The median follow-up period was 7.5 months, 18 Patients had at least a follow-up CT after SBRT. The 1&3-years local control (LC) of irradiated lesions was 94%. Median progression-free survival (PFS), hepatic and extrahepatic, was 6.1 months (BCLC-B was 13.9 months and BCLC-C was 4.3 months). Median overall survival was 14.6 Months (BCLC-B: 31.3 months & BCLC-C 8.3 months). 3 Patients (15.7%) experienced progress > 1 point in CP-Score till 6 months after SBR, none of the patients experienced RILD.