ESTRO 2021 Abstract Book

S1015

ESTRO 2021

PO-1227 Impact of inflammation using blood parameters in HCC patients treated with SBRT G. Radicioni 1 , J.H. Exner 2 , S. Adebahr 3 , E. Haehl 3 , S. Spohn 4 , A. Rühle 3 , C. Zamboglou 3 , N.H. Nicolay 3 , T. Sprave 3 , A. Grosu 3 , E. Gkika 3 1 University Hospital Freiburg, Department of Radiation Oncology, Freiburg, Germany; 2 University Hospital Freiburg, Department of Radiation Oncology, Freiburg, Germany; 3 University Hospital Freiburg, Department of Radiation Oncology , Freiburg, Germany; 4 University Hospital Freiburg, Department of Radiation Oncology , Freibirg, Germany Purpose or Objective To evaluate the impact of inflammation using blood parameters in patients with hepatocellular carcinoma treated with stereotactic body radiotherapy (SBRT) on the treatment outcome. Materials and Methods Consecutive patients with hepatocellular carcinoma treated in our institution were included in the analysis. In order to evaluate the impact of inflammation on the overall survival we calculated the neutrophils to lymphocyte ratio (NLR), the platelets to lymphocyte ratio (PLR) and the CRP to albumin ratio (CRP/ALB). Results A total of 100 patients with 128 lesions were treated with SBRT in 3 to 12 fractions. The median 2Gy equieffective dose (EQD2 10 ) was 71 Gy. The median age was 71 years and the median tumor diameter was 7cm. 69 patients had a Child Pugh (CP) score A, 28 patients a CP score B and 3 a CP score C. The local control after 3 years was 80%, while 51 patients had an albumin bilirubin (ALBI) grade 1, 43 patients an ALBI grade B and 6 patients an ALBI grade C. The median OS was 9 months. Both a higher ALBI grade (p=0,001) and a CP score (p=0,007) correlated with a worse survival. The NLR was calculated at baseline in 45 patients, the PLR in 25 patients and the CRP/ALB ratio in 46 patients. The NLR and CRP/ALB ratio correlated significantly with the OS (HR 1,349, 95% CI 1,090-1,668, p=0.006) and (1,032, 95% CI 1,007-1,056, p=0,01) respectively, while the PLR did not (HR 1,001, 95% CI 0.996-1.005, p=0,718). Conclusion Inflammation plays an important role in the emergence of hepatocellular carcinoma. Both the NLR and CRP/ALB might help stratify patients with a worse prognosis, which might benefit from combination treatments such as radioimmunotherapy. PO-1228 Stereotactic-Body-Radiotherapy (SBRT) As Radiacl Treatment For Pancreatic-Neuroendocrine- Tumors M. López González 1 , E. De Vicente 2 , H. Duran 2 , S. Prados 3 , O. Hernando-Requejo 1 , E. Sánchez 1 , Y. Quijano 2 , R. Ciervide 1 , B. Alvarez 1 , M. Garcia-Aranda 1 , X. Chen Zhao 1 , R. Alonso 1 , J. Valero 1 , C. Rubio 1 1 HM Hospitales, Radiation Oncology, Madrid, Spain; 2 HM Hospitales, Surgery, Madrid, Spain; 3 HM Hospitales, Gastroenterology, Madrid, Spain Purpose or Objective Surgery is considered the standard treatment for pancreatic-neuroendocrine-tumors (TNP) although it is occasionally associated with high-rates of morbid-mortality. Radiotherapy can be an effective alternative in selected patients, although there is lack of evidence. Purpose: Our objective is to evaluate the tolerance and efficacy of SBRT (Stereotactic-body-radiation-therapy) in terms of local-control, progression-free-survival and overall-survival as a radical treatment for TNP. Materials and Methods Patients with pathological diagnosis of TNP and smaller than 2cm were enrolled in this IRB-approved study with SBRT. All treatment decisions were based on multidisciplinary approach. Firstly, two internal fiducial markers were placed into the tumor by endoscopic ultrasound puncture and a simulation-CT was obtained. Clinical-target-volume (CTV) included pancreatic tumor. Planning-target-volume (PTV) was CTV with 5mm expansion. Patients received 40Gy in 5 fractions on an every other day. SBRT prescription dose to PTV was adapted to tumor volume. IMRT and daily IGRT was mandatory. Intrafraction tumor motion was controlled with EXacTrac Adaptative Gating ( Brainlab) . Results Between December 2017 and November 2020, we prospectively analyzed 13 patients (p). Patients’ characteristics: 6 female (46%) and 7 male (54%) with a mean age of 55.6 years-old. Tumor location: head 3p (23%), neck 3p (23%), body 6p (46%) and tail of pancreas 1p (8%). An Octreoscan prior to radiotherapy was positive in 8p (61.5%). FDG-PET was negative for all but one patient (SUV <4). With a median follow-up of 13.6 months (range 1.8- 34.4), 100% of patients are free of relapse. Acute tolerance was excellent. Only 3p (23%) showed asthenia. One patient developed peptic ulcer on follow-up. Conclusion SBRT is feasible and well tolerated and it could be an attractive alternative in selected patients with diagnoses of TNP. Further studies are necessary to confirm these results. PO-1229 ALBI & IBI score could help in deciding for or against a radioablative therapy in patients with HCC. P. Hass 1 , T.B. Brunner 1 , A. Gawish 1 , D. Ott 1 1 University Hospital Magdeburg, Radiooncology, Magdeburg, Germany Purpose or Objective Analysis of the influence of the albumin-bilirubin (ALBI) score and the inflammation-based index (IBI) on overall survival (OS) as well as progression-free survival (PFS) in patients with hepatocellular carcinoma (HCC) treated with interstitial HDR brachytherapy (iBT). Materials and Methods