ESTRO 2021 Abstract Book

S1189

ESTRO 2021

Demographic changes lead to a rising number of elderly head-and-neck squamous cell carcinoma (HNSCC) patients. As those patients are excluded or underrepresented in major clinical trials, high-level evidence is lacking for the challenging individual decision-making of this distinct patient cohort. Materials and Methods This international survey was distributed via email to all members of the German, Austrian and Swiss National Societies of Radiation Oncology. It included 21 questions on the preparation, treatment and supportive measures of elderly HNSCC patients undergoing (chemo-)radiation and two case scenarios with 3 questions each. SPSS was used to calculate frequency distributions and perform subgroup analysis. Results 132 radiation oncologists answered the survey including 34 (26%) from private practices, 52 (39%) from regional hospitals and 46 (35%) from university hospitals. 83(62%) responders reported to treat 1-5 and 42 (32%) more than 5 elderly HNSCC patients per month. Target volumes were defined analog current guidelines by 65 (50%) of responders with alterations based on age/comorbidities by 36 (28%) or tumor stage by 28 (22%). 108 (84%) physicians reported to routinely administer chemotherapy if indicated, with weekly 40mg/m 2 cisplatin being the most frequently applied scheme in the definitive (53%) and adjuvant setting (47%). Alternative fractionations were used by 20% (26, hypofractionation) and 9% (11 hyperfractionation/acceleration) of responders, respectively. Treatment was reported to be mainly conducted in an outpatient setting (125, 95%). In a case scenario of definitive (chemo)radiation for an elderly patient with locoregionally advanced HNSCC, 73 of responders (63%) recommended chemoradiation with bilateral elective node irradiation (ENI) based on current guidelines. In a corresponding adjuvant case scenario, recommendations regarding ENI and chemotherapy were heterogenous. The frequency of PET-CT for staging, port-catheter and PEG implantation, the choice of chemotherapy regimens and the use of alternative fractionations were significantly influenced by responders’ institutions. Conclusion Elderly HNSCC patients in German-speaking countries are mainly treated according to guidelines constituted for younger patients. Tools for patient stratification and de-intensification-algorithms are needed for this distinct patient cohort. PO-1449 Evaluation of the biological age in PCa patients treated with RT using a geriatric assessment. K. Lukasiak 1 , B. Stranz 1 , E. Thurner 1 , H. Stranzl-Lawatsch 1 , W. Schippinger 2 , U. Langsenlehner 2 , T. Langsenlehner 1 1 Medical University of Graz, Department of Therapeutic Radiology and Oncology, Graz, Austria; 2 Geriatric Health Centers, Albert Schweitzer Clinic, Graz, Austria Purpose or Objective Definitive radiation therapy (RT) for prostate cancer (PCa) represents a highly effective curative treatment option for PCa offering a particular advantage in avoiding perioperative surgical toxicity. Thus, the number of patients, especially patients aged ≥ 70 years, referred for radiotherapy has increased significantly during the last years. The evaluation of medical, psychosocial, and functional capabilities has been proposed as a tool for separating patients likely to benefit from standard cancer treatment and those who are at high risk of complications. In some studies, low geriatric assessment (GA) scores correlated with premature discontinuation of radiotherapy. The present study was aimed at investigating the ability of a GA to estimate the actual biological age in prostate cancer patients treated with RT. Materials and Methods A total of 132 patients treated with definitive RT for PCa in a curative setting at the Department of Therapeutic Radiology and Oncology, Medical University of Graz were included into the analysis. A GA comprising Mini–Mental State Examination (MMSE), Mini Nutritional Assessment (MNA), Nikolaus scale for Social Situation (SOS), Geriatric Depression Scale (GDS), Instrumental Activities of Daily Living (IADL), Activities of Daily Living (ADL) and Timed Up and Go (TUG) was performed prior to the start of treatment. The included individuals were divided into three age groups (<70, 70-80 and >80 years). Statistical analysis was performed using one-way ANOVA model. Results In the total cohort, mean values ± standard deviation for MMSE was 28.39 ± 2.08, for SOS 23.38 ± 1.68, for IADL 7.75 ± 0.95, for GDS 1.22 ± 1.76, for TUG 10.02 ± 2.2, for MNA 27.21 ± 1.73, and for ADL 99.66 ± 3.16, respectively. For the MMSE, SOS, GDS, ADL, and TUG, a significant difference was not detected between the different age groups (all p>0.05). A significant difference between the different age groups could be found in terms of MNA (p=0.009) and IADL (p=0.011). Conclusion As chronologic age alone is a poor descriptor of the heterogeneity in the aging process, a reliable assessment of the biological age is needed. Commonly used GA questionnaires may enable the determination of undiagnosed health problems that influence relative life expectancy as well as tolerance and efficacy of the therapy for PCa. In the present study, a significant association of MNA and IADL with the chronological age was detected whereas the other domains of the GA evaluated in our investigation, did not correlate with chronological age. Subsequent analysis addressing the ability of GA tests to predict radiation-induced toxicity and major outcome measures is warranted. PO-1450 Oncogeriatric impact evaluation in scamous primary skin cancer treatment response L. Zaragoza Cocero 1 , M.S. Talaya Alarcón 1 , D. Aldave Yaniz 2 , R. Rubiato Aragon 2 , M.T. Murillo Gonzalez 2 1 H.U. LA PRINCESA, RADIATION ONCOLOGY, MADRID, Spain; 2 H. U. La Princesa, Radiation Oncology, Madrid, Spain

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