ESTRO 2022 - Abstract Book

S1155

Abstract book

ESTRO 2022

Institute of Oncology IRCCS, Unit of Medical Physics, Milan, Italy; 5 IEO, European Institute of Oncology IRCCS, Department of Urology, Milan, Italy; 6 IEO, European Institute of Oncology IRCCS; University of Milan, Department of Urology; Department of Oncology and Hematoncology, Milan, Italy; 7 IEO, European Institute of Oncology IRCCS, Division of Radiology, Milan, Italy; 8 IEO, European Institute of Oncology IRCCS; University of Milan, Precision Imaging and Research Unit; Department of Oncology and Hematoncology, Milan, Italy; 9 IEO, European Institute of Oncology IRCCS; University of Milan, Applied Research Division for Cognitive and Psychological Science; Department of Oncology and Hematoncology , Milan, Italy; 10 IEO, European Institute of Oncology IRCCS, Scientific Directorate, Milan, Italy Purpose or Objective Stereotactic body radiotherapy (SBRT) is emerging as a low-toxicity treatment for prostate cancer (PCa) localizations allowing to postpone androgen deprivation therapy (ADT) in oligometastatic setting. In the phase II randomized clinical trial RADIOSA (NCT03940235, estimated primary completion date April 2022) the biology task comprises the identification of predictive and prognostic biomarkers in the setting of oligorecurrent-castration-sensitive PCa in order to discriminate poly- from oligo-metastatic patients, who could benefit from metastases-directed-therapies. This preliminary subgroup analysis aims to evaluate the change at 3 months of serum derived biomarkers after SBRT +/- ADT. Materials and Methods Patients matching the inclusion criteria of the study were stratified in two treatment groups according to ADT administration and site of metastases. The present analysis comprises all the enrolled patients with a minimum follow-up of 3 months. Common serum-derived biomarkers (albumine, total cholesterol, neutrophil and lymphocyte count) were collected at baseline and 3 months after RT. Controlling nutritional status (CONUT) score, a scoring system used to assess patient nutritional status, and prognostic nutritional index (PNI), an immunity and nutrition based prognostic score, were calculated according to available literature. Neutrophil-lymphocyte ratio (NLR) and NLR-albumine ratio (NLRAR) were evaluated as inflammatory status scores. Significant changes in collected samples were evaluated for ADT administration (yes vs no) and site of metastases (bone vs lymph node) with univariate non parametric Wilcoxon signed-rank test. Results Fifty-four patients were included in the following preliminary analysis. When stratified by ADT administration, statistically significant differences in PNI were observed in favor of the ADT-free group ( p= .046 ). As expected, differences in the total cholesterol count showed an increasing trend in the group receiving ADT ( p= .003 ). When patients were stratified by site of metastases, inflammatory scores (NLR and NLRAR) showed a higher inflammatory status in patients with bone localizations ( p = .006 and p= .030 respectively). It is well-known that higher inflammatory status is associated with a worse prognosis such as bone localization is slightly worse in terms of response compared to lymph nodes only sites. Conclusion Nutritional status appears to be affected by ADT addition, a well-known factor for quality of life worsening. Moreover, inflammatory status seems to be related with site of metastatic localization. Analyzed parameters would appear to represent interesting candidate to be possibly included in clinical decision-making in order to stratify patients who would benefit from more or less aggressive treatments. Further evaluations and correlations with clinical outcomes and longer follow-up are needed for the validation of these candidate biomarkers. C. Rosa 1,2 , L. Gasparini 1 , F.C. Di Guglielmo 3 , D. Fasciolo 1 , M. Borgia 1 , M. Lucarelli 1 , L. Caravatta 1 , M. Di Tommaso 1 , A. Porreca 4 , M. Di Nicola 5 , D. Genovesi 1,2 1 SS. Annunziata Hospital, Department of Radiation Oncology, Chieti, Italy; 2 G. D’Annunzio University, Department of Neuroscience, Imaging and Clinical Sciences, Chieti, Italy; 3 SS. Annunziata Hospital, Department of Radiation Oncology, Chiti, Italy; 4 G. D'Annunzio University of Chieti-Pescara, Department of Economics, Pescara, Italy; 5 G. D'Annunzio University, Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, Chieti, Italy Purpose or Objective Purpose: Neoadjuvant chemoradiotherapy (NCRT) followed by total mesorectal excision is a standard of care in locally advanced rectal cancer (LARC) patients. Considering the wide variation of both oncological responses and outcomes, it is currently important the possible identification of biomarkers in order to predict clinical outcomes. This aspect could allow a treatment personalization in order to obtain better responses. Our study aimed to investigate the role of haemoglobin and systematic inflammation values evaluated by neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) as possible biomarkers to predict tumor response and prognosis of LARC patients after neoadjuvant treatment. Materials and Methods Material and Methods: We retrospectively analysed seventy LARC patients, treated with long-course NCRT and radical surgery. Pathological tumor response was evaluated according to Mandard tumor regression grade (TRG). Venous blood samples were obtained within one week before starting NCRT and during the last week of treatment. We performed a t- test analysis between independent groups to explore the prognostic impact of haemoglobin, NLR and PLR on TRG and outcomes, as local control, disease-free survival and overall survival. Post-NCRT values were also evaluated. Results Results: Forty-four patients (62.9%) obtained a complete response (TRG 1-2). The median values of pre- NCRT haemoglobin, NLR, and PLR were 13.10g/dL, 2.10, and 124.19, respectively. The median values of post- NCRT haemoglobin, NLR, and PLR were 12.75g/dL, 6.09, and 296.69, respectively (Table 1). A statistically significant correlation between pre-treatment median value of NLR and TRG rates ( p=0.011 ) was obtained with values of 1.9 (range: 1.5-2.7) in TRG 1-2 versus 2.5 (range: 2.0-3.3) in TRG 3-4 (Figure 1). Besides, no statistically significant correlations were PO-1361 Systematic inflammation marker as predictor of response after neoadjuvant treatment in rectal cancer