ESTRO 2022 - Abstract Book

S203

Abstract book

ESTRO 2022

PD-0241 Resilience, spirituality and survival outcome in glioblastoma patients after radiotherapy

N. Dinapoli 1 , L. Dinapoli 1,2 , S. Chiesa 1 , C. Mazzarella 1 , E. Marconi 1,2 , D.P.R. Chieffo 2 , A. Fiorentino 3 , V. Valentini 1,4 , M. Balducci 1,4 1 UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; 2 UOS di Psicologia Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; 3 Dipartimento di Radioterapia Oncologica, Ospedale Generale Regionale F. Miulli, Acquaviva delle Fonti, Italy; 4 Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italy Purpose or Objective Spirituality is “a framework that provides people with a sense of ultimate purpose and meaning in life”. Resilience is the “ability to withstand adversity and bounce back and grow despite life’s downturns”. Resilience contains various attributes, one of whom is just spirituality. To date, the interest about cancer patients’ spirituality and resilience is growing even with respect to the clinical outcomes. Aim of this study is to investigate spirituality, resilience in newly diagnosed glioblastoma (GBM) patients undergoing radiotherapy (RT) and their influence on survival. Materials and Methods A multicentric prospective observational study on adult GBM patients undergoing on RT has been performed. Spirituality was evaluated by self-administered test: Functional Assessment of Chronic Illness Therapy - Spirituality (FACIT-SP12); Resilience by means of Connor Davidson Resilience Scale (CD-RISC). Factors already known to be meaningful prognostic factors in GBM have been analyzed (age cutoff>65; surgery type -gross total resection, partial resection, biopsy-; methylation -Y,N-). RT dose (RTD) was clustered in two groups: long course (RTD>=60 Gy), and short course (RTD<60 Gy). Overall survival (OS) analysis was performed by Kaplan Meier log-rank test (KMLR) in univariate setting, and Cox Proportional Hazards (CPH) in multivariate setting. A cutoff threshold of FACIT-SP12 and CD-RISC was defined by KMLR. Results We recruited 104 patients: 68 male, 36 female, median age 59. Median FUP was 338 days. All patients received concomitant temozolomide. The OS analysis showed that patients with lower spirituality and lower resilience survived shorter than patients with higher spirituality (FACIT-SP12>33, fig.1, p-value=0.008) and higher resilience (CD-RISC>75, fig.2, p- value=0.006). OS was significantly correlated with age (p-value=0.005) while OS didn’t show a correlation in our cohort with sex, RTD, methylation and surgery type. Age>65 was not cross-related with both low resilience and low spirituality (Fisher-test p-val>0,05). Resilience and spirituality were found to be cross-related so, only the most significant variable (resilience) with lower p-value in KMLR test was admitted in multivariate analysis. CPH showed that both age and resilience were significant for OS (p-val=0,013; p-val=0,012).

Conclusion Our data in GBM patients in RT showed that high spirituality is associated with high resilience. Patients with best spirituality and resilience survived longer that patients with poor spirituality and resilience. Psychological support in GBM patients should integrate the empowerment of resilience, in order to elicit spiritual resources and help patients to better cope with such a dismal diagnosis. Profiling spirituality and resilience in GBM patients during RT can give insights to identify novel characteristics in GBM patients for prognostic evaluation. According this experience the mechanistic relationship between resilience and better prognosis is worth to be further biologically investigated too.

PD-0242 Parameters driving oncologists’ selection of glioma grade 2 and 3 patients for proton therapy