ESTRO 2023 - Abstract Book

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ESTRO 2023

Results A total of 62 patients were referred with BM from GI malignancies. 4 were unfit for SRS, 2 died before SRS could be delivered and 2 declined and were excluded. 37 patients had extra-cranial metastases at time of referral. Thirty-one patients had colorectal cancer, 19 had oesophageal cancer, 2 had gastric cancer, 1 had pancreatic cancer and 1 had gallbladder cancer. 46 patients (85.2%) had histology consistent with adenocarcinoma. A total number of 92 metastases were treated with 85 being de novo metastases. The median age at time of SRS was 65 years (range 34 to 86). The median GTV treated was 4.85cc and the median cumulative GTV was 9.7cc. 38 metastases were treated with a single fraction, 26 with 3 fractions and 28 with 5 fractions. The median single fraction dose used was 20Gy (range 16 to 24Gy), 3 fraction dose was 27Gy (range 24 to 27Gy) and 5 fraction dose was 26.3Gy (range 25 to 30Gy). The most common toxicities documented were fatigue, headaches and memory impairment. LC rate was 74% based on available follow-up neuro-imaging. Distal intracranial relapse was 20%. Forty-four patients (81%) out of the 54 died. Cumulative proportion surviving was 58% (95% CI: 44% to 72%) at 6 months and 33% (95% CI: 20% to 46%) at 1 year. Median overall survival (OS) was 6.7 months. Conclusion Survival and intracranial disease control are poor for BM from GI malignancies. Our retrospective analysis shows that SRS is an effective treatment option and results in comparable OS rates as per reported literature. Larger, multicentre prospective studies are required to determine appropriate patient selection, optimal dose and follow-up protocols. Incorporation of SRS into a multimodal treatment approach should be evaluated to obtain better outcomes. Purpose or Objective Patients (pts) with meningioma are commonly treated with proton therapy (PT) in order to minimize integral dose to normal brain parenchyma. Considering the high local control probability, preservation of Quality of Life (QoL) is gaining increasing importance. Potential loss of employment, inability to work or need to reduce working hours may lead to financial worries negatively affecting QoL. We investigated the subjective QoL and disease burden in pts with meningioma treated with PT with regards to income, financial toxicity, inability to resume work before and after PT. Materials and Methods Data from prospectively assessed questionnaires (EORTC QLQ-C30) including an item for subjective financial difficulties, scaled from 1-4 (1=“not at all” to 4=”very much”), was collected from pts treated with PT for meningioma. Observed time points were prior to start of treatment (t1) and incrementally thereafter (completion of treatment, at 3months (ms),6ms,12ms,24ms,36ms and 48ms;t2-t8). Employment status was collected and net household income was assessed and ranked into 5 groups ranging from <1300 € to >5000 € . Results 171pts (39m/131f) aged 20-88yrs (mean 55.1) with meningioma were included. At a mean observation time of 29.6ms, 991 data sets were collected. 37pts (35.9%) reported health-related inability to work before PT. Over follow up (FU), it decreased to 33.8% at 12ms, 27.3% at 24ms, 15.4% at 36ms, 13.6% at 48ms. 34pts (33%) were employed prior to their diagnosis (14part-time, 18full-time). While rates of full-time employment initially decreased, it steadily increased from 1yr FU (t3-t8: 28.7%-59.1%), rates of part-time remained stable (t3-t8:27.2%-27.3%), see figure 1. Subjective financial burden correlated significantly with occupational situation (Spearman;p<0.001) indicating a reduction in patient-reported financial difficulties after commencement of work / increase in working hours. There were no relevant changes in pts´ income (Friedman:p=0.610); however, pts with lower income prior to PT reported subsequently higher levels of financial difficulties (Spearman:p<0.001). Before PT, 69 pts (40%) reported various levels of financial difficulties. Although rates decreased initially at the end of PT (30.2%), then increased 6ms (36.9%), they consistently decreased at all subsequent FUs (30.4% at 12ms, 29.0% at 24ms, 22.4% at 36ms, 20.6% at 48ms). This reflects the lower burden of financial toxicity over time. We observed a significant incremental increase in mean QoL score after PT (t3-t8: 4.86 to 5.40; Friedman:p<0.001). Lower rates of subjective financial burden correlated with increase in QoL scores (Spearman, r=-0.392, p<0.001). PO-1113 Financial toxicity, occupational status and QoL in meningioma patients treated with proton therapy M. Achtaewa 1 , C. Lütgendorf-Caucig 1 , L. Konrath 1 , E. Hug 1 , P. Fossati 1 , M. Pelak 1 , P. Georg 1 , B. Flechl 1 1 MedAustron, radiation oncology, Wiener Neustadt, Austria