ESTRO 2023 - Abstract Book

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ESTRO 2023

patients and improve survival in some. With the aim of evaluating outcomes after RIC and allo-HSCT we designed a multi centre retrospective observational study enrolling patients with refractory or relapsed lymphomas. Materials and Methods The study recruited 36 patients, 32 of whom had failed high-dose autologous HSCT (19 male, 17 female; median age 45 years;(range 7-79); mean KPS 90% (range: 70-100)). Patients were affected by Hodgkin’s lymphoma (16), T cell lymphoma (9), diffuse B cells large lymphoma (7), mantle cell lymphoma (2) and follicular lymphoma (2). Patients received fludarabine from days − 6 to − 2, cyclophosphamide on days -5 and -6 and 2-4 Gy total body irradiation on day -1. Allo-HSCT were HLA-matched related (16) or unrelated (20). Post-transplant immunosuppression consisted of cyclophosphamide, tacrolimus and mycophenolate mofetil in 20 unrelated allo-HSCT recipients and cyclophosphamide and cyclosporine for 16 matched allo-HSCT recipients. Results Stable engraftment was achieved in 32/36 patients; 4 patients had non fatal rejections. Good response was elicited in 23/32 patients (63.9%). Disease progression was observed in 9. The acute toxicity rate was 19.5.% (5 gastrointestinal, 1 renal, 1 veno-occlusive disease ( VOD) ). Post-transplant infections developed in 12/36 patients (33.3%). Acute graft versus-host disease (GvHD) was found in 9/36 patients (25%).It was Grade I in 3 (8.3%), Grade II in 4 ( 11.1%), Grade III in 2 (5.6%) . Six patients (16.7%) developed chronic GVHD (Grade I in 5 patients (13.9%) Grade II in 1 (2.8%). At 60 months post-transplant 7 patients (19.4%) died, 2 of relapse (5.6%) and 5 (13.9) of non-relapse mortality, one of them trasplantation related mortality. The 5-year Kaplan-Meier probabilities of overall and disease-free survivals were 78.1% and 93.4%, respectively. Conclusion Allo-HSCT after RIC is a promising salvage strategy for patients with relapsed and refractory lymphoma. The high response and low relapse rates suggest that lymphoma cells are susceptible to graft-vs-tumor responses. L. Bergamaschi 1,2 , M. Zaffaroni 1 , M.G. Vincini 1 , G. Marvaso 1,2 , S. Volpe 1,2 , F. Colombo 1,2 , C. Bonfiglio 1 , S. Zorzi 3 , M. Cossu Rocca 4 , A. Sabbatini 5 , G. Cannillo 5 , E. Zagallo 5 , M. Ansarin 3 , R. Orecchia 1 , D. Alterio 1 , B. Jereczek-Fossa 1,2 1 European Institute of Oncology IRCCS, Division of Radiation Oncology, Milan, Italy; 2 University of Milan, Department of Oncology and Hemato-Oncology, Milan, Italy; 3 European Institute of Oncology IRCCS, Division of Otolaryngology and Head and Neck Surgery, Milan, Italy; 4 European Institute of Oncology IRCCS, Department of Medical Oncology, Urogenital and Head and Neck Tumors Medical Treatment, Milan, Italy; 5 European Institute of Oncology IRCCS, Dietetic and Clinical Nutrition Unit, Milan, Italy Purpose or Objective To identify patients at higher risk of developing sarcopenia during RT and to evaluate the impact on oncological outcome and toxicity profile in a retrospective series of oropharyngeal cancer patients treated with curative RT +/- chemotherapy at a single institution. Materials and Methods Oropharyngeal SCC patients who underwent curative RT with a prescription of 70 Gy with VMAT technique +/- chemotherapy from 2012 to 2019 were considered for study inclusion. Contouring of the cross-sectional area (CSA) of the masticatory muscles (MM-CSA) at the level of bilateral mandibular notches (Fig.1) and of the paravertebral and sternocleidomastoid muscles at the level of the third cervical vertebra (C3-CSA) (Fig.2) on both simulation and 50 Gy revaluation CT scans was performed. MM-CSA and C3-CSA were used to estimate the CSA at 3rd lumbar vertebra (L3) from validated algorithms, to detect skeletal muscle index (SMI) and consequently assess sarcopenia both at baseline and at 50 Gy, based on predetermined thresholds. Poster (Digital): Head and neck PO-1172 Sarcopenia in oropharyngeal cancer treated with curative radiotherapy: time for a tailored approach?

Figure 1 ImageJ delineation of the masticatory muscles (threshold setting: -29 to +150 HU) in a sarcopenic patient.