ESTRO 36 Abstract Book

S96 ESTRO 36 2017 _______________________________________________________________________________________________

Between March 2007 and December 2014, 250 patients with localized prostate cancer underwent PPB, of which 32 patients had MLH identified radiologically on the MRI scan. These patients were divided into three MLH groups, mild(<5mm), moderate(5-10mm), severe(>10mm), by measuring the distance of MLH (dMLH); between the posterior transitional zone and the prostatic tissue protruding into the bladder. We retrospectively analyzed seed migration, DVH, operation time, genitourinary (GU) toxicity, and DFS. Results Median follow-up is 53.5 months (range; 9-104months) and median age is 68.5 years old(range; 57-75yo). MLH group were respectively classified mild in 12, moderate in 12, severe in 8. D’Amico risk classification were low risk in 21, intermediate risk in 11.Median prostate volume was such as 34.4cc/32.8cc/28.6cc (severe/moderate/mild). The median D90 was 145Gy. All patients still have achieved relapse-free survival. Implant migration and low-dose level of median lobe tended to increase in severe MLH.There was no relapse and PSA failure. The IPSS (International Prostate Symptom Score) for most patients worsened during the immediate post-implant period, but most of these patients were resolved by their second follow-up at 6 months. The median IPSS one month or six months after post-implant were respectively 21.5 or 13.We observed Grade 2 acute toxicity. The late toxicity such as Grade 2 was observed in 25%, such as erectile dysfunction, urinary hemorrhage and urethralgia. Hemorrhage in Grade 3 was observed in just one case, who had taken an aspirin for cerebral infarction. There was no Grade 4 complication and the all complication was In our study, MLH does not appear to be a strong contraindication to PPB because there were no significant differences in DFS and GU toxicity. However, we experienced that seed migration and cold spot degree tended to increase in severe MLH cases, we have to pay attention to treat severe MLH. Traditional approaches to head and neck cancer (HNC) have used either surgery +/- adjuvant radiotherapy, or radiotherapy +/- chemotherapy. Thus treatment was practiced with a paradigm that head and neck cancer (HNC) is one disease requiring the same treatment, modulated according to anatomic constraints influencing whether function might be preserved, largely governed by psychosocial attitudes directed at avoidance of surgical ablation with resulting loss of function and esthetic appearance. In fact, while avoiding surgery, a philosophy evolved that greater intensity of non-surgical management is optimal. However, current evidence suggests the contrary and strong evidence that treatment- related death (e.g. pharyngeal disabilities or other problems) is claiming 10-20% of contemporary HNC survivors (Forastiere et al JCO 2013) For the recently emerged HPV-related oropharyngeal cancer (OPC), approaches are even more complex since the traditional cause of death (local or regional recurrence) is now rare and most patients who die of disease succumb to distant metastases (DM). Stage-for-Stage HPV-related OPC has extremely favorable outcomes in terms of locoregional control, overall survival, and outcome of salvage treatments compared to traditional HNCs and the acceptable. Conclusion Award Lecture: Honorary Members’ Award Lectures SP-0191 Optimizing the Treatment of HPV-related Oropharyngeal Cancer: the difficult journey back B. O'Sullivan 1 1 Princess Margaret Cancer Centre University Health Network, Toronto, Canada

Mechanical uncertainties (type B) of PMMA jig position relative to OD1000 array were estimated to be 0.2mm. Repeated measurements with different afterloaders (without dismantling set-up) are plotted in figure 2. The maximum standard deviation was found to be 0.6mm for R26, 0.5mm for R30 ring. A non-linear least squares fit was made (Gander et al. 1994) to the mean positions R26 and R30 rings resulting in a radius of 13.2mm and 14.9mm, geometric centre location of (0.15,0.13) and (0.20,0.10) respectively. Conclusion Initial results indicate that the measurement technique is robust and reproducible. Repeated measurements with different afterloaders indicate a maximum standard deviation of 0.6mm (R26), 0.5mm (R30). Other central inserts can be devised for other applicators, and afterloader systems. Thus the technique is versatile but requires an high resolution 2D array and specialized measurement jig. Moreover our technique is currently limited to 2D source path determination viz. in the measurement plane, parallel to the ring plane. PV-0190 The analysis of prostate cancer with median lobe hyperplasia treated I-125 brachytherapy K. Muraki 1 , H. Suefuji 1 , E. Ogo 1 , H. Eto 1 , C. Tsuji 1 , C. Hattori 1 , Y. Miyata 1 , H. Himuro 1 , T. Abe 1 , S. Hayashi 2 , K. Chikui 2 , M. Nakiri 2 , T. Igawa 2 1 Kurume University, Radiology, Kurume, Japan 2 Kurume University, Urinology, Kurume, Japan Purpose or Objective Most patients with median lobe hyperplasia (MLH) have a large-volume prostate and severe dysuria. Prostate cancer with MLH is a relative contraindication of permanent prostate brachytherapy (PPB), because of the increased risk of post-implant urination disorder and the technical difficulties of stability while implanting intravesical tissue. We examined that the treatment outcome, seed migration, urination disorder after treatment in MLH patients who received PPB. The purpose of our research concerns is to what degree could MLH implant be stabilized. Material and Methods