ESTRO 36 Abstract Book

S287 ESTRO 36 2017 _______________________________________________________________________________________________

2 Universidad catolica de valencia, facultad de enfermeria, Valencia, Spain

1 Azienda Provinciale per i Servizi Sanitari APSS Trento, U.O. di Protonterapia, Trento, Italy Purpose or Objective Paragangliomas (PGL) are rare usually benign, slow growing but locally aggressive tumors, Overall and specific Survival analyses reveal that most patients do not die of PGLs thus local control and QoL are a meaningful endpoint for comparative decision making. Proton therapy (PT) can spare more healthy tissue than conventional and/or intensity-modulated X-ray therapy (IMRT) and it can result in fewer side effects. The aim of this study is to evaluate PT safety, feasibility and dosimetric aspects in the definitive treatment of PGL. Material and Methods From December 2015 to October 2016, six pts, five females and one male, median age 55.5 years (range, 39- 88 years) were treated for histological or radiological confirmed H&N PGL. Two patients (pts) had positive familiar history for PGL1 syndrome. Three patients had two PGLs treated, for a total of 9 PGLs. Locations were: jugulotimpanic (2); timpanic (1); jugular (1); vagal (2); carotid body (3). Maximum diameter ranged between 20 and 45 mm.. Five pts were irradiated with definitive intent, one pt was treated postoperatively because of gross residual disease; and one pt received PT for recurrent disease. Acute and late toxicities were evaluated according to the CTCAE scale version 4.0. Quality of Life was evaluated using the EORTC QLQ-C30 and H&N35 questionnaires. Results All pts were treated with active beam scanning PT using 2-3 fields with single field optimization (SFO) technique with a total dose of 50.0 GyRBE in 25 fractions of 2.0 GyRBE. Posterior beam arrangement was preferred when allowed in order to spare as much as possible critical structures: all pts had at least one or more posterior or posterior-oblique beams, four had also one lateral beam and two had one anterior-oblique beam. Median PTV (CTV + 4mm margin) volume was 63.85 cc, median ipsilateral OARS doses were: temporomandibular joint 37.22 GyRBE, choclea 36.72 GyRBE, parotid 22.30 GyRBE, superior constrictor muscles 19.19 GyRBE, oral cavity 2.29 GyRBE, hemimandible 7.67 GyRBE. All patients completed PT without interruptions. No acute toxicity > G2 was observed. Three pts experienced G2 skin toxicity and one pt G2 external otitis. No late toixicity was observed at the last follow-up. Two pts had improvement of symptoms related to the disease: one pt had dysphonia improvement one month after PT; in another pt improvement of VII cranial nerve paresis and reduction of tinnitus were observed. All pts reported stability or improvement in the evaluation of their health status and QoL. At the time of the analysis all patients are locally controlled Conclusion Proton therapy for PGLs is a safe, feasible, and well tolerated treatment. The superiority in dose distribution compared to X-ray therapy could translate in better results in terms of long-term toxicity and QoL . A longer follow-up is needed to confirm these favourable initial results . OC-0546 Video Launching during Irradiation – an alternative to anesthesia in pediatric patients? C. Palhetinha Aguas 1 , P. Humblet 1 , L. Renard 1 , A. Vaandering 1 , V. Roosen 1 , M. Coevoet 1 1 Cliniques Universitaires Saint Luc, Radiotherapy, Brussels, Belgium THIS ABSTRACT FORMS PART OF THE MEDIA PROGRAMME AND WILL BE AVAILABLE ON THE DAY OF ITS PRESENTATION TO THE CONFERENCE. OC-0547 Acute and late morbidity in a Phase II trial of adaptive radiotherapy for urinary bladder cancer

Purpose or Objective The increase in life expectancy also increases the possibility of occurrence of tumors in elderly population. Radical treatments in these patients may involve functional impairment or complications, often rejected. SBRT enables to apply a radical treatment in a few sessions, with little side effects and good results, and could be considered the technique of choice for certain patients considered elderly or frail. Our purpose was to assess survival in function of age and performance status in a group of elderly cancer patients. Material and Methods We analyzed 44 lesions treated with SBRT, in 39 patients aged 70-93 years (mean: 79.9; median: 80). Male: 32 (82.05%), female: 7 (17.95%).Performance status was determined before treatment with Karnofsky Performance Status Index (KPSI). Results Number of fraction s:

Seven fractions in 1 case (2.27%) Three fractions in 23 cases (52.27%) Two fractions in 9 cases (20.45%) One fraction in 11 cases (25%) Survival : Lost of follow up: 5 patients (12.82%). <6 months: 4 patients (10’25%)

6-12 months : 10 patients (25’64%) 12-18 months : 6 patients (15’38%) > 18 months : 14 patients ( 35’89% ) Performance status : KPS >70 was registered in 26 patients (66.6%); ≤70 in 13 patients (33.3%) Survival in KPSI ≤70: <6 months: 4 patients ( 11.76 %)

6-12 months : 4 patients (11.76 %) 12-18 months : 2 patients (5.88 %) > 18 months : 2 patients ( 5.88 % )

Survival in KPSI >70: <6 months: 0 patients

6-12 months : 6 patients ( 17.64 %) 12-18 months : 4 patients ( 11.76 %) > 18 months : 12 patients ( 35.29 % ) Age and survival : We divided the population in two groups of age, with a cut-off in 80 years. Group 70-80y :

<6 months: 1 patients (2.56%%) 6-12 months : 3 patients (7.69%) 12-18 months : 2 patients (5.12%) > 18 months : 6 patients (15.38%) Group ≥ 80y : <6 months: 3 patients (7.69 %)

6-12 months : 7 patients (17.94 %) 12-18 months : 3 patients (7.69 %) > 18 months : 9 patients (23.07%) Conclusion - Elderly patients treated with SBRT achieved a good survival. - A high KPS (>70) is better in terms of survival (35.29% vs 5.88% in >18 months). - If we consider 80 years as more old patients, advanced age appeared not to be worse than younger ones in terms of survival (23% vs 15% in >18m). - SBRT should be considered a good option of radical treatment in elderly patients because of good results in survival, which is better in patients with better performance status. OC-0545 Head and neck paragangliomas: preliminary results of the Protontherapy Centre of Trento (Italy) I. Giacomelli 1 , D. Scartoni 1 , M. Cianchetti 1 , F. Dionisi 1 , D. Amelio 1 , S. Lemoine 1 , F. Fellin 1 , R. Righetto 1 , M. Amichetti 1