ESTRO 36 Abstract Book

S607 ESTRO 36 2017 _______________________________________________________________________________________________

not changed in 377 cases (49%), and was increased in 46 lesions (7%). Hence, totally 93% of cases were controlled by treatment. Also 80 patients (6.8%) had recurrence. Conclusion Totally according to the obtained results it may be concluded that Gamma-knife surgery is effective in more than ninety percent of cases with cranial meningioma leading to low recurrence rate. However further studies should be carried out to determine the other contributing factors for recurrence and also comparison of the results of Gamma-knife therapy with other conventional methods. EP-1120 Fractionated stereotactic radiotherapy in adult craniopharyngiomas : outcomes and complications R. Benlloch Rodríguez 1 , R. Magallón Sebastián 1 , D. Rincón Cruz 1 , M.I. García Berrocal 1 , P. Ruiz García 2 , J. Romero Fernández 1 , I. Zapata Paz 1 , M.J. Expósito Casas 1 , B. Vaquero Barrón 1 , A. De la Torre Tomas 1 1 Hospital Universitario Puerta de Hierro, Radiation Oncology, Majadahonda - Madrid, Spain 2 Hospital Universitario Puerta de Hierro, Radiology, Majadahonda - Madrid, Spain Purpose or Objective To evaluate treatment-related complications and long term outcomes in adult craniopharyngioma patients treated with surgery and Fractionated Stereotactic Between 2002 and 2015, 30 patients (p.) with histologic diagnosis of craniopharyngioma were treated with FSRT. Median age: 42 years; Sex: 17 males, 13 females. FSRT was indicated for progressive disease after surgery or postoperatively after partial resection. FSRT was delivered to a median dose of 50.4Gy (1.8Gy/fraction). To evaluate tumour and treatment-related complications and quality of life, “Craniopharyngioma Clinical Status Scale” and “Functional Classification scale” were used. These questionnaires were completed before and after surgery and after FSRT. Median follow-up was 87 months. Follow-up included neurologic, ophthalmologic, endocrinology evaluations and MRI every 3 to 6 months. Statistics: Kaplan-Meier method and long-rank test. Results Five and 10-year actuarial local control and overall survival were 97% and 89% and 89% and 80% respectively. Seven patients presented enlargement of cystic component and 2 required drainage. Two patients died due to tumour progression. At initial diagnosis, 69% had visual field loss or decreased of visual acuity and 6% presented others neurological deficits Eight p. (27%) and 4 p. (13%) had partial or complete endocrinopathy, respectively; and hypothalamic function was deteriorated in 9 p. (31%). All p. presented good cognitive status at initial presentation. After surgery patients suffered a significant impairment of their neurologic (p=0.004) , endocrinologic (p<0,0001) and hypothalamic (p=0.004) functions. Visual status worsened in 9 p. (31%), 5 of whom presented severe deficit or complete blindness. Other neurologic deficits were seen in 6 p. (20%). Twenty p. (68%) had panhypopituitarism and diabetes insipidus and 10 p. (34%) presented severe hypothalamic dysfunction. Cognitive function worsened in 6 p. No patient presented decrease of vision or hypothalamic dysfunction after FSRT and only 1(3%) had neurologic and endocrinologic deficits. Cognitive status worsened in 1 p. after FSRT. Improvement of visual, neurologic and hypothalamic deficits were observed in 6 p. (20%), 3 p. (10%) and 6 p. (20%) respectively after FSRT. Radiotherapy (FSRT). Material and Methods

A total of 8 p. (27%) presented some grade of loss of independence in activities of daily living after both surgery and FSRT. Conclusion A high incidence of treatment-related side effects is reported mainly after surgery. Neurologic, endocrinologic and hypothalamic impairments after surgery were statistically significant compared with initial presentation. In our series FSRT is effective, well tolerated and in some cases even improves deficits. Further studies are needed to establish if a less aggressive surgery combined with postoperative FSRT provides same tumor control while diminishes complications. EP-1121 Newly diagnoses grade III glioma patients: evaluation of factors conditioning outcome. P. Navarria 1 , F. Pessina 2 , S. Tomatis 1 , L. Cozzi 1 , G.R. D'Agostino 1 , A.M. Ascolese 1 , M. Simonelli 3 , A. Santoro 3 , E. Clerici 1 , C. Franzese 1 , L. Bello 2 , M. Scorsetti 1 1 Istituto Clinico Humanitas, Radiotherapy and Radiosurgery, Rozzano Milan, Italy 2 Istituto Clinico Humanitas, Neurosurgery Oncology Department, Rozzano Milan, Italy 3 Istituto Clinico Humanitas, Oncology and Hematology Department, Rozzano Milan, Italy Purpose or Objective Current treatments in WHO grade III gliomas include surgery, radiation therapy (RT) and chemotherapy (CHT), but so far a standard of care is still lacking. The aim of this study was to analyze the outcome of patients with newly diagnosed WHO grade III gliomas treated with a multimodal approach. The adjuvant treatment, after surgery, has been chosen in relation to extent of resection (EOR), histological subtype and molecular profile. Material and Methods The present retrospective study includes patients with newly diagnosed WHO grade III gliomas treated at our institution. All patients underwent surgery followed by adjuvant treatment, chemotherapy only or radiation therapy with concurrent and adjuvant chemotherapy (TMZ) in relation to the extent of surgical resection (EOR), histological subtype, and molecular profile. Patients with oligodendroglial features (anaplastic oligodendroglioma or anaplastic oligodendroglioma), complete resection (CR), 1p/19q codeletion, IDH1 mutated, and MGMT methylated status underwent adjuvant chemotherapy alone; all the others underwent to concomitant and adjuvant CHT. CHT consisted of TMZ. The total RT dose prescribed was 60 Gy in 30 fractions. Clinical outcome was evaluated by neurological examination and brain MRI performed, one month after RT and then every 3 months. Response was recorded using the Response Assessment in Neuro- Oncology (RANO) criteria. The tumor progression was described as local, if it occurred in/or within 2 cm from primary site, and distant for new and non-contiguous enhancing or non-enhancing lesions. Hematologic and non- hematologic toxicities were graded according to Common Terminology Criteria for Adverse Events version 4.0. Results From January 2008 to May 2014, 123 consecutive patients were treated. Thirty-tree (26.8%) patients had diagnosed of anaplastic astocytoma, 36 (29.3%) patients anaplastic oligoastrocytoma and 54 (43.9%) anaplastic oligodendroglioma. Fifty-one (41.5%) underwent surgery plus adjuvant chemotherapy and 72 (58.5%) surgery plus concomitant and adjuvant chemo-radiotherapy. The median, 1-2-3- and 5-year PFS was 27 months, 85.4%, 65.5%, 21.2% and 21.2% respectively and the 1-2-3- and 5- year OS was 97.65%, 89.7%, 83.0%, and 58.4%, respectively. On univariate and multivariate analysis the EOR, IDH1 mutation and 1p19q codeletion influenced PFS while KPS, histological subtype, and IDH1 mutation influenced OS.