ESTRO 36 Abstract Book

S619 ESTRO 36 2017 _______________________________________________________________________________________________

patients (age <60 years) had a significantly higher rate of meds use (55% vs 33%, p=0.02). UNC patients had a significantly higher rate of SP referral (41% vs 29%, p=0.003), meds (44% vs 18%, p<0.0001), PST (p=0.03), mastectomy (p=0.002), RNI (<0.0001), and tumor bed boost administration (p=0.03) compared to FUH. After adjusting for age, subtype, T stage, surgery, and PST: UNC patients remained significantly more likely to refer to SP (RR=1.7) and to receive meds (RR=2.4).

Figure 1 Difference in the average mean dose between grades 1 and 2 The graph (Figure 1) shows between grades 1A-1B there is almost a plateau and similarly between grade 2A-2B, however there is a sharp increase between grade 1B-2A, suggesting a potential limiting mean dose of 32Gy. Conclusion Moderate oesophagitis is prevalent in breast cancer patients receiving radiotherapy to the SCF. Limiting the mean oesophageal dose to 32Gy could decrease the severity of oesophagitis in these patients. EP-1148 Distress and self-awareness of disease severity in early breast cancer: two Institutions comparison I. Meattini 1 , T. Zagar 2 , G. Francolini 1 , A. Deal 2 , G. Carta 1 , J. Camporeale 2 , L. Terzo 2 , L. Livi 1 , O. Kaidar-Person 2 1 Azienda Ospedaliero Universitaria Careggi - University of Florence, Radiation Oncology Unit - Oncology Department, Florence, Italy 2 University of North Carolina, Department of Radiation Oncology, Chapel Hill, USA Purpose or Objective Coping with cancer, even in the curative setting, may lead to emotional and psychological distress. However, resilience is dependent on many factors including social support and ethnic/cultural coping strategies. The aim of this multicenter retrospective study is to evaluate the distress among curative breast cancer (BC) patients in two different continents: USA and Europe. Material and Methods We collected data from medical records of early BC patients treated with curative intent at the Florence University Hospital (FUH; Italy) and at the University of North Carolina (UNC; USA) seen between November 2014 and December 2015. Data included demographics, stage, BC subtype, treatment received, referral to supportive services (SP), and use of mood/anxiety lytic and sleep medications (meds). Patients with inoperable or metastatic disease, known psychiatric disorder, or recurrent/synchronous cancer were excluded from this study. The use of SP and meds were compared between the two cohorts using Wilcoxon, Fisher´s exact, and Jonckheere–Terpstra tests. Adjusted relative risks (RR) were estimated using Poisson regression. Results In patients treated at FUH (n=110), rate of SP referral and use of meds was not significantly influenced by adjuvant or primary systemic therapy (PST), type of surgery (mastectomy versus conservative surgery), regional nodal irradiation (RNI) or use of boost, T or N stage. Patients treated at UNC (n=121) who received mastectomy had higher rates of SP vs BCT (62% vs 35%)p=0.02). The use of meds was significantly higher in patients who received adjuvant chemotherapy and RNI. Both SP referral and use of meds were significantly associated with increasing T stage (p=0.03 and p=0.003, respectively) and N stage (p=0.03 and p=0.0004, respectively). Younger UNC

Conclusion The rate of SP referral and the use of meds were higher in USA cohort versus the cohort from south of Europe. The reasons for these differences might be related to social and cultural differences, rather than availability of medications. EP-1149 Omission of completion axillary lymph node dissection in patients underrepresented in ACOSOG Z11 B. Gebhardt 1 , Z. Horne 1 , G. Ahrendt 2 , E. Diego 2 , S. Beriwal 1 1 University of Pittsburgh Cancer Institute, Radiation Oncology, Pittsburgh, USA 2 University of Pittsburgh Cancer Institute, Surgical Oncology, Pittsburgh, USA Purpose or Objective ACOSOG Z0011 demonstrated that axillary lymph node dissection (ALND) can be omitted in patients (pts) managed with breast conserving surgery (BCS) and 1-2 positive sentinel nodes (SLN) without adverse effects on loco-regional control (LRC) or survival. Adjuvant radiotherapy (RT) fields in this trial were heterogeneous and included high tangents in half of pts and a 3 rd nodal- directed field in one-third of pts. Most pts enrolled in Z11 were post-menopausal with hormone receptor positive breast cancer and axillary micrometastases. We investigated breast cancer ptswith clinicopathologic features underrepresented Z11 and analyzed RT patterns We retrospectively reviewed the records of pts who underwent BCS with positive SLNS but not undergoing ALND and who completed adjuvant RT. Eligible patients had T3 tumors, >2 positive SLNs, invasive lobular carcinoma, triple negative receptor status, extracapsular extension (ECE), positive surgical margins, Nottingham Grade 3, or age <50 years. Binary logistic regression was used to examine association of pt characteristics with delivered RT fields. Disease-free survival (DFS) and LRC were assessed using the Kaplan-Meier method and log-rank test for association with risk factors. Results We identified 106 pts treated from July 2011 to July 2016. The median follow-up among living pts was 28 (range, 1- 62) months. Nineteen (17.9%) pts were treated with whole-breast irradiation only, and 87 (82.1%) were treated with modified tangential fields covering axillary level I/II. Thirty-four (32.1%) pts received comprehensive nodal RT including a 3 rd supraclavicular (SCV) field. Fifty-two and clinical outcomes. Material and Methods