ESTRO 36 Abstract Book

S661 ESTRO 36 2017 _______________________________________________________________________________________________

Leuven, Belgium 7 KU Leuven - University of Leuven, Department of Radiology, Leuven, Belgium 8 Maastricht University Medical Centre- KU Leuven - University of Leuven, Department of Radiation Oncology MAASTRO, Maastricht, Belgium Purpose or Objective The purpose of our study is to quantify the influence of heart dose on the early and late onset of dyspnea in a cohort of non-small cancer (NSCLC) and malignant pleural mesothelioma (MPM) patients having multimodality treatment including radiotherapy (RT). Material and Methods Patient population consisted of: a) stage I-III MPM patients who completed trimodality treatment (induction chemotherapy, EPP and postoperative RT [PORT]); b) stage III (ypN2) NSCLC patients treated with induction chemotherapy, pneumonectomy or lobectomy (+PORT); c) stage I-III NSCLC treated with RT with curative intent (+/- chemotherapy). In 121 patients with multimodality-treated NSCLC and MPM the maximal dyspnea score (CTCAE 4.0) before RT, at an early (<6 months) and a late (7-12 months) time point were obtained. Included patients needed to be clinically and radiologically progression-free 9 months after the end of RT. The difference (Δ) between the maximal dyspnea at <6 months and at 7-12 months with the pre-RT dyspnea was calculated. Results Forty-four percent (50/113) of the patients developed an early worsening of at least 1 point in their dyspnea score (Δdyspnea >1) after the end of RT. Independent predictors of an early worsening were the mean heart dose (MHD) (for Δdyspnea >1: OR=1.032, p=0.04) and the dyspnea score before RT (for Δdyspnea >1: OR=0.40, p=0.0001; for Δdyspnea >2: OR=0.35, p=0.05). At the later time point, only the dyspnea score before RT (OR: 0.40, p=0.001) was identified as predictor of for Δdyspnea >1. Conclusion Our results, albeit exploratory, suggest that heart dose may play a role in the early worsening of the dyspnea in a heterogeneous cohort of patients having multimodality treatment including RT, whereas baseline dyspnea plays a major role for both early and later worsening. EP-1238 Patterns of recurrence in patients of pT2 esophageal squamous cell carcinoma after radical resection Y.X. Wang 1 , Y.H. Gao 1,2 , J. Li 1 , R. Qiu 1 , X.Y. Qiao 1 1 The Fourth Hospital of Hebei Medical University, Department of Radiation Oncology, Shijiazhuang, China 2 the 2th Central Hospital of Baoding, department of Medical Oncology, Zhuozhou, China Purpose or Objective To retrospectively investigate the patterns of recurrence and its related factors in patients of stage pT2N0-1M0 thoracic esophageal squamous cell carcinoma(ESCC) after radical resection. Material and Methods From 2008 to 2011, 222 cases of stage pT2N0-1M0 thoracic ESCCC with R0 resection were enrolled. There were 142 males and 80 females. There were 181 in pN1 and 41 cases in pN1. 142 patients has treated with surgery alone and 80 with adjuvant postoperative chemotherapy (POCT). Diagnosis of recurrence was primarily based on CT images. Results Electronic Poster: Clinical track: Upper GI (oesophagus, stomach, pancreas, liver)

Follow-up ended at 30, Sep, 2014. The overall recurrence rates was 35.1%. Locoregional recurrence (LR) was found in 25.7% of patients, distant metastasis (DM) in 5.9%, and LR plus DM in 3.6%, respectively. The LR occupied about 83.3% of any recurrence, and 87.7% of LR has occurred in mediastinum (91.2% of it located in upper- mediastinum). Multivariate Cox regression analysis showed that the danger of total recurrence, LR and DM for stage pN1 patients was about 7.1, 6.5 and 3.1 folds in comparied with stage pN0, respectively; the danger of total recurrence in females was about 49.1% in compared with males. But POCT could not influence total recurrence and The recurrence rate was very high in stage pT2N0-1M0 thoracic ESCC after radical resection, the most common site of recurrence was mediastinum (especially upper- mediastinum), it was probably the main target of postoperative radiotherapy. The recurrence was more frequently occurred in stage pN1 and males. T2N0-1M0 thoracic ESCCC with R0 resection were enrolled. There were 142 males and 80 females. There were 181 in pN1 and 41 cases in pN1. 142 patients has treated with surgery alone and 80 with adjuvant postoperative chemotherapy (POCT). Diagnosis of recurrence was primarily based on CT images. EP-1239 SBRT in patients with HCC/CCC or oligometastatic liver disease S. Gerum 1 , C. Heinz 1 , C. Belka 1 , M. Niyazi 1 , U. Ganswindt 1 , F. Roeder 1,2 1 LMU Munich, Department of Radiation Oncology, Munich, Germany 2 German Cancer Research Center DKFZ, Department of Molecular Radiation Oncology, Heidelberg, Germany Purpose or Objective To report our experience with stereotactic body irradiation in primary and secondary liver lesions. Material and Methods We retrospectively analysed 37 patients who had not been eligible for other local treatment options (surgery, RFA) and therefore received SBRT to 1-2 liver lesions (43 lesions in total) in our institution from 2011-2015. Median age was 66 years (31 – 83 years) and 20 patients were male. 16 patients suffered from HCC/CCC, 21 patients had oligometastatic liver disease, mainly originating from colorectal cancer. The majority presented in good performance status (median KPS 90%, range 60%-100%) with adequate liver function (cirrhosis Child A: 13, Child B: 2, Child C: 1, none: 21). Immobilization included a vacuum pillow in all patients and the use of abdominal compression since 2014. Treatment planning was based on 4D-CT (contrast-enhanced since 2014) usually after placement of fiducial markers and rigid registration with diagnostic MRI images. Median ITV to PTV margin was 6 mm. Results Mean follow-up was 14 months (range 1 - 47) Fiducials were needed in 29 patients (78%). Placement was feasible without any complications in all patients. Abdominal compression was used in 12 patients since 2014 to reduce breathing motion. Dose and fractionation varied dependent on localisation, size, motion and liver function. The most common schemes were 37.5 Gy/65% isodose in 3 fractions, 40 Gy/80% in 5 fx and 54Gy/80% in 9 fx. Median GTV volume on free-breathing CT was 13 ccm (1-247) and median PTV volume was 126 ccm (15-537). Local recurrence (in field) was observed in 6 patients (16%) resulting in a 1-year LC rate of 92%. New lesions in the liver (out-field) occured in 20 patients (54%), 15 (40%) patients developed extrahepatic progression. 5 patients have died, resulting in a 1-year overall survival of 87% in all patients. No significant differences in any endpoint have been observed between HCC/CCC and LR(P>0.05). Conclusion