ESTRO 36 Abstract Book

S662 ESTRO 36 2017 _______________________________________________________________________________________________

oligometastatic patients, although the latter ones had a higher absolute 1-year OS rate (73% vs 87%). Toxicity was generally mild (grade 1: 8 pts., grade 2: 2 pts.), except one patient with Child C cirrhosis who developed hepatic failure shortly after SBRT which was successfully treated by liver transplantation. Conclusion SBRT is a locally effective and well tolerated treatment method for primary and secondary liver lesions. Given the high rates of intrahepatic outfield failures, careful pretreatment evaluation and patient selection seems mandatory. EP-1240 Stereotactic radiotherapy in pancreatic cancer: a systematic review on pain relief M. Buwenge 1 , G. Macchia 2 , F. Deodato 2 , S. Cilla 3 , L. Caravatta 4 , A. Farioli 5 , A. Guido 1 , A. Arcelli 1,6 , F. Bertini 1 , F. Cellini 7 , G.C. Mattiucci 7 , M.C. Di Marco 8 , S. Cammelli 1 , G. Tolento 1 , V. Valentini 7 , L. Fuccio 5 , A.G. Morganti 1 1 University of Bologna, Radiation Oncology Center- Department of Experimental- Diagnostic and Specialty Medicine - DIMES, Bologna, Italy 2 Fondazione di ricerca e cura "Giovanni Paolo II", Radiotherapy unit, Campobasso, Italy 3 Fondazione di ricerca e cura "Giovanni Paolo II", Medical Physics Unit, Campobasso, Italy 4 Centro di Radioterapia e Medicina Nucleare- P.O. Businco, Radiotherapy Unit, Cagliari, Italy 5 University of Bologna, Department of Medical and Surgical Sciences - DIMEC, Bologna, Italy 6 Ospedale Bellaria, Radiotherapy Department, Bologna, Italy 7 Policlinico Universitario "A. Gemelli"- Università Cattolica del Sacro Cuore, Department of Radiotherapy, Roma, Italy 8 University of Bologna, Oncology Center- Department of Experimental- Diagnostic and Specialty Medicine - DIMES, Bologna, Italy Purpose or Objective In locally advanced pancreatic carcinoma (LAPC) standard radiotherapy and concurrent chemoradiation are able to reduce pain. Stereotactic radiotherapy (SBRT) is an emerging treatment technique but its role in pain palliation is not well known. Therefore, aim of this analysis was to systematically review the palliative effect of SBRT in LAPC. Material and Methods A systematic review based on PRISMA methodology of papers reporting pain control after SBRT in LAPC patients was performed using PubMed database. Combination with chemotherapy was allowed. Only article published in English were considered. Results A total of 11 studies reporting data on pain control after SRT in LAPC patients met the inclusion criteria. SBRT was performed using both standard and robotic Linacs. The prescribed SBRT median total dose 24 Gy (range: 14-45 Gy), and the median number of fraction was 3 (range: 1- 6). Median EQD 2 using α/β: 10 and α/β: 3 were 65.5 Gy (range 31.3-93.8) and 95.0 Gy (range 40.0-162.0), respectively. Nine of the 11 studies reported different rates pain reduction. Particularly, median pain ORR was 57.0% (range: 44.0-100.0%) with 2 studies reporting pain CR in 48.4% and 81.3% of patients. Reduction of analgesic consumption was recorded in 65.0-100.0% of patients. One study reported no significant pain reduction, while another study reported a significant worsening of pain 2 weeks after SBRT. Acute and late toxicity (grade ≥ 3) ranged between 3.3-18.0% and 6.0-8.2%, respectively. All recorded toxicity were GI complications. Conclusion SBRT was able to achieve pain reduction in most studies with a reasonable rate of side effects. Therefore, further prospective studies on palliative role of SBRT in LAPC

seems to be justified. Aim of these trials should be the definition of the optimal dose/fractionation and the best way to combine SBRT with systemic therapies. Finally, being treatment of LAPC patients mainly palliative, quality of life and particularly pain control should be considered as an end point in future SBRT trials. EP-1241 Successful pain relief after a short course of palliative radiotherapy in painful pancreatic cancer. G. Ebrahimi 1 , C.R.N. Rasch 1 , G. Van Tienhoven 1 1 Academic Medical Center, Radiation oncology, Amsterdam, The Netherlands Purpose or Objective Patients with pancreatic cancer have a high burden of symptoms. At time of diagnosis 30-40% of the patients report pain as a dominant symptom, which rises up to 90% shortly before death. Because of a poor overall survival, the burden of a palliative treatment should be balanced against the expected effect. This study was conducted to assess the effect of a short course of palliative radiotherapy on pain symptoms. Material and Methods All patients who were treated with palliative radiotherapy because of painful pancreatic cancer between 1998 and 2015 were retrospectively analyzed. Primary endpoint was pain relief and secondary endpoint was overall survival. Results 61 patients were treated with a short course of palliative radiotherapy at the Academic Medical Center. A majority had stage four disease (69%) and a minority had local recurrence after surgery (10%). Median age was 62 years, 51% of the patients were male and mean Karnofsky performance score (KPS) was 79%. Median pain score before treatment was 8 on an 11-point numeric pain rating scale. Eighty-five percent of the patients used strong opioids with a mean equivalent oral morphine dose of 147 mg a day. Four radiotherapy dose schedules were given: 3 x 8 Gy (46%), 2 x 8 Gy (39%), both once per week, 1 x 8 Gy (13%) and 1 x 6 Gy (2%). Pain relief after radiotherapy was experienced by 66% of patients. Median time to reduction in pain was 1 week after end of radiotherapy, although this time interval could only be assessed in 25 patients. Information on use of pain medication after treatment was not clearly documented. Four patients had complete pain relief and in 4 patients pain medication was reduced or even stopped. Nausea was a common reported side effect in 51% and vomiting was reported in 21%. Median overall survival was 3.5 months. Patients who had pain relief after treatment had a better overall survival (p<0,0001) compared to non responders. Conclusion A short course of palliative radiotherapy was effective in 66% of the patients with the most frequent given radiotherapy dose schedule of 3 x 8 Gy. Radiotherapy was fairly well tolerated. These results were the basis for a prospective phase-2 study at our institute named PAINPANC ( NTR5143) . Thirty patients with pain ful unresectable panc reatic cancer will receive 3 x 8 Gy, one fraction a week, and are prospectively followed with EORTC-QLQ-C15-PAL and Brief Pain inventory questionnaires during and after treatment. EP-1242 Palliative EBRT for incurable esophageal cancer and symptomatic dysphagia-single center results K. Yordanov 1 , A. Richetti 1 , S. Cima 1 , G. Pesce 1 , C. Azinwi 1 , F. Martucci 1 , B. Muoio 1 , P. Fanti 1 , M.C. Valli 1 1 Oncology Institute of Southern Switzerland, Radiotherapy, Bellinzona, Switzerland Purpose or Objective Purpose: to assess the effectiveness and safety of external beam radiation therapy (EBRT ) to palliate dysphagia in