ESTRO 36 Abstract Book

S693 ESTRO 36 2017 _______________________________________________________________________________________________

(11p in progression status and 191p with no evidence of disease). Anemia monitoring: only 36p (53.7%) of 67p with anemia detected before RDT, underwent subsequent Hb control (during or after RDT). Only 27p of 67p with anemia were previously treated with chemotherapy (40p were anemic with no systemic treatment). Differences between mean Hb levels were statistically significant for Hb1-Hb2 (p=,00), Hb1-Hb4 (p=,005), Hb3-Hb4 (p=,004) and Hb2-Hb4 (p=,001). Patients with pre-treatment Hb level <12g/dL presented worse overall survival (p=.021, Chi2 5.3), with mean OS of 53.39 months (range 45.5-61.3) vs. 61.4 (range 58.4-64.4) in patients with ≥ 12g/dL. Conclusion Despite evidence that anemia is frequent in patients with endometrial carcinoma and determine OS, the follow-up of anemia in cancer patients is still suboptimal. There is a strong need of guidelines for anemia monitoring in cancer patients. EP-1306 New pre-treatment eosinophiles-related ratios as predictive factors for OS in endometrial carcinoma. K. Holub 1 , A. Biete 1 1 Hospital Clínic i Universitari de Barcelona, Radiation Oncology Dpt., Barcelona, Spain Purpose or Objective To analyze the influence eosinophil levels in prognosis of We retrospectively evaluated 233 patients (p) out of a total cohort of 248p diagnosed with endometrial carcinoma and treated with radiotherapy (RDT) in our center between January 2011 and December 2015. We analyzed the prognostic value of pretreatment eosinophiles as well as we described new eosinophils- related ratios in endometrial cancer: Eosinophil-to- Lymphocyte Ratio and Eosinophil*Neutrophile-to- Lymphocyte Ratio. Statistics: Chi-square, Kaplan-Meier method. Results Age at diagnosis (years): mean 64.9 (range 36-90). All patients underwent surgery before RDT, with pelvic lymphadenectomy in 187p (80.3%). Histology: Endometrioid 172p (73.8%), non-endometrioid 61p (26.2%). FIGO stage (2009): IA-60p (27.8%), IB-92p (39.5%), II-32p (13.7%), IIIA-9p (3.9%), IIIB-0, IIIC1-20 (8.6%), IIIC2- 8 (3.4%), IVA-9 (3.9%), IVB-3(1.3%). Grade: I-50p (21.5%), II-91p (39%), III-88p (37.8%). External beam radiotherapy (EBRT) dose (Gy): mean 44.2 (range 9-65). Brachytherapy (BT) dose (Gy): mean 10.2 (range 5-20). Majority of patients was treated with combination of EBRT and BT. EBRT+BT dose (Gy): mean 41.2 (range 5-75). Mean follow- up (months): mean 32 (SD 17.5). Progression was observed in 40p (17.2%): only one patient developed pelvic node recurrence, 39p developed distant recurrence (4p with simultaneous vaginal progression, 3p with regional progression and one 1p with both vaginal and regional progression, remaining 31p presented exclusively distant progression). Mortality: 31p (13.3%), including cancer- specific mortality: 28p (12%) and 3 deaths not related with endometrial cancer (1.3%). Remaining 202p were alive (11p in progression status and 191p with no evidence of disease). endometrial carcinoma. Material and Methods

≥0. 1 <0. 4 vs ≥0. 4

Eosinophiles*Neutr ophils-to- Lymphocytes Ratio (ENR)

4.6 (1.14 - 12.5)

63.0 vs 53.6

,015 (5.86 )

112

4 vs 8

Conclusion Tumor-generated inflammation is considered to be one of the principal triggers for tumor progression. Several hypotheses link eosinophilia with cancer, however until now there has not been any evidence of impact of eosinophil levels in combination with other immune cells on prognosis of cancer. To our best knowledge, this is the first publication describing and analyzing the eosinophil- related ratios as a predictive factor in cancer . EP-1307 New neutrophils-related ratios as a novel predictive biomarkers for endometrial carcinoma. K. Holub 1 , A. Biete 1 1 Hospital Clínic i Universitari de Barcelona, Radiation Oncology Dpt., Barcelona, Spain Purpose or Objective To analyze the influence of neutrophils, lymphocytes, monocytes and platelet-related disorders in pre- treatment blood analysis on prognosis of endometrial carcinoma. Material and Methods We retrospectively evaluated 233 patients (p) out of a total cohort of 248p diagnosed with endometrial carcinoma and treated with radiotherapy (RDT) in our center between January 2011 and December 2015. We analyzed the prognostic value of pretreatment neutrophils and lymphocytes levels as well as Neutrophil-to- Lymphocyte ratio (NLR), Platelet-to-Lymphocyte ratio (PLR), Lymphocyte-to-Monocyte ratio (LMR) and Platelet*Neutrophil-to-Lymphocyte ratio (Systemic Immune-Inflammation Index, SII) in endometrial cancer. Statistics: Chi2, Kaplan-Meier method. Results Age at diagnosis (years): mean 64.9 (range 36-90). All patients underwent surgery before RDT, with pelvic lymphadenectomy in 187p (80.3%). Histology: endometrioid 172p (73.8%), non-endometrioid 61p (26.2%). FIGO stage (2009): IA-60p (27.8%), IB-92p (39.5%), II-32p (13.7%), IIIA-9p (3.9%) ,IIIB-0, IIIC1-20 (8.6%), IIIC2- 8 (3.4%), IVA-9 (3.9%), IVB-3(1.3%). Grade: I-50p (21.5%), II-91p (39%), III-88p (37.8%). Majority of patients was treated with combination of EBRT and BT. EBRT+BT dose (Gy): mean 41.2 (range 5-75), median 52. Mean follow-up (months): mean 32 (SD 17.5). Progression was observed in 40p (17.2%): only one patient developed pelvic node recurrence, 39p developed distant recurrence (in 4p with simulates vaginal progression, 3p with regional progression and one 1p with both vaginal and regional progression, remaining 31p presented exclusively distant progression). Mortality: 31p (13.3%), including cancer- specific mortality: 28p (12%) and 3 deaths not related with endometrial cancer (1.3%). The remaining 202p were alive (11p in progression status and 191p with no evidence of disease). Neutrophils-related ratio were calculated as follows: NLR-absolute neutrophil count/absolute lymphocyte count, PLR-platelet count/ absolute lymphocyte count, LMR-absolute lymphocyte count/absolute monocyte count and SII - platelet*neutrophil count/lymphocyte count.

Numb er of event s (deat hs)

Overal l surviv al (mont hs)

Eosinophiles- related ratios in pre-treatment analysis Eosinophils-to- Lymphocytes Ratio (ELR)

Numb er of patie nts

Mean (rang e)

Cu t- Off

p (Chi 2)

Numb er of event s (deat hs)

Overa ll surviv al (mont hs)

Num ber of patie nts

Hemogram parameters in pre-treatment blood analysis

Mean (range)

Cut -Off

p (Chi2)

0.08 (0.0- 0.31)

<0. 1 vs

64.0 vs 52.0

,001 (12.0 1)

131

3 vs 9