ESTRO 36 Abstract Book

S740 ESTRO 36 2017 _______________________________________________________________________________________________

Material and Methods Treatment results of 40 patients (8 female, 32 male) in median age 60 years (from 40-84 years), with primary cutaneous T-cell lymphoma (mycosis fungoides), stage IB- III, treated between 2001 and 2013 were reviewed. All patients were symptomatic. The median total dose was 32Gy (range 12-40Gy), applied with 1,5 Gy per day four times weekly for the whole skin. Results The median follow-up was 60 months. A clinical complete response was documented in 29 (72.5%) and a partial response in 11 patients (27.5%). The clinical response significantly influenced on the overall survival (OS) (p=0.002) and progression-free survival (PFS) (p<0.001). The mean OS was 76 months. The mean PFS was 48.9 months and the actuarial one-, two- year PFS were 67.5%, 55%. The statistically significant correlation was found between partial and total remission time and the stages of lymphoma (p=0.015). The side effects were observed in all patients during the treatment and include: erythema, skin dryness and desquamation, pruritus, onycholysis and alopecia. Conclusion For palliation of symptomatic cutaneous lymphoma, total skin electron beam therapy is well tolerated and an efficient treatment. EP-1400 Quality of Life in Responders after Palliative Radiation Therapy for Painful Bone Metastases L.C. Mendez 1 , J.L. Padilha 2 , K.M. Lima 3 , E. Chow 1 , F.Y. Moraes 4 , M.D.P.E. Esteves 5 , M.F. Silva 2 , G.N. Marta 6,7 1 Sunnybrook Odette Cancer Centre- University of Toronto-, Radiation Oncology, Toronto, Canada 2 Universidade Federal de Santa Maria, Radiation Oncology, Santa Maria, Brazil 3 Faculdade de Medicina da Universidade de São Paulo, Radiation Oncology, Sao Paulo, Brazil 4 Princess Margaret Cancer - University of Toronto, Radiation Oncology, Sao Paulo, Canada 5 Instituto do Câncer do Estado de São Paulo ICESP - Faculdade de Medicina da Universidade de São Paulo, Clinical Oncology, Sao Paulo, Brazil 6 Hospital Sírio-Libanês, Radiation Oncology, São Paulo, Brazil 7 Instituto do Câncer do Estado de São Paulo ICESP - Faculdade de Medicina da Universidade de São Paulo, Radiation Oncology, Sao Paulo, Brazil Purpose or Objective Bone metastases cause pain, suffering and impaired quality of life (QOL). Palliative radiotherapy (RT) is an effective method in controlling pain, reducing analgesics use and improving QOL. This study goal was to investigate the changes in QOL scores among patients who responded to RT. Material and Methods A prospective study evaluating the role of radiation therapy in a public hospital in São Paulo-Brazil recorded patients’ opioid use, pain score, Portuguese version of QLQ-BM22 and QLQ-C30 before and 2 months after radiotherapy. Analgesic use and pain score were used to calculate international pain response category. Overall response was defined as the sum of complete response (CR) and partial response (PR). CR was defined as pain score of 0 with no increase in analgesic intake whereas PR was defined as pain reduction ≥ 2 without analgesic increase or analgesic reduction in ≥25% without increase in pain at the treated site. Results From September 2014 to October 2015, 25 patients with bone metastases responded to RT (1 CR, 24PR). There were 8 male and 17 female patients. The median age and ECOG of the 25 patients was 57 years old (range 22 to 89) and 2 (range 0 to 3), respectively. Patient’s primary cancer site was breast (11), prostate (5), lung (2), others

(7). For QLQ-BM 22, the mean scores of 4 categories at baseline were: Pain site (PS) 39, Pain characteristics (PC) 61, Function Interference (FI) 49 and Psycho-social aspects (PA) 57. At 2 month follow up, the scores were PS 27, PC 37, FI 70 and PA 59. Statistical significant improvement (p<0.05) was seen in PS, PC, FI but not PA. In the QLQ- C30, the mean scores were not statistically different for all categories, except for pain that demonstrated a 29 point decrease in the pain score domain (69 to 40). Conclusion Responders to RT at 2 month presented improvement in BM22 and C30 pain domains, and also improvement in functional interference if BM22 questionnaire. Patients with painful bone metastases may receive palliative radiation therapy to improve both pain and QOL. EP-1401 SBRT for solitary extracranial metastases from gynecologic malignancies M.C. Repka 1 , N. Aghdam 1 , S. Suy 1 , S.P. Collins 1 , W. Barnes 2 , B.T. Collins 1 1 Georgetown University Hospital, Department of Radiation Medicine, Washington, USA 2 Georgetown University Hospital, Division of Gynecologic Oncology, Washington, USA Purpose or Objective Solitary extracranial metastases from gynecologic malignancies have historically been treated with either surgery or conventional radiation therapy. We report mature local control, toxicity, and survival for patients who received five-fraction stereotactic body radiation therapy (SBRT) at our institution. Material and Methods Patients presenting with biopsy-proven, solitary, small (<5 cm) extracranial metastasis from a gynecologic primary cancer, treated with robotic SBRT, were retrospectively reviewed. Vaginal cuff recurrences or multiple sites of disease were considered exclusion criteria for this analysis. Patients were stratified by the presence or absence of sarcomatous histology. The Kaplan-Meier method was used to estimate local control and overall survival. Durable local control was defined as lasting ≥12 months. Toxicity was scored per the CTC-AE v4.0. Results Twenty patients were treated over a five year period from July 2007 to July 2012 for solitary extracranial metastases from gynecologic malignancies. Sixteen patients were noted to have non-sarcomatous histology (six uterine and ten ovarian primary tumors), while four tumors were identified as sarcoma (all uterine primaries). No patients with solitary cervical cancer metastases were identified. Metastases involved the liver, lung, abdomen, spine, pelvis, and extremity. Thirteen patients had fiducials placed for tumor tracking; abdominal and spine metastases were tracked with a fiducial-less spinal tracking system. The median gross tumor volume (GTV) was 42.5 cc (range: 5 - 273 cc). The median dose delivered to the GTV was 35 Gy (range: 30 - 50 Gy) over 5 to 9 days (median: 6 days). At a median follow-up of 56 months (range: 6 - 108 months), the 5-year local control and overall survival rates were 71.2% and 47.5% respectively. However, when stratified by histology, the local control at 5 years was 93.7% in patients with classical histology versus 25.0% in patients with metastatic gynecologic sarcoma (p < 0.01) and only 50.0% of the sarcoma patients experienced durable local control. No grade 3 or higher toxicity was observed during or following treatment. Conclusion Five-fraction SBRT is a versatile, well-tolerated, and highly effective treatment option for small extracranial gynecologic metastases with an excellent 5-year local control of 93.7% in patients with classical ovarian and uterine primary tumors. However, patients with metastatic uterine sarcoma may require a more aggressive or alternative treatment approach.