ESTRO 36 Abstract Book

S745 ESTRO 36 2017 _______________________________________________________________________________________________

Hematologic and non-hematologic toxicities were graded according to Common Terminology Criteria for Adverse Events version 4.0. Results From February 2013 to February 2016, among patients referred to our institution for anaplastic gliomas, 24 patients were included in this evaluation. Biopsy was performed in 13 patients, complete resection in 5 and partial resection in 6. Concomitant and/or adjuvant chemotherapy was administrated in 7 patients. The median time and the 6 and 12 months progression-free survival (PFS) rate were 4.4 months, 46% and 12%. The median overall survival (OS) time and the 1 year OS rate were 7.3 months, 70.8% and 16.7%. On univariate and multivariate analysis MGMT status and administration of adjuvant chemotherapy more than concurrent chemotherapy significantly impacted on PFS and OS (p < 0.01). The treatment was well tolerated, no severe toxicity was recorded. Conclusion In our experience, hypofractionated radiotherapy with VMAT-RA in elderly and frail patients could be a safe and feasible therapeutic option. Adjuvant chemotherapy, in selected patients, can improve survival. EP-1410 Role of PMRT in Elderly Patients with T1-2 and 1 to 3 Positive Nodes Breast Cancer L. Cao 1 , M.Y. Kirova 2 , C. Xu 1 , K.W. Shen 3 , J.Y. Chen 1 1 Ruijin Hospital- Shanghai Jiaotong University School of Medicine, Department of Radiation Oncology, Shanghai, China 2 Institut Curie, Department of Radiation Oncology, Paris, France 3 Ruijin Hospital- Shanghai Jiaotong University School of Medicine, Comprehensive Breast Health Center, Shanghai, China Purpose or Objective Even if evidence of post-mastectomy radiotherapy (PMRT) in patients with T1-2 and 1 to 3 positive nodes breast cancer is increasing, controversies still exist, especially in elderly patients because the risk of treatment-related toxicity. The aim of this study is to evaluate the efficacy and toxicity of PMRT in elderly as well as the place and use of systemic treatment in this population of patients. Material and Methods We retrospectively reviewed records of consecutive patients with T1-2 and 1 to 3 positive nodes treated with mastectomy at our institution between June 2009 and June 2014. Elderly patients were defined as 65 years or above. Patients who had received neoadjuvant treatment were excluded from the analysis. In total, we analyzed 73 patients, of them only 23 received PMRT. Locoregional recurrence (LRR) was defined as any recurrence within the ipsilateral chest wall, ipsilateral axillary, internal mammary, infraclavicular or supraclavicular lymph nodes. All recurrences at other sites were recorded as distant disease recurrence (DDR). Disease-free survival (DFS) was defined as the time from start of PMRT until recurrence of tumor or death from any cause. Overall survival (OS) is defined as the time from start of PMRT until death from any cause. Results The median age was 72 years (range, 65-91 years). There were 10 patients with HER2 positive tumors, of them100% (n=4) received trastuzumab in the PMRT group and 2 of 6 patients in non-PMRT group. All patients with HR positive tumor received endocrine therapy. The patients in the PMRT group were younger (69 years vs. 75 years, P=0.005). Higher number of patients in the PMRT group received adjuvant chemotherapy (82.6 % vs 48 %, P=0.006). At a median follow-up of 48 months (range, 25-85 months), there were 2 LRR diagnosed concurrently with distant metastasis, one in each group respectively. We observed six distant metastases and 5 deaths. In the whole cohort,

Conclusion Most elderly patients have a BMI at the start of treatment not indicative of malnutrition, and hardly changes during treatment All patients have some degree of weight loss at the beginning of treatment. During the treatment and at the end, most do not progress in such loss or it is less than 5% Patients have a progressive difficulty in feeding, mainly due to dysphagia, but this does not translate for changing the type of diet It is essential to assess the nutritional status of elderly patients with lung cancer at the start of oncological treatment, as well as a scheduled monitoring to control feeding problems and give adequate dietary guidelines EP-1409 Prospective study of hypofractionated radiotherapy for elderly patients with High Grade Glioma E. Clerici 1 , P. Navarria 1 , A.M. Ascolese 1 , F. Pessina 2 , S. Tomatis 1 , L. Cozzi 1 , M. Simonelli 3 , A. Santoro 3 , C. Franzese 1 , L. Bello 2 , M. Scorsetti 1 1 Istituto Clinico Humanitas, Radiotherapy and Radiosurgery, Rozzano Milan, Italy 2 Istituto Clinico Humanitas, Neurosurgery Oncology Department, Rozzano Milan, Italy 3 Istituto Clinico Humanitas, Oncology and Hematology Department, Rozzano Milan, Italy Purpose or Objective Published studies showed that a short course of radiation therapy (RT) in elderly and frail patients with diagnosed anaplastic glioma is safe, feasible and better tolerated compared to standard RT fractionation. Based on this background we designed a prospective trial of hypofractionated radiotherapy. The aim of this study was to evaluate patients outcome in terms of progression free survival (PFS) and Overall Survival (OS) rate, and treatment related toxicity. Material and Methods Elderly patients (≥70 years old) with poor Karnofsky performance status and histological confirmed high grade glioma (HGG) were included in this evaluation. All patients underwent hypofractionated radiotherapy with or without concomitant and adjuvant chemotherapy in relation to MGMT status, using temozolomide (TMZ). To precisely define the target volume, computer tomography (CT) scan with and without contrast and magnetic resonance images (MRI) were acquired and images were coregistered. The clinical tumor volume (CTV) corresponded to surgical cavity or to T1 FLAIR abnormality in case of biopsy only. Planning target volume (PTV) was generated adding an isotropic margin of 5 mm from CTV. All plans were optimized on PTV using volumetric modulated arc therapy (VMAT) mode. Dose prescription was 52 Gy in 15 consecutive daily fractions (BED 10 70.88 Gy). Clinical outcome was evaluated by neurological examination and brain MRI performed, one month after RT and then every 3 months. Response was recorded using the Response Assessment in Neuro-Oncology (RANO) criteria. The tumor progression was described as local, if it occurred in/or within 2 cm from primary site, and distant for new and non-contiguous enhancing or non-enhancing lesions.