ESTRO 36 Abstract Book

S747 ESTRO 36 2017 _______________________________________________________________________________________________

chemotherapy according to intradepartmental standards. For the analysis of the QoL the EORTC QLQ-C30 and the EORTC QLQ-LC13 were used. QoL data was collected before radiation treatment, 6 weeks, 12 weeks, 6 month and 12 month after RT. Additionally factors were analyzed, including clinical outcome, survival, treatment induced side effects. Results The median follow up was 34,5 weeks. In total 49,4 % of patients had a complete or partial remission and 16,0 % a stable local disease. Local failure occurred in 24,7 % of patients. Distant failure occurred in 44,4 % of patients. Severe dysphagia occurred in up to 9 % of patients, up to 50 % experienced mild dysphagia. The overall rates for RT induced pneumonitis (RP) were low with a maximum of 8 % 12 weeks after RT. The median survival time was 34 weeks with a range from 1 to 220 weeks. All functional scales showed a variable course but maxed or at least showed a recovery 12 weeks after RT. Symptoms with a high mean symptom score (> 40) were fatigue, dyspnoea and coughing. Insomnia, peripheral neuropathia, appetite loss, dyspnoea (from QLQ-LC13) and all parameters for pain had an intermediate mean score (10 – 40). There were low mean scores of fewer than 10 for nausea and vomiting, diarrhoea, sore mouth and haemoptysis. The GLM revealed no statistically significant difference for any QLQ-C30 parameter over time. For the QLQ-LC13 statistically significant differences over time were found for the peripheral neuropathy (p = 0,011) and the dysphagia (p = 0,034). There was a highly significant correlation between the clinical dysphagia and the dysphagia scores (p < 0,005). The correlation between clinical RP and the scores for dyspnoea and coughing was significant at some follow- up appointments. The EORTC QLQ-C30 and QLQ-LC13 scores did not prove to have a significant influence on the overall survival or distant and local failure. Conclusion 12 weeks after RT the scores of the QLQ-C30 functional scales showed the highest scores or at least a temporary recovery. The symptom scales accurately reflected the common symptoms and treatment related toxicities. There was a significant correlation between clinical dysphagia and pneumonitis and associated QoL scores. QoL did not prove to be a significant predictor for survival or distant and local control. EP-1413 IORT for treatment of recurrent tumors - A single institution analysis. T.M. Coelho 1 , R.C. Fogaroli 1 , A.C.A. Pellizzon 1 , D.G. Castro 1 , G.R.M. Gondim 1 , M.L.G. Silva 1 , M.J. Chen 1 , A.A. Ambrosio 1 1 Accamargo cancer center, Radiotherapy, Sao Paulo sp, Brazi Purpose or Objective The incidence of recurrent retroperitoneal or pelvic tumors (rRPT) varies from 20% to 77% in literature and requires a multidisciplinary approach. Local control (LC) with isolated salvage surgical resection is dismal, and intraoperative radiotherapy (IORT) can be considered an adjuvant treatment option for selected cases, in special those with previous course of radiation. This study assessed the feasibility, efficacy and morbidity of IORT as adjuvant treatment of rRPT who underwent to salvage surgical resection. Material and Methods 41 patients with non-metastatic and isolated (one anatomic site) rRPT were treated from 2004 to 2015. All patients were treated with intraoperative electron beam, except one patient who was treated with intraoperative high dose rate brachytherapy. The mean doses were 16 Gy (range 10-21) and 14Gy (range 9-20) for patients without and with previous external beam radiation therapy (EBRT), respectively. The dose was delivered with a 2cm safe margin around the tumor bed. Seventeen (39%) patients had additional EBRT (mean dose 45 Gy) after

surgery and IORT. Median survival times were calculated using Kaplan-Meier analysis and differences in survival between groups were tested using log-rank test. The Cox proportional hazards regression model was used to estimate the hazard ratio (HR) for potential predictors of LC, overall survival(OS) and disease-specific survival(DSS). A difference was considered statistically significant if Twenty-two (54%) patients had pelvic lesions and 19(46%) had retroperitoneal disease. In addition, 3 patients had a second course of RTIO for a second recurrent tumor in different anatomical site, 31 patients (82%) had resection R0 and 8 patients (18%) had resection R1. The most common recurrent tumors were colorectal cancer (36%) and retroperitoneal sarcomas (50%). With a median follow-up of 70 months (range 12-92), the median DSS was 54 months (range 28-80). The 5-year actuarial OS, LC and DSS were 71%, 68% and 44%, respectively. On univariate analysis margin status of resection significantly affected LC. For patient with resection R0, LC was 83% whereas no patient with R1 resection obtained local control (p<0,01). Toxicity presented in 11(27%) patients and pain was the most common side-effect (64%) followed by enteritis (18%). Conclusion IORT is an efficient method of salvage treatment to improve LC in selected patients with isolated locally recurrent tumors for recurrent pelvic or retroperitoneal tumors, with acceptable incidence of morbidity. EP-1414 Toxicity of concurrent stereotactic radiotherapy and targeted or immunotherapy: a systematic review S.G.C. Kroeze 1 , C. Fritz 1 , M. Hoyer 2 , S.S. Lo 3 , U. Ricardi 4 , A. Sahgal 5 , R. Stahel 6 , R. Stupp 6 , M. Guckenberger 1 1 University Hospital Zürich, Department of Radiation Oncology, Zurich, Switzerland 2 Aarhus University, Danish Center for Partical Therapy, Aarhus, Denmark 3 University of Washington School of Medicine, Department of Radiation Oncology, Seattle, USA 4 University of Turin, Department of Radiation Oncology, Turin, Italy 5 University of Toronto, Department of Radiation Oncology, Toronto, Canada 6 University Hospital Zürich, Department of Oncology, Zurich, Switzerland and targeted/immunotherapy play an increasingly important role in personalized treatment of metastatic disease. The combined application of both therapies is rapidly expanding in daily clinical practice. Patients may benefit from additive cytotoxic effects, but currently not much is known regarding safety and the potential induction of toxicity. Toxicity data from targeted/immunotherapy combined with conventionally fractionated radiotherapy cannot be extrapolated to SRT because of the differences in physics and biology. The aim of our systematic review was to summarize severe toxicity observed after PubMed and EMBASE databases were searched for English literature published up to april 2016 using keywords 'radiosurgery”, 'local ablative therapy”, 'gamma knife” and 'stereotactic”, combined with 'bevacizumab”, 'cetuximab”, 'crizotinib”, 'erlotinib”, 'gefitinib”, 'ipilimumab”, 'lapatinib”, 'sorafenib”, 'sunitinib”, 'trastuzumab”, 'vemurafenib”, 'PLX4032”, 'panitumumab”, 'nivolumab”, 'pembrolizumab”, 'alectinib”, 'ceritinib”, 'dabrafenib”, 'trametinib”, 'BRAF”, 'TKI”, 'MEK”, 'PD1”, 'EGFR”, 'CTLA-4” or 'ALK”. Studies performing SRT during p≤0,05. Results Purpose or Objective Stereotactic radiotherapy (SRT) concurrent treatment. Material and Methods