ESTRO 36 Abstract Book

S754 ESTRO 36 2017 _______________________________________________________________________________________________

B. Alvarez 1 , A. Montero 1 , E. Sanchez 1 , R. Ciervide 1 , F. Aramburu 2 , M. Hernández 1 , M. López 1 , S. Rodríguez 2 , M. Valero 2 , J.J. Valero 1 , M. García-Aranda 1 , E. Calvo 2 , O. Hernando 1 , X. Chen 1 , R. Alonso 3 , P. García de la Peña 2 , C. Rubio 1 1 Hospital universitario hm madrid sanchinarro, Radiation Oncology, Madrid, Spain 2 Hospital universitario hm Madrid sanchinarro, rheumatology, Madrid, Spain 3 Hospital universitario hm puerta del sur, radiation oncology, madrid, Spain Purpose or Objective to evaluate feasibility and duration of response induced by low dose radiotherapy (RT) in patients with painful degenerative diseases comprising enthesiopathies or osteoarthritis refractory to any conventional treatment. Material and Methods From April 2015 to October 2016, 53 patients with painful skeletal disorders of different locations were treated; 16 (30%) patients were monitored for more than six months. The pain was evaluated before radiotherapy and 6 weeks after treatment according to the visual analogue pain scale (VAS) and the requirements of daily oral analgesic intake. All patients underwent CT simulation and were treated in a conventional linac. PTV included the affected joint and periarticular soft tissues. Prescribed dose to the PTV was 6 Gy at 1Gy/fraction each two days. If needed, a second course similar to the previous was delivered after 6-8 All 16 patients were women and the average age was 68 years old. Five treatments were located on hands, 4 on knees, and the 6 remaining at diverse joints. A second course of 6 Gy was required by 50% of patients. Pre-RT median pain score according to VAS was 7.5 (range 4-9); median post-RT pain according to VAS was 1 (range 0-4). There was a reduction of more than 4 points in all patients. Eighty-one per cent of patients reported subjective clinical improvement of their joint pain; 38% of patients reduced their analgesic intake, 6% maintained the same and 31% discontinued oral analgesic. Conclusion Our results support the efficacy and safety of low-dose anti-inflammatory radiotherapy as an alternative treatment for painful osteoarticular degenerative diseases. Pain response and functional improvement maintained for long time in a substantial proportion of patients on follow-up. weeks. Results EP-1430 Venous thromboembolism in radiation oncology: retrospective trial M. Cherkashin 1 , N. Berezina 1 , N. Vorobyov 1 , E. Pinelis 2 1 Dr Berezin Medical Center, Oncology, Saint-Petersburg, Russian Federation 2 Albert Einstein College of Medicine, Respiratory Care, New York, USA Purpose or Objective Venous thromboembolism (VTE) prevention in oncology patients during external beam radiation therapy (RT) in outpatient setting is the challenging question. There is no clear statement from international societies (ASCO, ESMO, ACCP) and os far it is unclear if RT is an independent risk factor for VTE. Last years a couple of published trials have reported some VTE cases in this group of patients, but lack of evidence is the common problem. The objective of this study is the clear assessment of VTE incidence in these patients Material and Methods In retrospective analysis 3280 patients' medical records were included (1612 with RT and 1668 with chemotherapy). Inclusion criteria were: RT in outpatient

In this modern era of precision radiation therapy treatment planning, peer review of the planning process has a vital role. Peer review of treatment plans among radiation oncologist improves the process and recommended changes can be incorporated in the the treatment plans in a timely manner. The study shows that the review of treatment plans is a necessary quality step in radiation therapy and can be done on a weekly basis for all the patients. Hence, the quality of planning is improved in a resource limited university hospital. EP-1428 Stereotactic body radiotherapy for isolated metastasis from different primitive tumors A. Lancia 1 , G. Ingrosso 1 , A. Carosi 1 , L. Di Murro 1 , E. Giudice 1 , S. Cicchetti 1 , P. Morelli 1 , C. Bruni 1 , D. Di Cristino 1 , A. Murgia 1 , A. Cancelli 1 , I. Turturici 1 , A. Iadevaia 1 , R. Santoni 1 1 Tor Vergata University Hospital, Department of Diagnostic Imaging- Molecular Imaging- Interventional Radiology and Radiotherapy, Roma, Italy Purpose or Objective The oligometastatic state identifies a subset of patients who might be amenable to curative therapy. In this specific group of patients, Stereotactic Body Radiation Therapy (SBRT) has been shown to reach high levels of local tumor control through the delivery of high doses of radiation in few fractions, without the development of significant toxicity. Any meaningful improvement in survival remains debatable. Material and Methods From July 2007 to March 2016, 78 patients were treated at our Department with Stereotactic Radiotherapy for isolated body metastasis. The most frequent primary tumor was prostate cancer (28.2%), followed by colorectal cancer (23.1%), and lung cancer (20.5%). All patients received a radical treatment to the primary tumor site . Median time from primary tumor treatment to SBRT for oligometastatic disease was 30.3 months (range 1.07- 232.3). No patient had synchronous metastases at the time of SBRT. Median age at diagnosis of oligometastatic disease was 70 years (range 47-88). Median Karnofsky Performance Status (KPS) was 90 (range 70-100). Patients were also evaluated in terms of Charlson Comorbidity Score (CCS). The most used SBRT dose fractionation scheme was 35 Gy in 5 fractions. Overall Survival (OS), Cancer-Specific Survival (CSS), and Local Control (LC) were calculated from the end date of SBRT to the end of follow-up; Progression-Free Survival (PFS) was calculated from the end date of SBRT to the first clinical progression. Treatment related toxicity was evaluated using the CTCAE version 4.0. Results Median follow-up was 22.68 months (range 1.9-95.73). One year and 2 years LC were 91% and 89%, respectively. At the time of analysis, thirty-one patients (39.7%) were free from local and systemic progression: one and 2-year PFS were 85% and 72%, respectively. CSS at one year was 93% and it was 85% at two years. One and 2-year OS were 92% and 82%, respectively . At the univariate analysis, we found that KPS ≥ 80 was a statistically significant prognostic factor for OS, and PFS (p=0.001 for both). OS was also influenced by the primitive tumor (p=0.006). 8 (10.2%) patients developed acute toxicity >2, while 5 patients (6.4%) developed late toxicity >2. Conclusion SBRT is a safe and effective management option for the control of oligometastatic disease . This therapeutic approach can have an important role in delaying disease progression. Toxicity seems to be moderate in most cases EP-1429 maintaining efficacy of low-dose radiotherapy on pain and function in degenerative skeletal diseases