ESTRO 36 Abstract Book

S337 ESTRO 36 _______________________________________________________________________________________________

Medical Student, Orlando, USA 2 University of Central Florida, College of Medicine, Orlando, USA 3 UF Health Cancer Center-Orlando Health, Radiation Oncology, Orlando, USA Purpose or Objective We examined the impact of patient and tumor-specific factors on overall survival in patients with brain metastases from breast cancer treated with stereotactic radiosurgery. Material and Methods We performed an IRB-approved retrospective analysis of patients treated at our institution with LINAC-based, image-guided, frameless stereotactic radiosurgery for brain metastases from breast cancer between November 2008 and July 2016. We identified 184 metastatic brain lesions treated in 52 breast cancer patients. Out of the 184 treated brain metastases, 174 had at least one follow up study. Patients were followed with serial brain MRIs with contrast to assess for local progression and recurrence every 2-3 months. Patient characteristics collected included extracranial disease status, Karnofsky performance status (KPS), tumor histology, history of whole brain radiation therapy (WBRT), history of IMRT, history of craniotomy, date of death or last clinical contact, and age at initial SRS treatment. Treatment characteristics evaluated included tumor volume, number of tumors, prescription dose, prescription isodose, and maximum dose. Actuarial patient survival was defined as the time in months from initial SRS treatment to date of death or date of last clinical contact. The overall survival was calculated from date of first SRS treatment session to date of death or progression via the Kaplan-Meier method. Results At the time of initial treatment, 21% of patients were categorized as RPA class I, 69% as RPA class II, and 10% as RPA class III. The median survival was 59.0 months for RPA class I, 14.1 months for RPA class II, and 9.4 months for RPA class III. The median overall survival was 15.0 months. The Kaplan-Meier overall survival estimates at 6 and 12 months were 80.1% and 57.5%, respectively, from the time of initial SRS treatment. The median survival for patients with active extracranial disease was 9.36 months, compared to 59.0 months for patients with inactive extracranial disease (p-value = 0.012). Other factors examined including age, KPS, tumor histology (ductal vs. lobular vs. unknown), ER, PR and Her 2-Neu status, did not have a statistically significant impact on survival. Conclusion Breast cancer patients with brain metastases display a broad range of survival outcomes following SRS, with RPA class I having a median survival of 59 months in our dataset. Those with inactive extracranial disease in our group had the best prognosis following SRS. There was no effect on post-SRS survival based on age, KPS score, pre- SRS WBRT, concurrent WBRT, tumor histology, ER, PR, and Her 2-Neu expression status. These data support the use of SRS in a broad range of breast cancer patients and further reveal no improvement in survival for patients receiving WBRT during their brain metastasis treatment.

chemoradiotherapy in the subgroups of the patients with different demographic and disease characteristic as well as the different short term results of the chemotherapy and the chemoradiotherapy in its entirety. Material and Methods Material/methods: The study included 676 previously untreated patients with morphologically proven aggressive NHL who received combined modality therapy. The characteristic of the patients: male - 319 (47,2%), female - 357 (52,8%). Age 15 – 86 years (median age 45 years). International prognostic index (IPI) 0-1 (favourable) - 314 (46,4%), 2-3 (intermediate) - 297 (43,9%), IPI 4-5 (unfavourable) - 65 (9,6%); stage I-II - 409 (60,5%), stage III-IV - 267 (39,5%). All patients received initially 6-8 cycles of CHOP or CHOP-like regimens ± Rytuximab and complete remission (CR) or partial remission (PR) was achieved in all of them. Then the radiation therapy was performed. All sites of initial involvement were irradiated in local stages, patients with advanced stages get radiation therapy on PET(+) lesions, partially regressed tumors, sites of initial bulky tumors. Daily doses were 1,8- 2Gy, summary doses 30-50Гр. Relapses in the sites of initial involvement were classified as local (true), in initially uninvolved sites - as distant. Mixed relapses (local and distant) were counted in both groups. After completion of the treatment patients were followed up during 1,17-30 years, mean – 5,2±0,2 years, median – 3,1 years. Results Results: The results of the study are presented in the table. Table 1. Relapses in the different groups of patients with aggressive non-hodgkin lymphoma after chemoradiation therapy

Conclusion Conclusion: The probability of relapse of aggressive non- hodgkin lymphoma after chemoradiation therapy is about 30%, but local relapse – only 10%. The probabilities and patterns of the relapses are the same in the young and aged patients. The local and advanced stages have statistically proven differences in the probabilities of all relapses and local relapses (+10%), but the risk of the distant relapse is very close in this groups. Patients from favourable prognostic group (IPI 0-1) have the minimal risk of the relapse, both local and distant in comparison with other IPI prognostic groups. Extranodal lymphomas differ favourably from nodal lymphomas: after chemoradiation therapy the relapses are less common in this group, to the greatest extent – the local relapses ( p=0,04) . The immediate effect of chemotherapy significantly affects the absolute risk of all relapses and the risk of distant relapse, but only the response to radiotherapy determines the probability of local relapse. At the same time, the partial remission due to the partial regression of the lesion after irradiation) is an additional poor prognostic factor for all relapses and for distant relapses. These

Poster: Clinical track: Haematology

PO-0645 The patterns of the relapses of aggressive non- hodgkin lymphomas after chemoradiotherapy V. Sotnikov 1 , G.A. Panshin 1 , N.V. Nudnov 1 , V.A. Solodkiy 1 1 Russian Scientific Center of Roentgenoradiology, Radiation therapy, Moscow, Russian Federation Purpose or Objective Purpose: To study the number and the patterns of the aggressive non-hodgkins lymphomas relapses after