ESTRO 36 Abstract Book

S338 ESTRO 36 _______________________________________________________________________________________________

effects persist after the separate analysis of the local and advanced stages. PO-0646 Nodular Lymphocyte Predominant Hodgkin’s Lymphoma (NLPHL): Early Outcomes N. Khanna 1 , N. Kalyani 1 , J. Godasastry 1 , H. Menon 2 , M. Sengar 2 , N. Khattry 2 , U. Dangi 2 , B. Arora 2 , T. Shet 3 , S. Gujral 3 , E. Sridhar 3 , V. Rangarajan 4 , S. Banavali 2 , S. Laskar 1 1 Tata Memorial Hospital, RADIATION ONCOLOGY, Mumbai, India 2 Tata Memorial Hospital, MEDICAL ONCOLOGY, Mumbai, India 3 Tata Memorial Hospital, PATHOLOGY, Mumbai, India 4 Tata Memorial Hospital, NUCLEAR MEDICINE, Mumbai, India Purpose or Objective To evaluate treatment response, patterns of failure and prognostic factors for patients with NLPHL treated at the Tata Memorial Hospital (TMH). Material and Methods Between January 2007 & July 2013, 61 patients with histologically proven NLPHL in the age group of 6-70yrs (Median 30.5Yrs) were treated at TMH. Forty four (72%) were males. Majority had Stage I [29 patients (47%)] & Stage II [15 patients (25%)] disease. Fifteen (25%) had bulky disease at presentation. Sixteen (26%) were treated with Involved Field Radiation Therapy (IFRT) alone, 18 (30%) received Chemotherapy (CTh) alone, while 23 (38%) received a combination of CTh followed by IFRT. Four patients underwent surgery as the local treatment. The IFRT doses were in the range of 20-36 Gy. Thirty five (80%) patients received ABVD CTh. Five (8%) patients received Rituximab. Primary MINE CTh was used for 4 (6%) patients. Results After a mean and median follow-up of 43 and 41 months, the 5 year disease free survival (DFS) and overall survival (OS) were 65% and 93% respectively. Complete response (CR) at completion of primary treatment was 92%. At last follow up 46 (75%) were alive without disease. Two (3%) patients had residual disease, three (5%) patients each had in-field, out of field relapse. Five (8%) had disseminated relapse and one (2%) patient each had transformation to DLBCL and second primary disease (carcinoma tongue). Ten (66%) out of 15 patients with disease relapse received salvage treatment (3 IFRT, 3 CTh, 1 both), of which 7 were disease free at last follow up. Two patients have been planned for autologous stem cell transplantation. On univariate analysis, early stage (75% Vs 27%, p=0.07), absence of B symptoms (67% Vs 57%, p=0.08) and use of IFRT (69% Vs 60%, p=0.38) resulted in superior DFS. For patients with early stage disease (stage I and II), there was no difference in DFS between patients receiving IFRT alone (87%) and CTh + IFRT (80%), however DFS was inferior for patients who received only chemotherapy (55%). All patients tolerated treatment well without any grade III or IV toxicities. Conclusion NLPHL is associated with excellent overall survival. For patients with early stage disease, IFRT alone results in similar outcomes compared to CTh+IFRT. Early Stage at presentation, absence of B symptoms and the use of IFRT confers superior outcome. PO-0647 Factors associated with pulmonary toxicity after conditioning with total body irradiation H.K. Byun 1 , H.I. Yoon 1 , H.J. Kim 1 , J. Cho 1 , C.O. Suh 1 Yonsei Cancer Center, Radiation oncology, Seoul, Korea Republic of Purpose or Objective To evaluate clinical and therapeutic factors associated with pulmonary toxicity and related to survival outcome after myeloablative conditioning using fractionated total

body irradiation (TBI), followed by allogenic stem cell transplantation (allo SCT). Material and Methods A total of 58 patients with 43 ALL, 8 AML, and 7 others (1 neuroblastoma, 1 ewing sarcoma, 3 lymphoma, 2 aplastic anemia) who underwent fractionated TBI-based myeloablative conditioning and allo SCT between January 2005 and December 2014 were reviewed retrospectively. Total doses of TBI ranged from 8 Gy to 12 Gy, although most of the patients (91 %) received 12 Gy in 1.5 Gy b.i.d. fractions delivered using a dose rate of 7 to 19 cGy/minute. Patients with clinical symptoms were considered having pulmonary toxicity only if they have radiologic evidence or reduced pulmonary function and were furtherly subdivided based on presence or absence of concurrent infection detected through mediums such as blood or bronchoalveolar lavage. The relationship between the pulmonary toxicity and clinical factors were investigated using univariate and multivariate analysis. In addition, we also performed each survival analysis for treatment-related mortality (TRM) and overall survival (OS) rates. Results Overall pulmonary toxicities developed in 36 (62%) patients, of which 16 (28%) were proven to have a concurrent infection, and no pathogens were seen in 20 (35%). Median time to onset of pulmonary toxicity from transplantation was 6 months (range 1-31) in patients with infectious pneumonia and 7 months (range 0-26) in patients with the idiopathic pneumonia syndrome (IPS). The leading etiology of infectious pneumonia was bacteria (75%), followed by fungus (37.5%) and virus (12.5%). On univariate analysis, conditioning chemotherapy regimen (p=0.028) was significantly related to infectious pneumonia, while donor type (p=0.021) and transplanted cell type (0.031) was significantly associated with IPS. On multivariate analysis, only the donor type (matched unrelated vs. matched sibling, p=0.021, HR 12.67, 95% CI 1.46-110.30) was an independent factor related to the IPS. Conditioning chemotherapy regimen showed a trend towards significance for the development of infectious pneumonia. Other clinical factors did not have significant impacts on the development of infectious pneumonia or IPS. On survival analysis, patients with infectious pneumonia showed significantly higher rates of TRM (p=0.026) and lower OS rates (p=0.039), whereas patient with IPS did not affect the rates of TRM or OS. Conclusion Our findings demonstrate that donor type, transplanted cell type and conditioning chemotherapy regimen may have an effect on post-transplant pulmonary toxicity combined with fractionated TBI. Clinicians should consider those clinical factors besides radiation-related factors in deciding on a treatment strategy for individual patients. PO-0648 Is age >60 unfavorable prognostic factor in early stage upper aerodigestive tract NK/T-cell lymphoma? B. Chen 1 , Y. Li 1 , W. Wang 1 , J. Jin 1 , S. Wang 1 , Y. Liu 1 , Y. Song 1 , H. Fang 1 , H. Ren 1 , S. Qi 1 , Y. Tang 1 , X. Liu 1 , Z. Yu 1 1 National Cancer Center / Cancer Hospital- Chinese Academy of Medical Sciences & Peking Union Medical College, Department of Radiation Oncology, Beijing, China Purpose or Objective The purpose of this study was to determine the survival and prognosis of patients with age>60 in early stage upper aerodigestive tract NK/T-cell lymphoma (UADT-NKTCL) ， and to estimate whether patients with age>60 have lower survivals than with age≤60. Material and Methods Between December 1979 and December 2014, 544 patients with Stage IE and IIE UADT-NKTCL were treated. Of them, there were 58 patients with age>60. Radiotherapy was the