ESTRO 36 Abstract Book

S45 ESTRO 36 _______________________________________________________________________________________________

well as the visual analog scale (VAS) for pain were used to record and monitor pain. Data on pain status and dosage/frequency of analgesic consumption were recorded before treatment (baseline evaluation) and during follow-up. HBI encompassed the lower half body (pelvic bones, lumbo-sacral vertebrae and upper third of femurs). Prostate cancer metastases received 15 Gy/3Gy fraction along 5 days. Skeletal metastases due to other primary tumors received accelerated HBI (3 Gy fractions twice daily, 6–8 h apart, on 2 consecutive days, up to 12 Gy). Results 258 patients (M/F 102/156; median age: 64; range 29-95) were enrolled and completed the treatment. After HBI, a significant reduction of pain, as evaluated by VAS, was recorded (pre- treatment versus post- treatment mean VAS: 5.4 versus 2.7, CI 2.2-3.2; p=0.0001). Moreover, 62 patients (24%) had complete pain relief and 64 patients (25%) showed more than a 30% VAS reduction. Overall response rate for pain was 53% (CI 0.95: 46.2% - 60.4%). In 182 patients (71%) Pain and Drug scores before and after treatment were valuable. Statistical analysis showed a significant reduction of Pain and Drug scores especially concerning patients with the highest scores before treatment (Chi squared test: p=0.001). In particular, 26 patients (14%) achieved a Drug Score’s reduction and 40 patients (22%) discontinued analgesic therapy. Nineteen percent of all series exhibited no treatment related complications, and an additional 79% experienced only mild or moderate (transitory) toxicity. As a whole, Grade > 3 toxicity (severe) was seen in four patients (2%): haematologic G3 (1 pt) and gastro-intestinal G3 (2 pts). Only 1 Grade 4 haematologic toxicity was registered. 111 patients (43%) presented pain flare’s phenomenon. Conclusion HBI is safe and effective, providing long lasting pain reduction in patients with multiple bone metastases. PV-0089 Relation between pain control and bone mineral density change in bone metastases H. Kobayashi 1 , H. Takagi 1 , K. Tanaka 1 , T. Matsuyama 1 , K. Yamazaki 1 , M. Matsuo 2 , T. Yanase 1 , M. Tanaka 1 1 Ogaki Municipal Hospital, department of radiotherapy, Ogaki, Japan 2 Ogaki Municipal Hospital, department of nursing, Ogaki, Japan Purpose or Objective External beam radiation therapy is an effective technique for bone metastases. The main roles of radiotherapy are relief of pain and stabilizing metastatic bones. In achieving pain control in patients with bone metastases, pain relief is usually obtained in 70% of patients by using a variety of dose fraction schemes. However the role of radiotherapy in stabilizing is unclear. The purpose of this study is to investigate the relationship between the pain control effects of radiotherapy and bone mineral density change after the after the compression of radiotherapy Material and Methods Data from 102 patients who underwent radiation therapy because of lytic bone metastases lesions from January 2015 to December 2015 were retrospectively reviewed. Forty patients (sixty-two lesions) received computed tomography (CT) scans prior to initiation and at least twice after radiation therapy. The most common primary site was breast accounting for 14 (35%). Liver, lung, esophagus and rectal tumors accounted for 11 (27.5%), 8 (20%), 3 (7.5%), and 2 (5%) patients, respectively. Percent change in bone attenuation between pre-radiation therapy and post-radiation therapy were computed for irradiated metastatic bone (IMB) lesions and irradiated non-metastatic bone (INMB). Pain intensity was self- assessed by patients using a scale graduated from 0 to 10. Patients were asked for the scale at least once a week from the beginning of radiotherapy till 3 weeks after

Calculation of the prognostic score ECOG PS 2-4

2 points 2 points

No systemic treatment

Pleural effusion and/or metastases 2 points On intravenous antibiotics during last 2 weeks 1 point ESAS appetite worse than median 1 point ESAS pain while not moving worse than median 1 point Conclusion The presence of pain while not moving and reduced appetite (below/above median) predicted significantly shorter survival. The score identified 4 groups with clearly different prognosis and should be examined in additional independent cohorts. Future research should include patient-reported symptoms because they were more important than primary tumor type, age and other baseline parameters.

PV-0088 Half body irradiation schedule in patients with multiple bone metastases: a phase I-II trial M. Ferro 1 , F. Deodato 1 , F. Dello Iacovo 1 , G. Macchia 1 , S. Di Santo 1 , M. Nuzzo 1 , S. Cilla 2 , A. Farioli 3 , A. Zamagni 4 , L. Ronchi 4 , A. Arcelli 4,5 , S. Mignona 6 , R. Frakulli 4 , E. Farina 4 , S. Cammelli 4 , G.P. Frezza 5 , V. Valentini 7 , A .G. Morganti 4 1 Fondazione di Ricerca e Cura “Giovanni Paolo II”, Radiotherapy Unit, Campobasso, Italy 2 Fondazione di Ricerca e Cura “Giovanni Paolo II”, Medical Physics Unit, Campobasso, Italy 3 University of Bologna, Department of Medical and Surgical Sciences - DIMEC, Bologna, Italy 4 University of Bologna, Radiation Oncology Center- Department of Experimental- Diagnostic and Specialty Medicine - DIMES, Bologna, Italy 5 Ospedale Bellaria, Radiotherapy Department, Bologna, Italy 6 Fondazione di Ricerca e Cura “Giovanni Paolo II”, Oncology Unit, Campobasso, Italy 7 Policlinico Universitario “A. Gemelli”- Università Cattolica del Sacro Cuore, Department of Radiotherapy, Rome, Italy Purpose or Objective To evaluate the efficacy of an half-body irradiation (HBI) schedule on pain relief in multiple bone metastases cancer patients. The secondary aim was to evaluate the safety of this short course hypofractionated treatment. Material and Methods From August 2003 to February 2016, patients with widespread symptomatic bone metastases and no previous history of large field radiotherapy were enrolled. The pain score (pain evaluation obtained by multiplying severity × frequency) and the drug score (analgesic assumption evaluation obtained by multiplying severity×frequency) as