ESTRO 36 Abstract Book

S645 ESTRO 36 _______________________________________________________________________________________________

EP-1191 Postmastectomy locoregional irradiation to temporary tissue-expander or permanent breast implant M.A. Gerardi 1 , D.P. Rojas 2 , R. Ricotti 1 , M.C. Leonardi 1 , G. Riva 2 , D. Ciardo 1 , C.M. Francia 2 , R. Cambria 3 , R. Luraschi 3 , F. Cattani 3 , C. Fodor 1 , F. De Lorenzi 4 , M. Rietjens 4 , P. Veronesi 5 , A. Morra 1 , V. Dell'Acqua 1 , R. Orecchia 6 , B.A. Jereczek-Fossa 2 1 European Institute of Oncology, Department of Radiation Oncology, Milan, Italy 2 European Institute of Oncology - University of Milan, Department of Radiation Oncology - Department of Oncology and Hemato-oncology, Milan, Italy 3 European Institute of Oncology, Department of Medical Physics, Milan, Italy 4 European Institute of Oncology, Department of Plastic and Reconstructive Surgery, Milan, Italy 5 European Institute of Oncology, Department of Surgery, Milan, Italy 6 European Institute of Oncology - University of Milan, Department of Medical Imaging and Radiation Sciences - Department of Oncology and Hemato-oncology-, Milan, Italy Purpose or Objective The aim of the study (partially supported by a research grant from Accuray Inc. entitled 'Data collection and analysis of Tomotherapy and CyberKnife breast clinical studies, breast physics studies and prostate study”) is to evaluate acute and intermediate toxicity in postmastectomy patients with implant-based immediate breast reconstruction receiving locoregional intensity modulated radiotherapy (IMRT) with a hypofractionated scheme. Material and Methods Data of the first 121 consecutive post-mastectomy locoregional patients treated with Helical Tomotherapy between May 2012 and May 2015 with a hypofractionated scheme (2.67Gy/fr, 15 fractions) have been prospectively collected. Breast reconstruction was performed with temporary tissue expander implantation in 57% of patients (69/121 expander-patients) and with permanent prosthesis in 43% of patients (52/121 prosthesis-patients). Acute toxicity was evaluated using RTOG/EORTC criteria, while late toxicity was recorded according to LENT/SOMA scale. Results All patients completed the treatment course without interruption for toxicity. In the expander group, one patient died for leukemia 20.3 months after radiotherapy and two had distant metastasis.Acute toxicity was assessed in 121 patients (mean follow up: 2.4 months, range: 0-8.1 months). No patient experienced grade >2 toxicities (edema, erythema or desquamation). No significant difference (p=0.06) in acute toxicities were observed between the type of allogenic reconstruction: 43.5% (30/69) of expander-patients and 26.9% (14/52) of prosthesis-patients presented toxicities of grade 2. The most common toxicity was edema, which was of grade 2 in 33.3% (23/69) of the expander-patients and 21.2% (11/52) of prosthesis-patients (p=0.141). Grade 2 acute erythema was observed in 14.5% (10/69) of expander- patients and 7.7% (4/52) of prosthesis-patients (p=0.249). Statistically significant (p=0.04) higher incidence of grade 2 edema was found in patients with high BMI. This was found also in the prosthesis-patient subgroup (p=0.05).Intermediate toxicity was evaluated at a median follow up of 14.2 months (range: 5.8-35.0) on 85 patient (54 expander-patients and 31 prosthesis-patients). No grade ≥2 skin dryness, telangiectasia, ulcer, hypo- and hyper-pigmentation were reported (Tab.1).

Conclusion Acute toxicity of Helical Tomotherapy-based IMRT after immediate breast reconstruction was satisfactory and intermediate toxicity was acceptable. Based on this preliminary analysis, hypofractionation might be considered also in the settings of locoregional treatments, providing advantages for patients’ convenience and for fruitful use of resource. EP-1192 Assessment of quality of life in phase III clinical trials of radiation therapy in breast cancer G.N. Marta 1,2 , F.Y. Moraes 3 , E.T. Leite 2 , E. Chow 4 , D. Cella 5 , A. Bottomley 6 1 Hospital Sírio-Libanês, Radiation Oncology, São Paulo, Brazil 2 Instituto do Câncer do Estado de São Paulo ICESP - Faculdade de Medicina da Universidade de São Paulo, Radiation Oncology, Sao Paulo, Brazil 3 Princess Margaret Cancer Center- University of Toronto, Radiation Oncology, Toronto, Canada 4 Sunnybook Odette Cancer Centre- Sunnybrook Health Sciences Centre, Radiation Oncology, Toronto, Canada 5 Northwestern University, Medical Social Sciences, Chicago, USA 6 European Organisation for Research and Treatment of Cancer Headquarters, Quality of Life, Brussels, Belgium Purpose or Objective The aim of this study was to investigate the magnitude to which health-related quality of life (HRQOL) parameters have been used in phase III studies on breast cancer patients who received post-operative radiation therapy, as well as the frequency and correlates of significant HRQOL gains. Material and Methods A systematic review in accordance with The Cochrane Collaboration Handbook of Interventions Systematic Reviews was performed. Only prospective phase III clinical trials in patients with breast cancer were included. Eligible trials must state radiation therapy as the main element of treatment in at least one of the groups. With regard to HRQOL as an endpoint in the studies, we first attempted to identify any mention in the paper of HRQOL data collection during the trial, or, when no such mention were found, the existence of a companion paper dedicated to HRQOL analysis separately. When HRQOL was a study endpoint, we collected data on the instruments used for HRQOL analysis, assessing if there was formal statistical comparison between study groups and the