ESTRO 36 Abstract Book

S667 ESTRO 36 _______________________________________________________________________________________________

We compare our results with previous evidence-based recommendations. Results A total of 53 patients with SPN and no previous history of cancer were operated. The mean size were 2.67cm; the mean SUVmax was 7.16 and 94% had SUVmax over 2. The clinical diagnosis before surgery were stage I NSCLC, lung metastases and benign lesion in 58%, 26% and 16% respectively. The diagnosis was confirmed in 89% of the cases. From the 31 lesions treated with clinical diagnosis of NSCLC, it was confirmed pathologically in 27 (87%). Conclusion These results validate the clinical criteria of the lung committee in the Hospital of Navarra, as the accuracy of the diagnosis of stage I NSCLC was 87%, exceeding the threshold of 85% previously recommended. EP-1237 Heart dose as a risk factor for dyspnea worsening after multimodality treatment for NSCLC and MPM A. Botticella 1 , C. Billiet 2 , G. Defraene 3 , S. Peeters 3 , C. Draulans 3 , P. Nafteux 4 , J. Vansteenkiste 5 , K. Nackaerts 5 , C. Dooms 5 , C. Deroose 6 , J. Coolen 7 , D. De Ruysscher 8 1 KU Leuven - University of Leuven, Oncology Department- Laboratory of Experimental Radiotherapy, Leuven, Belgium 2 Hasselt University, Faculty of Medicine and Life Sciences, Hasselt, Belgium 3 KU Leuven - University of Leuven, Department of Oncology- Laboratory of Experimental Radiotherapy, Leuven, Belgium 4 KU Leuven - University of Leuven, Department of Thoracic Surgery and Leuven Lung Cancer Group, Leuven, Belgium 5 KU Leuven - University of Leuven, Department of Respiratory Medicine Respiratory Oncology Unit and Leuven Lung Cancer Group, Leuven, Belgium 6 KU Leuven - University of Leuven, Department Imaging and Pathology- Nuclear Medicine and Molecular Imaging, Leuven, Belgium 7 KU Leuven - University of Leuven, Department of Radiology, Leuven, Belgium 8 Maastricht University Medical Centre- KU Leuven - University of Leuven, Department of Radiation Oncology MAASTRO, Maastricht, Belgium Purpose or Objective The purpose of our study is to quantify the influence of heart dose on the early and late onset of dyspnea in a cohort of non-small cancer (NSCLC) and malignant pleural mesothelioma (MPM) patients having multimodality treatment including radiotherapy (RT). Material and Methods Patient population consisted of: a) stage I-III MPM patients who completed trimodality treatment (induction chemotherapy, EPP and postoperative RT [PORT]); b) stage III (ypN2) NSCLC patients treated with induction chemotherapy, pneumonectomy or lobectomy (+PORT); c) stage I-III NSCLC treated with RT with curative intent (+/- chemotherapy). In 121 patients with multimodality-treated NSCLC and MPM the maximal dyspnea score (CTCAE 4.0) before RT, at an early (<6 months) and a late (7-12 months) time point were obtained. Included patients needed to be clinically and radiologically progression-free 9 months after the end of RT. The difference (Δ) between the maximal dyspnea at <6 months and at 7-12 months with the pre-RT dyspnea was calculated. Results Forty-four percent (50/113) of the patients developed an early worsening of at least 1 point in their dyspnea score

(Δdyspnea >1) after the end of RT. Independent predictors of an early worsening were the mean heart dose (MHD) (for Δdyspnea >1: OR=1.032, p=0.04) and the dyspnea score before RT (for Δdyspnea >1: OR=0.40, p=0.0001; for Δdyspnea >2: OR=0.35, p=0.05). At the later time point, only the dyspnea score before RT (OR: 0.40, p=0.001) was identified as predictor of for Δdyspnea >1. Conclusion Our results, albeit exploratory, suggest that heart dose may play a role in the early worsening of the dyspnea in a heterogeneous cohort of patients having multimodality treatment including RT, whereas baseline dyspnea plays a major role for both early and later worsening. EP-1238 Patterns of recurrence in patients of pT2 esophageal squamous cell carcinoma after radical resection Y.X. Wang 1 , Y.H. Gao 1,2 , J. Li 1 , R. Qiu 1 , X.Y. Qiao 1 1 The Fourth Hospital of Hebei Medical University, Department of Radiation Oncology, Shijiazhuang, China 2 the 2th Central Hospital of Baoding, department of Medical Oncology, Zhuozhou, China Purpose or Objective To retrospectively investigate the patterns of recurrence and its related factors in patients of stage pT2N0-1M0 thoracic esophageal squamous cell carcinoma(ESCC) after radical resection. Material and Methods From 2008 to 2011, 222 cases of stage pT2N0-1M0 thoracic ESCCC with R0 resection were enrolled. There were 142 males and 80 females. There were 181 in pN1 and 41 cases in pN1. 142 patients has treated with surgery alone and 80 with adjuvant postoperative chemotherapy (POCT). Diagnosis of recurrence was primarily based on CT images. Results Follow-up ended at 30, Sep, 2014. The overall recurrence rates was 35.1%. Locoregional recurrence (LR) was found in 25.7% of patients, distant metastasis (DM) in 5.9%, and LR plus DM in 3.6%, respectively. The LR occupied about 83.3% of any recurrence, and 87.7% of LR has occurred in mediastinum (91.2% of it located in upper- mediastinum). Multivariate Cox regression analysis showed that the danger of total recurrence, LR and DM for stage pN1 patients was about 7.1, 6.5 and 3.1 folds in comparied with stage pN0, respectively; the danger of total recurrence in females was about 49.1% in compared with males. But POCT could not influence total recurrence and The recurrence rate was very high in stage pT2N0-1M0 thoracic ESCC after radical resection, the most common site of recurrence was mediastinum (especially upper- mediastinum), it was probably the main target of postoperative radiotherapy. The recurrence was more frequently occurred in stage pN1 and males. T2N0-1M0 thoracic ESCCC with R0 resection were enrolled. There were 142 males and 80 females. There were 181 in pN1 and 41 cases in pN1. 142 patients has treated with surgery alone and 80 with adjuvant postoperative chemotherapy (POCT). Diagnosis of recurrence was primarily based on CT images. LR(P>0.05). Conclusion Electronic Poster: Clinical track: Upper GI (oesophagus, stomach, pancreas, liver)

EP-1239 SBRT in patients with HCC/CCC or oligometastatic liver disease S. Gerum 1 , C. Heinz 1 , C. Belka 1 , M. Niyazi 1 , U. Ganswindt 1 , F. Roeder 1,2