ESTRO 36 Abstract Book

S745 ESTRO 36 _______________________________________________________________________________________________

EP-1391 Digestive toxicity after conformal radiotherapy for palliative cervico-thoracic spinal metastases G. Peyraga 1 , D. Caron 1 , Y. Metayer 2 , Y. Pointreau 3 , F. Denis 3 , G. Ganem 3 , C. Lafond 3 , S. Roche 3 , O. Dupuis 3 1 Institut de Cancérologie de l'Ouest, Radiation Therapy, Angers, France 2 Centre Jean Bernard, Medical Physics, Le Mans, France 3 Centre Jean Bernard, Radiation Therapy, Le Mans, France Purpose or Objective The palliative treatment of cervico-thoracic spinal metastases is based on a conformal radiotherapy (CRT), delivering 30 Gy in 10 fractions (5 days a week for 2 weeks). Digestive toxicities (esophagitis, nausea and vomiting) are common after these radiations and cause a clinical impact probably underestimated in patients. We performed a retrospective monocentric study of early digestive toxicities occurred secondarily to palliative CRT of cervico-thoracic spinal metastases. Material and Methods All patients receiving palliative CRT at Jean Bernard Center from January 2013 to December 2014 of spinal metastases (all primitive tumors were included) between the fifth cervical vertebra (C5) and 10th thoracic vertebra (T10) for which clinical follow-up was available beyond 3 months were included. Re-irradiations were excluded. CRT was delivered by a linear accelerator (CLINAC, Varian). Premedication to prevent digestive toxicities was not recommended. Adverse events (esophagitis and nausea/vomiting < 3 months) were evaluated according the NCI-CTCae (version 4). Results From January 2013 to December 2014, 128 patients met the study criteria. The median age was 69.6 years [31.8; 88.6]. The majority (84.4%) patients received a dose of 30 Gy in 10 fractions. The median treatment duration was 13 days [3-33]. Forty patients (31.3%) experienced grade 2 or 3 of esophagitis (35 grade 2 (27.4%) and 5 grade 3 (3.9%)), and 8 patients (6.3%) experienced grade 2 or 3 of nausea or vomiting (6 grade 2 (4.7%), 1 grade 3 (0.8%) and 1 grade 4 (0.8%)). The risk of digestive toxicities seems to be related to spinal localization of metastases (38.5% of grade 2 or 3 esophagitis if radiation from C5 to T4 versus 31.2% if radiation from T5 to T10, and 87.5% of nausea and vomiting concerned T9 or T10) and to the number of irradiated vertebrae (43.9% of esophagitis if more than 5 vertebrae are irradiated versus 25.3% if less than 6 vertebrae are irradiated). Conclusion The incidence of esophagitis after palliative CRT of cervico-thoracic spinal metastases led to considering static or dynamic Intensity Modulated Radiation Therapy (IMRT) to reduce the dose to organ at risk (esophagus). IMRT could be primarily beneficial if palliative radiotherapy concerns vertebrae between C5 and T4 and if it affects more than 5 vertebrae. EP-1392 Prognostic factors for survival in patients with bone metastases P.M. Samper Ots 1 , M. Hernandez Miguel 1 , E. Amaya Escobar 1 , M.D. De las Peñas Cabrera 1 1 Hospital Rey Juan Carlos, Servicio de Oncologia Radioterapica, Mostoles - Madrid, Spain Purpose or Objective To analyze the prognostic factors for survival in patients

lung 36 cases (34.6%), prostate 24 (23.1%) and breast 13 (12.6%). The means time diagnosis of bone metastases was 14.55 ± 2 months. 85 patients were treated with 3DRT (81.7%), 9 SBRT (8.7%) and 10 no treatment (9.6%). The study was approved by the Ethics Committee for Clinical Research (CEIC) and meets the standards of data protection. For statistical analysis SPSS version 22.0 was used. Results 70 patients (67.3%) died with a median survival of 14.4 months after the diagnosis of bone metastases. Survival according to the treatment was: 3DRT 13.73 ± 21.3 months, SBRT 20.7 ± 12.0 months and without RT 10.48 ± 10.7 months (p <0.001). The median survival after end of radiotherapy was 19.4 ± 5.66 months. Prognostic factors for survival were: primary tumor controlled versus uncontrolled 45.3 ± 15.4 versus 7.64 ± 1.09 months (p = 0.001), metastases in other organs 15.23 ± 5.2 versus not 22 ± 4.7 months (p = 0.04), lymph node metastasis 13 ± 5.06 versus not 18 ± 4.3 months (p = 0.007), liver metastases 6.42 ± 1.52 versus not 24.44 ± 7.75 months (p = 0.028), ECOG 0 (49.5 ± 17.1), 1 (7.49 ± 1.38), 2 (8.78 ± 1.97) and 3 (3.88 ± 1) p = 0.003. The primary diagnosis: lung 5.68 ± 1.25 months, breast 59.81 ± 21.12 months, prostate 18.85 ± 5.2 months (p = 0.013). In patients with lung cáncer, the histology was a prognostic factor: epidermoid 2.65 ± 0.9 months, adenocarcinoma 7.69 ± 1.8 months and small cell 1.92 ± 1.32 months (p = 0.009). The time to diagnosis of bone metastases was not prognostic factor for survival. Conclusion In patients with bone metastases, the best prognosis are breast cáncer, primary controlled, no other metastases, SBRT and ECOG 0. EP-1393 Prognostic factors for survival in patients with brain metastases P.M. Samper Ots 1 , M. Hernandez Miguel 1 , E. Amaya Escobar 1 , M.D. De las Peñas Cabrera 1 1 Hospital Rey Juan Carlos, servicio de oncologia Radioterapia, Mostoles - Madrid, Spain Purpose or Objective To analyze the prognostic factors for survival in patients Retrospective analysis of 87 patients referred for treatment of brain metastases, median age was 62.3 ± 13 years, 56 males (64.4 %). The most common primary tumors were: lung 56 cases (64.4%), breast 12 (13.8 %) and colorectal 9 (10.3%). The means time diagnosis of brain metastases was 16.3 ± 35.36 months. 63 patients were treated with holocraneal 3DRT (72.4%), 5 holocraneal and boost (5.7%), 6 Stereotactic fracctionated radiotherapy (SFR) (6.8%) and 13 no treatment (14.9%). The study was approved by the Ethics Committee for Clinical Research (CEIC) and meets the standards of data protection. For statistical analysis SPSS version 22.0 was used. Results 73 patients (83.9%) died with a median survival of 7.66 ± 0.96 months after the diagnosis of brain metastases. Survival according to the treatment was: holocraneal 6.84 ± 0.97 months, holocraneal and boost 13.06 ± 6.04 months, SFR 7.38 ± 1.5 months and without RT 6.38 ± 2.6 months (p <0.519). The median survival after end of radiotherapy was 6.47 ± 0.98 months. The time to diagnosis of brain metastases, the situation of the primary, metastases in other organs, number of brain metastases, surgery of metastases, radiosurgery were not prognostic factors for survival. Prognostic factors for survival were: ECOG 0 (8.99 ± 1.43 months), 1 (8.05 ± 2.26 months), 2 (2.78 ± 0.64 months) and 3 (1.24 ± 0.94 months) p = 0.000. Not completing radiotherapy 0.24 ± 0.12 versus with brain metastases. Material and Methods

with bone metastases. Material and Methods

Retrospective analysis of 104 patients referred for treatment of bone metastases, median age was 59 years, 69 males (66.3%). The most common primary tumors were: