ESTRO 36 Abstract Book

S756 ESTRO 36 _______________________________________________________________________________________________

(36%) and retroperitoneal sarcomas (50%). With a median follow-up of 70 months (range 12-92), the median DSS was 54 months (range 28-80). The 5-year actuarial OS, LC and DSS were 71%, 68% and 44%, respectively. On univariate analysis margin status of resection significantly affected LC. For patient with resection R0, LC was 83% whereas no patient with R1 resection obtained local control (p<0,01). Toxicity presented in 11(27%) patients and pain was the most common side-effect (64%) followed by enteritis (18%). Conclusion IORT is an efficient method of salvage treatment to improve LC in selected patients with isolated locally recurrent tumors for recurrent pelvic or retroperitoneal tumors, with acceptable incidence of morbidity. EP-1414 Toxicity of concurrent stereotactic radiotherapy and targeted or immunotherapy: a systematic review S.G.C. Kroeze 1 , C. Fritz 1 , M. Hoyer 2 , S.S. Lo 3 , U. Ricardi 4 , A. Sahgal 5 , R. Stahel 6 , R. Stupp 6 , M. Guckenberger 1 1 University Hospital Zürich, Department of Radiation Oncology, Zurich, Switzerland 2 Aarhus University, Danish Center for Partical Therapy, Aarhus, Denmark 3 University of Washington School of Medicine, Department of Radiation Oncology, Seattle, USA 4 University of Turin, Department of Radiation Oncology, Turin, Italy 5 University of Toronto, Department of Radiation Oncology, Toronto, Canada 6 University Hospital Zürich, Department of Oncology, Zurich, Switzerland and targeted/immunotherapy play an increasingly important role in personalized treatment of metastatic disease. The combined application of both therapies is rapidly expanding in daily clinical practice. Patients may benefit from additive cytotoxic effects, but currently not much is known regarding safety and the potential induction of toxicity. Toxicity data from targeted/immunotherapy combined with conventionally fractionated radiotherapy cannot be extrapolated to SRT because of the differences in physics and biology. The aim of our systematic review was to summarize severe toxicity observed after PubMed and EMBASE databases were searched for English literature published up to april 2016 using keywords 'radiosurgery”, 'local ablative therapy”, 'gamma knife” and 'stereotactic”, combined with 'bevacizumab”, 'cetuximab”, 'crizotinib”, 'erlotinib”, 'gefitinib”, 'ipilimumab”, 'lapatinib”, 'sorafenib”, 'sunitinib”, 'trastuzumab”, 'vemurafenib”, 'PLX4032”, 'panitumumab”, 'nivolumab”, 'pembrolizumab”, 'alectinib”, 'ceritinib”, 'dabrafenib”, 'trametinib”, 'BRAF”, 'TKI”, 'MEK”, 'PD1”, 'EGFR”, 'CTLA-4” or 'ALK”. Studies performing SRT during or within 30 days of targeted/immunotherapy, reporting severe (≥Grade 3) toxicity were included. Results A total of 49 studies were included. Of these, 13 (321 patients) were prospective studies, 27 (653 patients) retrospective studies and 9 (16 patients) case reports. The number of patients per study ranged from 1 to 106 (median 15). Targeted agents concurrent with cranial SRT were tested in 34 studies and with extra-cranial SRT in 19 studies. For cranial SRT, severe toxicity was observed in 14% (89/644) of patients, for extra-cranial SRT in 16% (84/524). Severe toxicity possibly related to cranial SRT or extra-cranial SRT was observed in 6% (5.4% Gr3; 0.6% Gr4; 0% Gr5) and 9% (7.6% Gr3; 0.8% Gr4; 0.6% Gr5), Purpose or Objective Stereotactic radiotherapy (SRT) concurrent treatment. Material and Methods

respectively. Overall, concurrent cranial SRT was well tolerated, except when combined with BRAF-inhibitors (severe toxicity in 20/75 patients (27%)). Furthermore, there is a high risk of morbidity when extra-cranial SRT is combined with EGFR-targeting tyrosine kinase inhibitors and bevacizumab, which was not observed after cranial SRT. Conclusion The currently available information concerning toxicity after concurrent SRT and targeted/immunotherapy is limited. The focus of published studies lies mainly on concurrent cranial SRT, where the combination generally is well tolerated. For extra-cranial SRT, no definitive conclusions can be drawn. This review underlines the need for clinical studies testing the combination of SRT and targeted drugs/immune check point Inhibitors. EP-1415 Interventions to Address Sexual Problems in People with Cancer L. Barbera 1 , C. Zwaal 2 , D. Elterman 3 , W. Wolfman 4 , A. Katz 5 , K. McPherson 6 , A. Matthew 7 1 Odette Cancer Centre - Sunnybrook Health Sciences Centre, Radiation Oncology, North York- Toronto, Canada 2 McMaster University, Oncology, Hamilton, Canada 3 University Health Network, Urology, Toronto, Canada 4 Mount Sinai Hospital, Obstetrics and Gynecology, Toronto, Canada 5 CancerCare Manitoba, Cancer and Sexuality Counselling, Winnipeg, Canada 6 Cancer Care Ontario, Patient and Familty Advisory Council, Toronto, Canada 7 University Health Network, Surgical Oncology, Toronto, Canada Purpose or Objective Objective: Sexual dysfunction in people with cancer is a significant problem. This guideline aimed to address the following question: “What is the effectiveness of pharmacologic interventions, psychosocial counselling or devices to manage sexual problems after cancer treatment?” Material and Methods Methods: This guideline was created with the support of the Program in Evidence-Based Care. We searched for existing systematic reviews, guidelines and relevant primary literature from 2003-2015. Men and women were evaluated separately. No restrictions were made on cancer type or study design. When first approaching the guideline the working group chose to focus on sexual disorders commonly known to arise in people with cancer. These included decreased desire, arousal disorders, pain (in women) and erectile dysfunction (in men). Only studies that evaluated the impact of an intervention on a sexual function outcome were included. Results Results: The panel made one overarching recommendation that there be a discussion with the patient, initiated by a member of the health care team, regarding sexual health and dysfunction resulting from the cancer or its treatment. The Expert Panel felt that this is vital since the additional recommendations cannot be used unless someone has taken the initiative to ask. There were numerous limitations of the existing literature. However, we made additional recommendations on 11 outcomes: 6 for women (sexual response, body image, intimacy/relationships, overall sexual function/satisfaction, vasomotor symptoms, genital symptoms) and 5 for men (sexual response, genital changes, intimacy/relationships, overall sexual function/satisfaction, vasomotor symptoms). There is a role for medication or devices in particular