ESTRO 38 Abstract book

S180 ESTRO 38

Baseline mean neurocognitive scores were IQ (99.7±22.5), WIAT Reading (97.4±10.3), WIAT Math (98.2±12.2), WIAT Spelling (94.5±10.3), and VAL (97.3±22.2). Linear mixed models with random coefficients revealed no significant change over time and a slightly decline in WIAT reading scores during follow-up (WIAT Reading slope estimate - 0.7444±0.3818 points/year; P=0.0631). Gender, age at time of radiotherapy, radiation dose to the supratentorial brain, temporal lobes and entire brain, the use of pre-CRT chemotherapy and number of surgeries was not significantly associate with cognitive function. Only tumor location (frontal vs. other) was significantly associated with WIAT Spelling (p=0.0223). Conclusion In a cohort of children with supratentorial ependymoma and extended follow-up, CRT using photons spared cognitive function. These results challenge the premise that newer methods of radiation therapy will improve outcomes in these patients. PV-0364 Pulmonary function after high dose chemotherapy + total lung irradiation for pediatric Ewing sarcoma B. Diletto 1 , E. Pecori 1 , N. Puma 2 , O. Alessandro 3 , S. Meroni 4 , M. Podda 2 , A. Busia 5 , F. Allegri 5 , A.C. Ogliari 5 , C. Materazzo 6 , R. Boffi 5 , E. Pignoli 4 , R. Luksch 2 , L. Gandola 1 1 Fondazione IRCCS Istituto Nazionale dei Tumori, Radiation Oncology 1, Milan, Italy ; 2 Fondazione IRCCS Istituto Nazionale dei Tumori, Pediatric Oncology, Milan, Italy ; 3 Università degli Studi di Milano, Residency Program in Radiation Oncology, Milan, Italy ; 4 Fondazione IRCCS Istituto Nazionale dei Tumori, Medical Physics, Milan, Italy ; 5 Fondazione IRCCS Istituto Nazionale dei Tumori, Pulmonary Unit, Milan, Italy ; 6 Fondazione IRCCS Istituto Nazionale dei Tumori, Cardiology Unit, Milan, Italy Purpose or Objective Total lung irradiation (TLI) following high dose chemotherapy with busulfan and melphalan (BuMel) and autologous stem cell transplantation (ASCT) is an intensive strategy improving outcomes of pediatric Ewing sarcoma (ES) pts with lung metastases. A critical issue regarding the combination of BuMel-ASCT and TLI is the supposed additional lung toxicity. Results of pulmonary function of a subgroup of metastatic ES children treated with this approach in a single Institution within a multicentric prospective study are reported. Material and Methods Clinical records of lung metastatic ES children treated in our Institution were collected. Pts were treated according to 3 international and national protocols: ISG/SSG (Italian Sarcoma Group/Scandinavian Sarcoma Group) IV, ISG- AIEOP (Associazione Italiana Ematologia Oncologia Pediatrica) EW-2, ISG/AIEOP-Rel. TLI was administered at least 8 weeks after BuMel-ASCT, and the prescribed total dose was 15 Gy in 10 daily fractions. Lung and cardiac functions were assessed by pulmonary function tests (PFTs) (including spirometry, lung volume measurements and single-breath carbon monoxide-diffusion capacity - DLCO-) and echocardiogram before BuMel-ASCT, between BuMel-ASCT and TLI, after TLI and regularly during the F- UP. Ejection fraction (EF), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), total lung capacity (TLC), and DLCO were recorded. Results Data from 17 pts (ISG/SSG IV: 6, ISG-AIEOP EW2: 10, ISG/AIEOP-Rel: 1) were collected (10 F, 7 M, median age 15.3 y, range 3.9-20). All pts performed PFTs and echocardiogram regularly. Median time from BuMel-ASCT to TLI was 95 days (73–335). After BuMel-ASCT a mild restrictive syndrome was observed in 7 pts (41%) and a mild obstructive syndrome in 1 pts (6%). After TLI 9 (53%) patients presented a mild and 1 pts (6%) a moderate restrictive syndrome, 1 pts showed a mild obstructive

Conclusion High-dose spine SRS can offer patients with chordoma the chance of durable radiographic control and effective symptom relief, with acceptable toxicity. SRS should be considered as definitive therapy for unresectable tumor due to surgical morbidity, neoadjuvant prior to resection, and adjuvant post-subtotal resection or for positive margins. PV-0363 Cognitive Outcomes after Conformal Radiotherapy in Pediatric Patients with Supratentorial Ependymoma M. Mizumoto 1 , Y. Oshiro 2 , S. Wu 3 , T.E. Merchant 1 1 St Jude Children's Research Hospital, Radiation Oncology, Memphis, USA; 2 Tsukuba Medical Center Hospital, Radiatiom Oncology, Tsukuba, Japan ; 3 St Jude Children's Research Hospital, Biostatistics, Memphis, USA Purpose or Objective This study investigated cognitive function after conformal radiotherapy (CRT) for pediatric supratentorial ependymoma. Material and Methods From 1997 to 2009, 30 pediatric patients diagnosed with supratentorial ependymoma received photon-based CRT (54.0 or 59.4Gy) using a 0.5-1.0cm clinical target volume margin and were evaluated for change in cognitive function. The median age was 6 years (range 1 – 19 years). The tumor location was frontal (n=8), parietal (n=5), occipital (n=4), fronto-parietal (n=4), IIIrd ventricle (n=3) and other (n=6). The median follow-up period was 12.8 years (range, 2.2–19.0 years). 877 evaluations were performed including estimated IQ (n=209), WIAT Reading (n=174), WIAT Math (n=174), WIAT Spelling (n=173), and VAL (n=147). Results