ESTRO 38 Abstract book

S705 ESTRO 38

A double-blind randomized clinical trial with 2 parallel arms (A and B) was designed. BC patients were randomized to assume a preparation containing 125 mg anthocyanins (3 times a day) versus placebo. Supplementation started 1 week before and lasted till the end of RT. One group of patients (MARA3) received 44 Gy simultaneous integrated boost (SIB) over 16 fractions in 3 weeks by an hybrid IMRT class solution; the other group (MARA4) received 60 Gy SIB over 25 fractions in 5 weeks. Patients used a moisturizing cream (® Atonderma) during RT. Clinical evaluation was performed at the end of treatment and skin toxicity was graded according to RTOG score. Moreover, skin parameters, as elasticity (R0, R2 and R5 values), erythema (Mexa_Er) and pigmentation (Mexa_M), were measured in predefined areas of the irradiated breast and in the contra-lateral one through a specific device (Cutometer® dual MPA 580), before (T0), at the end (T1) and 1, 6 and 12 months after RT. Results 242 patients were eligible and 195 were randomized to groups A and B (Figure 1). Both clinical and cutometer evaluations failed to show differences in terms of skin toxicity (elasticity, erythema and pigmentation) between groups A and B. The elasticity parameters R0 (p=0.54) and R2 (p=0.27) similarly decreased from T0 in both arms, while Mexa_M (P=0.74) and Mexa_Er (P=0.25) similarly increased in both groups, suggesting no protective effect of anthocyanin supplementation. Neither RT protocol seemed to differently affect elasticity parameters. However, the increase in Mexa_M and Mexa_Er was greater in MARA4 (5 week RT) than in MARA3 (3 week RT) (p=0.0027 and p=0.0087, respectively). Comparing irradiated and contra-lateral breast no differences were observed for R0 (p=0.48) and Mexa_M (p=0.14) variations from T0 to T1 in groups A and B. On the contrary, decrease of R2 and increase of Mexa_Er were observed only in irradiated but not in contra-lateral breast (p<0.0001). Clinical toxicity RTOG data did not correlate with variations in parameters recorded by cutometer.

Purpose or Objective A within patient non inferiority randomised study was conducted to test whether StrataXRT (SX) was as effective as Mepitel film (MF) in reducing the severity and duration of acute radiation dermatitis (ARD) in breast cancer patients receiving post mastectomy radiation therapy (PMRT). Material and Methods Breast cancer patients undergoing chest wall with or without nodal irradiation radiation therapy were eligible. Lateral and medial halves of the skin areas to be irradiated were randomized to MF or SX. Bolus was applied to the half of the course of radiation therapy (50-50.4Gy). ARD was assessed using the Common Terminology Criteria for Adverse Events scale (version 4.03) weekly for 10 weeks. The outcome measures were occurrence of moist desquamation in each half of the irradiated area, time weighted average (TWA) grade of radiation dermatitis and worst grade of radiation dermatitis over 10 weeks. Results A total of 44 breast cancer patients receiving post mastectomy radiation therapy were recruited between January 2017 and December 2017. Of those, 43% had pathologic stage II and 57% had pathologic stage III disease. Seventy three percent received tangent based inverse planned intensity modulated therapy and 27% received volumetric arc therapy. For the 40 assessable patients (minimum of 6 weekly observations), the maximum grade of ARD in the SX halves were CTCAE grade 1 (30%) and grade 2 (70%) compared with grade 0 (5%), grade 1 (42.5%), grade 2 (50%) and grade 3 (2.5%) in the MF halves. The rate of moist desquamation was 12.5% for SX versus 20% for MF (p=0.099). The TWA of radiation dermatitis in the chest wall halves up to 10 weeks is 0.16 higher for SX vs MF (95% CI: 0.09- 0.23). The upper limit of the CI is <0.25 (criterion for non- inferiority set in protocol), it is concluded that SX is not inferior to MF at the 95% level. Although the difference between SX vs MF is statistically significant (p=0.0001), it was not clinically significant. The worst grade of radiation dermatitis in the halves within 10 weeks is 0.15 higher for SX vs MF (95% CI: -0.02- 0.32). The upper limit of the CI is <0.50 (criterion for non- inferiority set in protocol), it is concluded that SX is not inferior to MF at the 95% level. The difference between SX vs MF is not statistically significant (p=0.075). Conclusion The occurrence of moist desquamation, TWA grade of ARD and the worst grade of ARD for StrataXRT was not inferior to MF. EP-1287 Preliminary results of anthocyanin supplementation in breast cancer RT: impact on skin side effects M. Boccardi 1 , F. Bracone 2 , F. Deodato 1 , A. De Curtis 2 , G. Macchia 1 , S. Cilla 3 , A. Di Castelnuovo 2 , A. Ianiro 3 , C. Cerletti 2 , A.G. Morganti 4 , M.B. Donati 2 1 Fondazione di Ricerca e Cura “Giovanni Paolo II”- Università Cattolica del Sacro Cuore, Radiotherapy Unit, Campobasso, Italy ; 2 IRCCS Neuromed, Dipartimento di Epidemiologia e Prevenzione, Pozzilli, Italy ; 3 Fondazione di Ricerca e Cura “Giovanni Paolo II”- Università Cattolica del Sacro Cuore, Medical Physics Unit, Campobasso, Italy ; 4 Radiation Oncology Center, Department of Experimental- Diagnostic and Specialty Medicine DIMES- University of Bologna, Bologna, Italy Purpose or Objective The role of anthocyanins has been studied in the prevention of radiotherapy (RT) side effects. In a prospective randomized study (Athena Project-FP7 European Union), we verified the impact of anthocyanin supplementation on acute and medium-term skin side effects of RT in breast cancer (BC) patients. Material and Methods

Conclusion Preliminary data failed to demonstrate that an anthocyanin supplementation can effectively protect BC patients from skin side effects of two different RT regimens. EP-1288 Dosimetric Comparison of Protons and Photons in Musculoskeletal Sparing During Breast Irradiation A. Prescott 1 , J. Strauss 1 , E. Donnelly 1 , M. Gentile 1 , R. Patel 1 , D. Lipps 2 , S. Oza 3 1 Northwestern University, Radiation Oncology, Chicago, USA ; 2 University of Michigan, Kinesiology, Ann Arbor, USA ; 3 Memorial Sloan Kettering, Physical Medicine & Rehab, New York, USA