ESTRO 38 Abstract book

S724 ESTRO 38

Material and Methods A retrospective review of the breast cancer database at the Centro del Cáncer of the Universidad Católica de Chile (CECA-UC) and at Instituto Nacional del Cáncer (INC) for patients treated from 2017 to 2018. All breast cancer patients treated at CECA-UC where included and a random sample of equal number of the patients treated at INC where included. Age, tumor size, neoadjuvant treatment, time to surgery and time to radiation were registered. Patients were analyzed according to health insurance (public or private). Student T test for continuous variables and Chi 2 for categorical variables were used. Results Two hundred and seventy-nine women were included (168 public insurance, 111 private insurance), median age was 57 years (range 25-88). The median clinical tumor size (T) was 24.3 mm (2-100), pathologic T was 20.8 mm (0-116). Tumor status was T1 n=157, T2 n=94, T3 n=12. Nodal status was N0=170, N1=64, N2=21, N3=10. Neoadjuvant chemotherapy was received in n=55 and neoadjuvant radiotherapy n=2. By Insurance, public and private, clinical T was 29 and 21.5 mm (p=0.005), pathologic T 22.5 and 19.9 mm (p=0.5), nodal status was N0=92 and 78, N1=36 and 28, N2=18 and 3, N3 8 and 2 (p=0.02), received neoadjuvant chemotherapy 23.8% and 13.5% (p=0.034), respectively. Mean time from diagnosis to surgery in patients without neoadjuvant treatment was 66,4 and 30 days (p=0.001), time from diagnosis to radiotherapy was 263 and 128 days (p< 0.001), and time from surgery to radiotherapy was 153 and 80 days (p<0.001). Conclusion Patients with public insurance have significantly more advanced cancer stage at diagnosis and have a longer time to surgery and to adjuvant radiotherapy than patients with private insurance. EP-1322 “Every breath you take”: first results of INHALE (Inspiration Breath hold health related QoL) study E. Ippolito 1 , S. Silipigni 1 , A. Sicilia 1 , S. Palizzi 1 , G.M. Petrianni 1 , B. Santo 1 , S. Gentile 1 , P. Zuccoli 1 , E. Molfese 1 , A. Iurato 1 , R.M. D'Angelillo 1 , S. Ramella 1 1 Campus Biomedico University, Radiotherapy, Roma, Italy Purpose or Objective Breath holding (BH) techniques enable clinicians to reduce radiation dose to the heart and the left descending artery (LAD) in left breast cancer patients. Despite such advantages, BH radiotherapy (RT) compared to free breathing RT (FB RT) has been shown to require more efforts during simulation and treatment delivery for both clinicians and patients. The aim of this study is to evaluate whether BH RT affects QoL and physical (fatigue) as well as psychological distress in breast cancer patients. Herewith we report the preliminary results. Material and Methods All breast cancer patients aged less than 60 years old who were referred to our department of radiation oncology were asked to participate in this study. Patient-reported outcomes (PROMs) including EORTC QLQ CD30-BRC23 questionnaire (22 items), FACIT – Fatigue Scale vers. 4 (13 items), Hospital Anxiety and Depression Scale - HADS (14 items) were prospectively collected before the start of adjuvant radiotherapy (baseline) and at the end of treatment. All scores were square-root transformed (scale 0-10). Analysis of covariance (ANCOVA) was used with pre and post radiotherapy change in questionnaires scores as dependent variable, the treatment group (BH vs FB) as independent variable and the baseline measure as covariate. Results Thirty-five consecutive breast cancer patients deemed to start radiotherapy treatment were asked to participate. All accepted to fulfill the questionnaires. Median age was

Purpose or Objective Improvements in oncologic treatments, including radiation therapy (RT), have decreased death due to breast cancer over the last decades. Up to 33% of deaths are attributed to cardiac causes in this treatment population, and mean heart dose (MHD) is associated with a relative increase in cardiovascular events (CVE) of 16% per Gray. The purpose of this study is to estimate potential survival benefit and cardiac risk of RT in a cohort of Chilean women with breast cancer. Material and Methods Women with breast cancer who received adjuvant 3-D RT with curative intent between May 2017 and August 2018 were eligible for analysis. Predict® version 2.1 online tool and the American Heart Association (AHA) Predictive Score for cardiovascular disease were used to calculate the estimated overall survival and the CVE risk at 10 years. RT volumes and MHD were registered from their RT plans. The increase of CVE risk was estimated based on the model by Darby et al. Mortality from heart attack/stroke was estimated based on HeartScore® from the European Association of Preventive Cardiology, and the reduction on breast cancer mortality from RT based on the EBCTCG meta-analysis. Results Seventy-two eligible women with breast cancer were analyzed, none had bilateral cancer. Mean age was 66 years (range: 43 to 87 yrs). Thirty-two patients (44%) had right breast cancer and 40 (56%) had left breast cancer. Mean baseline AHA 10-year CVE risk was 9.1% (0.2 to 44.6%), 38% were considered as high risk by AHA definition. The estimated mean 10-year mortality from heart attack and stroke was 2.38%. RT volume included the internal mammary chain in 7 (10%) patients, the mean dose to breast or chest wall was 41.6 Gy, the mean heart dose (MHD) was 2.37 Gy (0.6 to 12.9 Gy), 1.54 Gy (0.6 to 8.6 Gy) and 2.96 Gy (0.9 to 12.9 Gy) in whole cohort, right and left treatments, respectively. With RT, the mean 10- year estimated breast cancer survival increased from 64,6% to 68,4% (absolute mortality reduction 3.75%) and the mean the 10-year CVE risk increased from 9.14% to 12.3% (absolute 3.16%, range: 0.02 to 25.37%). If all patients had optimal management of their cholesterol, blood pressure and smoking habit, the 10-year CVE risk would be 7% without RT and 9.5% with RT (absolute increase 2.50%). Conclusion RT for breast cancer increase the 10-year estimated overall survival in 3.75% and the CVE risk in 3.15%. An optimal management of cardiovascular risk and lowering the MHD will maximize the benefit of the treatment. EP-1321 Waiting times for breast cancer treatment in Chile according to public or private health insurance T. IP 1 , C. Gabler 2 , C. Carvajal 2 , C. Osorio 2 , M. Camus 3 , C. Sánchez 4 , M. Silva 2 , T. Merino 1 1 Pontifica Universidad Católica de Chile, Radiation Oncology, Santiago, Chile ; 2 Instituto Nacional del Cáncer, Radiation Oncology, Santiago, Chile ; 3 Pontifica Universidad Católica de Chile, Surgical Oncology, Santiago, Chile ; 4 Pontifica Universidad Católica de Chile, Medical Oncology, Santiago, Chile Purpose or Objective Chilean people can either have public or private health insurance. As breast cancer is the leading cause of cancer death in Chilean women, it has been prioritized in Chilean health system by law. It establishes that treatment should start within 30 days of being diagnosed and adjuvant treatment should start within 20 days from indication. The purpose of this study is to report stage of cancer and time from diagnosis to treatment in breast cancer patients according to health insurance system.