ESTRO 38 Abstract book

S830 ESTRO 38

G0: 237 (78.5%); G1: 45 (14.9%); G2: 10 (3.3%); G3: 8 (2.6%); G4: 2 (0.7%); Maximum haematuria in follow-up: G0: 257 (85.1%); G1: 16 (5.3%); G2: 18 (6.0%); G3: 11 (3.6%). Maximum rectal bleeding in follow-up: G0: 251 (83.1%); G1: 30 (9.9%); G2: 8 (2.6%); G3: 13 (4.3%). Conclusion Conclusions: Optimal dose of radiotherapy +/- Hormonotherapy in prostate cancer achieves a local control of the disease that translates into a low probability of death from cancer. The risk of regional failure has been extremely low (1.3%) despite not treating the pelvic lymph nodes. EP-1539 Early experience and quality of life in SBRT prostate cancer boost of 9 Gy in a phase II trial. F. Ferrer 1,2,3 , A. Pont 4 , R. De Blas 5 , A. Boladeras 1,3 , O. Garin 4,6 , M. Ventura 1,3 , E. Zardoya 5 , J. Delgado 1 , E. Condom 7 , E. Merino 8 , J. Mases 1 , M. Castells 2,9 , I. Guix 1 , J.F. Suarez 10 , J. Gonzalez 1 , S. Almendros 1 , M. Garcia 11 , M.A. Berenguer 1,3 , N. Garcia 1 , M. Stefanovic 1 , C. Gutierrez 11 , C. Picon 5 , M. Ferrer 4,12 , F. Guedea 1,2,3 1 Catalan Institute of Oncology, Radiation Oncology, L'Hospitalet Barcelona, Spain ; 2 Faculty of Medicine and Health Sciences. University of Barcelona, Clinical Sciences, L'Hospitalet Barcelona, Spain ; 3 IDIBELL, Cancer and Radiobiology Research Group, L'Hospitalet Barcelona, Spain ; 4 Institut Municipal d'Investigacions Mèdiques, Health Services Research Unit, Barcelona, Spain ; 5 Catalan Institute of Oncology, Medical Physics and Radiologic Protection, L’Hospitalet Barcelona, Spain ; 6 University Pompeu Fabra, Experimental Sciences, Barcelona, Spain ; 7 Bellvitge Hospital, Pathology, L’Hospitalet Barcelona, Spain ; 8 Intstitute for diagnostic with images IDI, Magnetic resonance imaging MRI, L’Hospitalet Barcelona, Spain ; 9 Bellvitge Hospital, Urology, L'Hospitalet Barcelona, Spain ; 10 Bellvitge Hospital, Urology, L’Hospitalet Barcelona, Spain ; 11 Catalan Institute of Oncology, Radiation Oncology- Brachytherapy Unit, L'Hospitalet Barcelona, Spain ; 12 Autonomous University of Barcelona, Health Sciences, Barcelona, Spain Purpose or Objective Extracranial stereotactic body radiation therapy (SBRT) allows delivering high doses per fraction with high accuracy to the prostatic gland in a low number of fractions. Dose escalation in normofractionaded radiation prostate cancer trials showed an increased toxicity. In order to evaluate the feasibility and toxicity of a regimen of a single dose hypofractionated prostate stereotactic boost a phase II study was undertaken. Self-reported quality of life (QOL) measures were also obtained in order to better define the possible deleterious effect of treatment. Material and Methods Patients included were diagnosed of prostate cancer with T3aN0M0 Gleason score 8 or less (N+risk<25%) and IPSS 0- 12. Hormonal-therapy was prescribed according to risk classification. Image Guided RT with Cone Beam CT was mandatory. Dose SBRT was delivered at a prescribed planning target volume (PTV) 9 Gy after 60 Gy 2 Gy per fraction in 30 days, using with RapidArc VMAT, with 6 MV FFF photons. Equivalence of dose at 2 Gy per fraction, using Linear Quadratic Model is round 87Gy. RTOG-EORTC and CTCAE v4.0 morbidity scores were used to assess toxicities. Health-related quality of life questionnaire was administered centrally by telephone interview before treatment and during follow-up (at 3, 6 and 12 months). Study was planned following a Simon’s 2-stage design. Due to a low recruitment rate firsts 22 evaluable patients were

Intermediate: 28; High risk: 19. Mean PSA at the time of relapse was 6.3 ng/ml. Twenty-five had a SLT (cryotherapy: 23; SBRT:1; HIFU:1) and 42 a simple monitoring. Mean follow-up was 48 months. Three-year overall survival (OS: 93%) and distant metastasis-free survival (DMFS: 85%) were similar in both groups. But SLT postponed the use of ADT: at 3 year, 71% of the patients treated with SLT did not receive ADT versus 37% in the other group (p=0.001). We observed 24% of grade 3-4 side effects after cryotherapy, mainly incontinence, with two patients receiving an artificial urinary sphincter. Conclusion we did not observed an improvement in 3-year OS or DMFS after SLT for LR after RT. But it could delay the use of ADT. Due to the potential side effects of salvage treatments, a stringent selection of the patients based on imaging, analysis of prognostic factors and life expectancy must be recommended. EP-1538 Where fail PC patients treated with limited RT to prostate and sv with 76-80 Gy +/- hormonotherapy? J. Lopez Torrecilla 1 , P.P. J 1 , V. A 2 , G.H. T 2 , G.S. D 1 , A. P 1 , H.M. A 1 , G.M. E 1 , G.P. Jc 1 , B. L 2 , G. D 2 , R.F. J 2 1 H. General Univ Valencia, Radiation Oncology-ERESA, Valencia, Spain ; 2 H. General Univ Valencia, Radiofísica- ERESA, Valencia, Spain Purpose or Objective To analyse where they fail and what are the causes of death of patients treated with an "optimal" dose of radiotherapy. Material and Methods Between November 1997 and July 2007, 302 patients were treated with external radiotherapy +/- hormone therapy (29 with RTC-3D, 227 with IMRT and 52 with IMRT-IGRT). The average age of the series was 70.15 years (range of 51-87 years). Average follow-up 117.49 months, with a median of 130 months. The patients who died at the time of the analysis, the mean follow-up was 87.19 months, with a median of 87.5 months. Distribution by TNM: T : T1c: 80 (26.5%); T2a: 90 (29.8%); T2b: 36 (11.9%); T2c: 12 (4.0%); T3a: 42 (13.9%); T3b 38 (12.6%); T4: 2 (0.7%); Tx: 2 (0.7%). N : N0: 250 (82.7%); Nx: 52 (17.2%). M : M0: 233 (77.2%) ptes. Mx: 69 patients. Initial PSA <10 ng/ml: 177 (58.6%); 10-20: 87 (28.8%); > 20: 32 (10.6%), in 6 patients we do not know the PSA before any treatment. Gleason was <7: 225 (74.5%); 7:58 (19.2%); 8-10: 17 (5.6%). 2 patients unknown. Distribution by groups of risk (NCCN 2018 classification): Low risk 80 (26.55%), Intermediate risk: 86 (28.5%); high risk: 77 (25.5%), Very high risk 49 (16.2%), Unknown 10 (3.3%).The dose in prostate was 76 Gy in 119 (39.4%) patients and 80 Gy in 183 (60.6%). The dose in seminal vesicles was 50 Gy in 145 (47.9%) of the patients and 58 Gy in 152 (50.4%) patients. Patients were treated with 15 MV photons by 6 incidences with a rate of 200 cGy per session, 5 times per week. They did not receive hormone therapy 65 (21.5%) patients. Results Survival at 5 and 10 yea rs: Global 84.4% and 65.0%. Free of biochemical failure (BQF): 89.1% and 82.0%. Free of metastasis: 96.4% and 94.3%, respectively. At the time of the analysis 143 (47.4%) patients are alive, 158 (52.3%) have died and one is lost. BQF has presented 54 (17.9%) patients, of them 30 (9.9%) have not developed clinical disease, 11 (3.6%) presented local failure (LF) , 4 (1.3%) regional failure (RF) and 17 (5.6%) metastasis ). The cause of death was 106 (67.1%) intercurrent disease, 28 (17.7%) a second tumour, 24 (15.2%) due to prostate cancer. Of the 143 living patients 121 (84.6%) are disease- free, 22 (15.4%) with BQF (5 of them with associated LF, 1 LF + metastasis and 1 single metastasis). Of this group 5 patients (3.7%) are alive with a second tumour. Late Complications (RTOG): GU: G0: 40 (13.2%); G1: 134 (44.4%); G2: 98 (32.5%); G3: 27 (8.9%); G4: 3 (1.0%). GI:

studied. Results

First's 22 patients included were analyzed. Mean age was 69.6 years old. Median follow-up was 9 months (2-50) with more than 60% having at least 6 months of follow-up.