ESTRO 38 Abstract book

S876 ESTRO 38

SBRT is a safe and effective method for treating metastases in the adrenal gland. None of the patients had treatment-related acute or late toxicities ≥ grade 2, and 70.8% of the patients were progression-free after RT. EP-1626 "TEACHH MODEL" as a tool for decision- making in palliative patients: Our experience A. Miranda Burgos 1 , C. Escuín Troncho 1 , G. Molina Osorio 1 , C. Garcia Aguilera 1 , L. Alled Comín 1 , J.M. Ponce Ortega 1 , R. Ibáñez Carreras 1 1 Hospital Universitario Miguel Servet, Radiation Oncology, Zaragoza, Spain Purpose or Objective Radiotherapy is an effective and cost-effective treatment when patients have symptoms such as metastatic bone pain, hemorrhages or cerebral edema. Up to 16% of planned patients do not receive treatment for causes such as clinical worsening or death. It is important to estimate the life expectancy to make appropriate decisions according to radiotherapy treatment. Our objective is to introduce in our clinical practice a scale of prognostic assessment that will help us decide on the relevance of palliative radiotherapy indication and thus reduce the rate of untreated planned patients below 10%. Material and Methods After the review of literature, we considered the TEACHH model suitable as a support tool for decision making in palliative radiotherapy. The TEACHH model divides patients into three life expectancy groups (1.7, 5, and 19.9 months) based on the score obtained according to the patient's clinical characteristics (type of cancer, Eastern Cooperative Oncology Group performance status, age, prior palliative chemotherapy, prior hospitalizations, and hepatic metastases). We decided to use the TEACHH model in all the patients that were hospitalized and needed palliative radiotherapy. Results We selected 147 patients candidates for palliative radiotherapy. We administered radiotherapy for metastatic bone pain in 42% of the patients, with hemostatic intention in 10%, for brain metastases in 28% and finally, for spinal cord compression in 20% of the patients. Of the total of treated patients, 22% were in the life expectancy group of 1.7 months; 74% in 5 months and 4% in 19.9 months. The use of the model allowed us to reject the treatment in 33 (22.5%) patients (18 in the group 1.7 months, 14 in 5 months and 1 in 19.9 months). We planned 21 (14%) patients who were not treated for death (3 in 1.7 months and 18 in 5 months). Conclusion It is a tool that allows us to administer a palliative treatment or dismiss it individually to each patient considering their life expectancy and thus reduce the rate of planned patients not treated by improving the use of resources of our Service. EP-1627 Impact of body morphology on survival in patients with bone metastases: A prospective cohort study B. Pielkenrood 1 , P. Van Urk 2 , J. Van der Velden 1 , N. Kasperts 1 , J. Verhoeff 1 , G. Bol 1 , L. Verkooijen 1 , J. Verlaan 2 1 UMC Utrecht, Radiotherapy, Utrecht, The Netherlands ; 2 UMC Utrecht, Orthopedic Surgery, Utrecht, The Netherlands Purpose or Objective An increasing number of patients is diagnosed with spinal metastases due to more effective treatment and better survival of cancer. Patients with painful spinal metastases are treated with radiotherapy, combined with surgical

Conclusion The onboard clinical workflow of the 1.5 T MR-linac, with daily contour adaptation and full online re-planning, can successfully be used to treat patients with pelvic and low abdominal lymph node oligometastases using an SBRT approach. EP-1625 Patterns-of-care and outcome-analysis of the stereotactic body RT (SBRT) of adrenal-gland- metastases T. Voglhuber 1 , S.E. Combs 1 , K.A. Kessel 1 , M. Oechsner 1 1 Technical University of Munich TUM, Department of Radiation Oncology, München, Germany Purpose or Objective High-precision stereotactic body radiotherapy (SBRT) has proven to be a valuable method in the curative and palliative treatment of different tumor entities and is meanwhile an established keystone in the field of neoadjuvant tumor-therapy. In this study, we evaluate the effect of SBRT in patients with metastases in the adrenal gland focused on progress- free-survival (PFS), overall survival (OS), and acute as well as late toxicity. Material and Methods A cohort of 24 patients was analyzed treated with SBRT for metastases in the adrenal gland between 2006 and 2018. Treatment-planning was performed through contrast-enhanced CT followed by the image-guided radiation therapy (IGRT) using Cone-beam-CT (CBCT). SBRT was applied with a cumulative median dose of 35 Gy (range: 25-40 Gy) and a single dose of 5 Gy in five fractions per week. Results The evaluation is still ongoing. Primary tumors of the patients were: NSCLC 45.8 %, Mamma-Ca 12.5 %, Melanoma 12.5 %, Sarcoma 8.3 %, and others 20.9 %. At the time of analysis, 7 patients (29.2 %) experienced local failure (LF) of the neoplasia in the adrenal gland (mean LF: 52.0 months, 95%-KI: 26.2-77.8 months, median not reached), 19 (79.2 %) faced a distant progression (median- PFS: 2.2 months, 95%-KI: 1.8-2.6 months). 12 patients were still alive (50 %), 5 of them without LF (41.7 %), 4 of them (33.3 %) without any tumor progression (median OS: 12.9 months, 95%-KI: 6.3-19.5 months). Our results showed that there occurred no treatment- related side-effects ≥ grade 2, which reflects the overall low-grade-toxicity of SBRT used for adrenal-gland- metastases. Toxicity rates ≥ grade 2 were as follows: 41.7 % suffered from acute (<= 6 months) gastrointestinal disorders like nausea (29.2 %), vomiting (8.3%), and abdominal pain (4.2 %); 29.2 % also reported acute fatigue, constipation, throbbing pain in the renal area and increase of the retention parameters. Only 20.8 % of the patients faced late-toxicities like loss of weight (4.2 %), fatigue (4.2 %) and gastrointestinal medical conditions (12.5 %) persisting or appearing after the 6-month-period. Conclusion