ESTRO 38 Abstract book

S778 ESTRO 38

months). Median follow-up was 86 months (range 2-88 months). FFLP was 83% and 67% at 1 and 2 years, respectively. At univariate (p<0.03) and multivariate analysis (p<0.001), lesion size was significant for LC. Median PFS was 11 months. Median OS from diagnosis was 17 month. CT administered before SBRT (p< 0.005) and FFLP (p<0.002) were significantly correlated with OS. Grade 3 gastrointestinal toxicity was detected in 2% of patients. Conclusion SBRT is an effective and safe local therapy for selected patients with LAPC. Our results suggest that the stereotactic treatment may be a promising therapeutic option in the multi-modality treatment of these patients EP-1431 Impaired health in long term survivors of esophageal cancer after neo-adjuvant chemoradiotherapy? C. De Groot 1 , K. Muijs 1 , J. Plukker 2 , P. Van Luijk 1 , H. Langendijk 1 , J. Beukema 1 1 UMCG, Radiation Oncology, Groningen, The Netherlands ; 2 UMCG, Surgical Oncology, Groningen, The Netherlands Purpose or Objective Due to the clinical introduction of neo-adjuvant chemoradiotherapy (nCRT) prior to surgery, the number of long-term survivors of esophageal cancer (EC) is rising. Therefore, treatment-related toxicity, in particular cardiopulmonary toxicity, becomes increasingly important. The primary objective of this cross-sectional pilot study was to identify (subclinical) cardiopulmonary dysfunction in EC patients after nCRT followed by surgical resection as compared to surgery alone. Material and Methods EC survivors who were 5-15 years after curative resection with (n = 20) or without (n = 20) nCRT were enrolled. All patients underwent the following examinations; anamnesis (incl ACE-27), physical examination, quality of life (QoL) questionnaires, blood tests and a 6-minute walking test. Results Patient characteristics at baseline and at the time of the cross-sectional measurements are listed in table 1 . Using the EORTC -C30, a trend towards impaired role functioning in the nCRT group was observed (89 v 95, p=0.13). Additionally, fatigue was more common after nCRT (14.9 v 9.2; p=0.13). Other domains, symptom scales and global QoL were similar in both groups. The 6-minute walking test showed reduced exercise tolerance in the nCRT group. In this group, 11 (55%) patients had poor scores (<80% of predicted; corrected for age, gender and BMI) compared to 5 (25%) in the surgery alone group (p = 0.07). ACE-27 scores increased over time in both groups. Although statistically significance was not reached in this small cohort (p = 0.11), the increase in ACE score was more pronounced in the nCRT group (∆ACE = 0.75) compared to those treated with surgery only (∆ACE = 0.30). Moreover, patients in the nCRT group were younger and had shorter (follow up) time to develop toxicity/comorbidity (average FU time: 88 v 126 months). Similar results were found for the cardiovascular subscale of the ACE-27, which showed again a marked increase after nCRT (∆ACE=0.80 v 0.35; p=0.10). This was in particular due to a higher incidence of de novo atrial fibrillation after nCRT (CTCAE v4.0 ≥ grade 2: 5 v 1 new cases, p=0.08). Relatively high serum NT-proBNP levels were found in both groups ( table 1 ). After excluding patients with known cardiovascular disease from the analysis, average NT- proBNP levels in the surgery alone group decreased to normal (115 ng/L) whereas levels in the nCRT group remained elevated (271 ng/L; p=0.06). Troponin-T levels are similar in both groups and all in the normal range.

Conclusion Despite younger age and shorter follow up, patients treated with neo-CRT showed more increase in (cardiac) comorbidity scores compared to patients who underwent surgery alone. In addition, their exercise tolerance seems to be worse as well. The results of this pilot study emphasizes the need for further research in larger cohorts of patients. EP-1432 Re-irradiation of abdominal malignancies: toxicity, cumulative dose and outcome L. Caravatta 1 , F. Fiorica 2 , F. Dionisi 3 , C. Rosa 1 , L. Boldrini 4 , M. Lupattelli 5 , D. Genovesi 1 , M. Massaccesi 6 1 “SS Annunziata” Hospital- “G. D’Annunzio” University, Radiation Oncology Unit, Chieti, Italy ; 2 University Hospital Ferrara, Department of Radiation Oncology, Ferrara, Italy ; 3 Azienda Provinciale per i Servizi Sanitari- APSS, Proton Therapy Unit- Department of Oncology-, Trento, Italy ; 4 Fondazione Policlinico Universitario "A. Gemelli"- Catholic University of Sacred Heart, Radiology Department, Rome, Italy ; 5 University of Perugia and Perugia General Hospital, Radiation Oncology Section, Perugia, Italy ; 6 Fondazione Policlinico Universitario "A. Gemelli"- Catholic University of Sacred Heart, Department of Radiological- Radiotherapy and Hematology Sciences, Rome, Italy Purpose or Objective A systematic review about abdominal re-irradiation (Re-I) was performed, on behalf of the Association of Radiation Oncology (AIRO) study group for the re-irradiation, aiming to explore the toxicity, cumulative dose and outcome. Material and Methods A computerized search of the literature was performed by MEDLINE, EMBASE, OVID, and Cochrane database. The computer search was supplemented with hand searches of reference lists. Only studies analyzing reporting toxicity and/or safety as outcomes of patients re-treated where Re-I involved overlap with previous radiotherapy (RT) were taken into consideration. Retrospective and prospective studies with at least 10 patients were