ESTRO 37 Abstract book

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ESTRO 37

treated with induction WK-PC (NB-Pac 80 mg/m 2 + carboplatin AUC 2 intravenous Day1) followed by definitive RT alone or CTRT (same as induction regimen) were retrieved from departmental archives. Toxicities were evaluated using acute morbidity scoring criteria of RTOG. Responses were evaluated as per WHO criteria. Recurrence free survival (RFS) and overall survival (OS) were estimated from the date of diagnosis using Kaplan Meier method. Results Patient characteristics are summarized in table 1. Median number of NACT and concurrent chemotherapy cycles was 4 (2-6) and 4 (3-6) respectively. 45 patients (86.5%) received RT after NACT. Of these 45, 30 patients (66.6%) received CTRT. Median RT dose for RT alone group was 60 Gray and for CTRT patients was 50 Gray (both at 2 Gray per fraction delivered 5 days a week with 3-dimensional conformal plans). Patients <70 years vs. ≥ 70 years (68% vs. 41%; p=0.094) and male vs. female (70% vs. 33%; p=0.033) had more chances to receive CTRT. Grade 1, 2 and 3 leucopenia was noted in 5.7%, 28.8% and 5.7% patients respectively. Grade 1, 2, 3 dysphagia was noted in 4.4%, 51.1% and 15.5% patients respectively. Median follow up was 13.34 months (5.2-51.5 months). Overall complete response, partial response, progressive disease and death at the time of last follow up were 35%, 29%, 25% and 11% respectively. 1-year and estimated 2 year RFS were 92.1% and 70% respectively. Estimated 2 year OS was 89.6%. Patients receiving CTRT had better outcome as compared to those with RT alone (one year RFS: 80.2% vs. 41.3%; two year RFS: 47.1% vs. 13.8%; p=0.005). Conclusion Weekly NACT with NB-Pac and carboplatin followed by definitive CTRT with same regimen is well tolerated, feasible and associated with decent survival outcomes in patients of carcinoma esopahgus deemed unsuitable for surgery or cisplatin based CTRT. In this subset of patients, age <70 years and male sex have higher chances of receiving CTRT after NACT and delivery of CTRT (as compared to RT alone) is associated with significant increase in survival. This novel approach needs further evaluation in prospective phase II/III trials. EP-1434 Patient reported outcomes after palliative radiotherapy for metastatic pancreatic cancer X. Zhu 1 , S. Dongchen 1 , L. Fuqi 1 , J. Xiaoping 1 , C. Yangsen 1 , Q. Shuiwang 1 , C. Fei 1 , S. Yuxin 1 , F. Fang 1 , J. Zhen 1 , Z. Huojun 1 1 Changhai Hospital, Radiation Oncology, Shanghai, China Purpose or Objective Patients with metastatic pancreatic cancer may experience distressing symptoms, which require palliative treatment and supportive care promptly because any benefits associated with a short overall survival may be counterbalanced by negative impacts on quality of life (QoL) attributable to cancer-related local symptoms and complications. Therefore, local treatment modality, such as stereotactic body radiation therapy (SBRT), may be an option to ameliorate these symptoms. Hence, the aim of this study was to evaluate patient reported outcomes after palliative SBRT for metastatic pancreatic cancer. Material and Methods Patients with biopsy-proven and radiologically metastatic pancreatic cancer were included from 2012 to 2016. Data were collected prospectively from 2013 to 2016 and retrospectively collected before 2013. Brief Pain Inventory (BPI), a five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) and Edmonton Symptom Assessment System (ESAS) 3 months after treatment were employed for pain measures, evaluation of QoL and symptoms. Patient-reported global changes were defines as better, the same and worse, used as the reference standard for responsiveness. Cox proportional hazards

regression was used to identify factors predictive of survival. Propensity score matching (PSM) analysis was employed to assess the efficacy of SBRT and SBRT combined with chemotherapy. Results Two hundred and twenty-five patients were included with the median prescription dose and BED 10 was 35Gy and 59.5Gy, respectively. Three patients died within 3 months, which were precluded for analysis. After multivariate analysis, baseline visual analogue scale, treatment sequence of chemo-SBRT, BED 10 , CA19-9 response, post-treatment ESAS and BPI correlated with overall survival (OS) and the former five plus EQ-5D-5L were predictive of progression free survival (PFS). More patients (n=16, 43.2%) receiving SBRT alone had lower BPI scores than those with SBRT and chemotherapy (n=41, 22.2%) (P=0.007), while more patients (n=48, 25.9%) undergoing multimodality therapy had higher EQ-5D-5L scores than those with SBRT alone (n=1, 2.7%) (P=0.001). No significant difference of ESAS scores was found between these two groups (P=0.422). Irrespective of patient global changes, longer OS and PFS was found in patients with SBRT and chemotherapy than those with SBRT alone (OS: 8.9 months vs. 4.6 months, P<0.001) (PFS: 5.4 months vs. 2.0 months, P<0.001). Additionally, more patients (n=76, 41.1%) with SBRT and chemotherapy had CA19-9 response than those with SBRT alone (n=0, 0%) (P<0.001). After PSM, survival benefits were found in patients with SBRT and chemotherapy than those with SBRT alone (OS: 6.5 months vs. 4.6 months, P=0.042) (PFS: 2.8 months vs. 2.1 months, P=0.027), though more patients with SBRT alone had lower BPI and ESAS scores. Conclusion Although SBRT alone may be beneficial for symptom amelioration, SBRT combined with chemotherapy may provide survival benefits and be not inferior to SBRT alone in improvement of QoL. EP-1435 The role of elective nodal irradiation in radiotherapy for stage I esophageal cancer S. Tsuruoka 1 , M. Kataoka 2 , K. Makita 1 , H. Ishikawa 1 , N. Takada 1 , K. Nagasaki 1 , Y. Hamamoto 1 , T. Mochizuki 1 1 Graduate School of Medicine Ehime University, Radiology, Ehime, Japan 2 National Hospital Organization Shikoku Cancer Center, Radiation Oncology, Ehime, Japan Purpose or Objective The reports on the results of radiotherapy (RT) for stage I esophageal cancer is limited, and the efficacy of elective nodal irradiation (ENI) is still unclear. The purpose of this retrospective study is to evaluate the efficacy of ENI in stage I esophageal cancer treated with RT. Material and Methods From April 2006 to December 2014, 79 patients with stage I esophageal cancer were received RT in our institute. Two patients combined with stage IV hypopharyngeal carcinoma, three patients whose follow- up time was less than 6 months and two patients who failed to complete RT were excluded, and 72 patients were analyzed in this study. Sixty patients out of 72 (83.3%) were treated with concurrent chemoradiotherapy (CRT) (delivered median 60Gy (41.4 to 60Gy)) and 22 of 72 (30.6%) were with RT alone (delivered median 66Gy (60 to 70Gy)). Twenty patients (27.8%) were received RT with ENI. Endoscopic submucosal dissection was performed before RT in 12 patients. The primary outcomes were overall survival (OS) and disease-free survival (DFS). Results The median age was 68 years old (50 to 89). The male/female ratio was 64/8. The median follow-up was 54.7 months (2.5 to 126.5 months). The tumor histology was squamous cell carcinoma in all patients. The subsites of the primary tumors were upper/middle/lower thoracic