ESTRO 37 Abstract book

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ESTRO 37

Conclusion Awaiting the results of randomized trials (e.g. SAKK 9/10), these data, while retrospective, seem to confirm that dose-escalated radiotherapy, even in the early salvage setting, improves bDFS without substantially altering toxicity EP-1598 Patient reported urinary symptoms and 1-2 year anxiety and depression after post-prostatectomy RT. F. Munoz 1 , P. Gabriele 2 , B. Avuzzi 3 , F. Migliaccio 4 , E. Delmastro 5 , T. Giandini 6 , G. Sanguineti 7 , B. Saracino 7 , D. Cante 8 , E. Petrucci 9 , E. Villa 10 , P. Salmoiraghi 11 , J. Waskiewicz 12 , P. Farina 13 , G. Girelli 14 , B. Farina 15 , F. Badenchini 16 , C. Bianconi 17 , C. Sini 18 , I. Improta 18 , B. Noris Chiorda 3 , R. Valdagni 16 , C. Fiorino 18 , C. Rancati 16 , C. Cozzarini 17 1 Ospedale Regionale U.Parini-AUSL Valle d’Aosta, Radiotherapy, Aosta, Italy 2 Istituto di Candiolo- Fondazione del Piemonte per l'Oncologia IRCCS, Radiotherapy, Candiolo Torino, Italy 3 Fondazione IRCCS Istituto Nazionale dei Tumori, Radiotherapy, Milan, Italy 4 Ospedale Regionale U.Parini-AUSL Valle d’Aosta, Medical Physics, Aosta, Italy 5 Istituto di Candiolo- Fondazione del Piemonte per l'Oncologia IRCCS, Medical Physics, Candiolo Torino, Italy 6 Fondazione IRCCS Istituto Nazionale dei Tumori, Medical Physics, Milan, Italy 7 Istituto Nazionale dei Tumori “Regina Elena”, Radiotherapy, Rome, Italy 8 Ospedale di Ivrea- A.S.L. TO4, Radiotherapy, Ivrea, Italy 9 Ospedale di Ivrea- A.S.L. TO4, Medical Physics, Ivrea, Italy 10 Cliniche Gavazzeni-Humanitas, Radiotherapy, Bergamo, Italy 11 Cliniche Gavazzeni-Humanitas, Medical Physics, Bergamo, Italy 12 Comprensorio Sanitario di Bolzano, Radiotherapy, Bolzano, Italy 13 Comprensorio Sanitario di Bolzano, Medical Physics, Bolzano, Italy 14 Ospedale degli Infermi, Radiotherapy, Biella, Italy 15 Ospedale degli Infermi, Medical Physics, Biella, Italy 16 Programma Prostata- Fondazione IRCCS Istituto Nazionale dei Tumori, Radiotherapy, Milan, Italy 17 San Raffaele Scientific Institute, Radiotherapy, Milan, Italy 18 San Raffaele Scientific Institute, Medical Physics, Milan, Italy Purpose or Objective The QoL of pts submitted to both adjuvant (ADV) and salvage (SALV) post-prostatectomy RT may be severely affected by urinary symptoms (US), even and especially in the long term. This RT-induced impairment, often permanent, of urinary function may lead to a significant but probably still underestimated risk of long-lasting and clinically significant (ANX) and depression (DEP). Purpose of this study was to investigate the US most affecting the risk of long-term ANX and DEP after ADV and SALV RT, and to analyse any possible difference in terms of risk of both psychological disturbances in pts treated with the two different RT intents Material and Methods Pts enrolled in an ongoing multicentric observational trial, activated in 2014, registered at ClinicalTrials.gov and aimed at the evaluation of toxicity from RT including prophylactic whole-pelvis irradiation were evaluated.

Static-field IMRT (11%), Tomotherapy (44%) and VMAT (45%) were allowed. US were evaluated by means of both the IPSS and ICIQ-SF questionnaires, while ANX and DEP were evaluated through the Hospital Anxiety and Depression Scale (HADS, 14 items). All the questionnaires were filled in by pts at different time intervals. Median time from prostatectomy to RT (TTRT) and EQD2 RT dose to prostatic bed (PB) for α/β=1Gy were 3.72 vs 24.43 months (p<.0001), and 73.48 vs 74 Gy in ADV and SALV cohort, respectively. Median EQD2 RT dose to pelvic lymph-nodal area (PLNA) was 48.13 Gy in both groups. Clinically significant ANX and DEP, corresponding to a HADS score >8 points for both psychological disturbances, was set as endpoint for statistical analyses. The possible role, with respect to the risk of ANX and DEP at 12 and 24 months, of a large set of clinical and dosimetric variables, as well of the seven patient-reported US and of urinary incontinence (UI) as measured by the IPSS and ICIQ-SF questionnaires, respectively, was analysed by means of univariate logistic analysis (UA). Variables with a p-value <0.20 at UA were entered into a multivariable analysis (MVA). Results 185 pts (88 ADV/87 SALV) with complete data at baseline and at 1 year were analysed. For 104 of these, data at 2 years were also available. Median baseline, 1- and 2 year ANX were 3 vs 4, 2 vs 2.5 and 2 vs 2 in ADV and SALV cohorts, respectively, The corresponding values for DEP were 2.5 vs 3, 2 vs 2 and 1 vs 2. At MVA, 1-year urinary intermittency and UI were the only 2 variables independently predictive of both ANX and DEP (Tab. 1). Two-year UI and nocturia independently predicted the risk of 2-year ANX, while 2-year UI was the only covariate independently predictive of 2-year DEP (Tab. 1).

Conclusion No significant differences in terms of risk of both baseline and long-term ANX and DEP were observed between pts treated with ADV or SALV RT. One- and two-year urinary incontinence was a strong predictor of long-term ANX and DEP. An independent role of urinary intermittency in impairing both psychological disturbances at 1 year, as well as of nocturia in increasing the risk of 2-year ANX, also emerged. EP-1599 MRI-guided contouring in SBRT of the prostate for localized disease A. Magli 1 , E. Moretti 2 , M. Guernieri 2 , M. Urpis 1 , A. Prisco 1 , M. Crespi 2 , C. Foti 2 , P. Scalchi 2 , M. Trovo' 1 1 ASUIUD, Department of Radiation Oncology, Udine, Italy 2 ASUIUD, Medical Physics / Fisica Sanitaria, Udine, Italy