ESTRO 37 Abstract book

S896

ESTRO 37

assessments among the three axillary surgery groups, except for a worsening of 12/100 in diarrhoea in the axillary node dissection group and 6/100 points in systemic therapy in the no surgery group, that were not related to RT. The axillary node dissection group had less future perspective (15 points), more diarrhoea (10 points) and appetite loss (7 points) in the three years follow-up assessment than the other two axillary surgery groups, and more lymphoedema (9 points) and difficulties to raise the arm (13 points) than the no surgery group. Conclusion Results suggest good patients’ adaptation to their disease and treatments in the long follow-up period, and to the administration of RT in early stages breast cancer patients. There were few QL differences between the axillary surgery groups that favoured less aggressive modalities EP-1664 Systematic review on radiotherapy in elderly patients with gastrointestinal upper abdomen tumors S. Ciabatti 1 , A. Guido 1 , L. Giaccherini 1,2 , V. Panni 1 , V. Dionisi 1 , G. Siepe 1 , A. Arcelli 1,3 , M. Buwenge 1 , G. Macchia 4 , F. Deodato 4 , S. Cilla 5 , V. Picardi 4 , F. Cellini 6 , G.C. Mattiucci 6 , V. Valentini 6 , S. Cammelli 1 , F. Frezza 3 , A.G. Morganti 1 1 Department of Experimental- Diagnostic and Specialty Medicine - DIMES- University of Bologna- S.Orsola- Malpighi Hospital, Radiation Oncology Unit, Bologna, Italy 2 Department of Oncology and Advanced Technology- Arcispedale S. Maria Nuova-IRCCS, Radiation Oncology Unit, Reggio Emilia, Italy 3 Bellaria Hospital, Radiation Oncology Unit, Bologna, Italy 4 Fondazione di Ricerca e Cura “Giovanni Paolo II”, Radiotherapy Unit, Campobasso, Italy 5 Fondazione di Ricerca e Cura “Giovanni Paolo II”- Università Cattolica del S. Cuore-, Medical Physics Unit, Campobasso, Italy 6 Policlinico Universitario «A. Gemelli»- Università Cattolica del Sacro Cuore, Department of Radiotherapy, Rome, Italy Purpose or Objective To evaluate feasibility and outcome of radiotherapy (RT) in the complex setting of gastrointestinal (GI) tumors of the upper abdomen in elderly patients Material and Methods A systematic review of the literature about patients aged ≥ 65 years, who underwent RT for GI neoplasms of the upper abdomen was performed using the PRISMA methodology Results A total of 9 papers, amounting to 4255 patients, were included in the analysis. RT was prescribed as single modality treatment or in combination with surgery and/or chemotherapy. Irradiation was delivered by megavoltage external-beam RT with conventional fractionation, hypofractionated RT based on stereotactic technique, or proton therapy. RT dose ranged between 22 and 70 Gy (median 50 Gy) and was delivered to different targets depending on tumor and treatment aim and setting. Treatment-related severe (G ≥ 3) toxicity was reported in 4 out of 9 studies (total number of patients: 109) with 24 cases of acute toxicity (22.0%) and 3 cases of late toxicity (2.8%). When considering outcome in all patient group, overall survival ranged from 6.4 to 69 months (median 22.6 months) in patients who received

radiation treatment, and from 14.3 to 31.3 months (median 24.2 months) in patients who were not radio- treated. Median 2-years survival rates were 49% (range 6.6-75.5%) and 50.4% (range 31-58%) respectively. Anyway, considering only studies comparing RT-treated and non-RT-treated patients, median survival and 2-years survival were 28.3 months (range 22.6-69), and 56% (range 49-75.5%) respectively in treated patients versus 24.2 months (range 14.3-31.2, p=0.200) and 50.4% (range 31-58%, p=0.486) in non-treated patients Conclusion RT of upper GI tumors in elderly patients seems to be tolerable and safe, particularly in terms of late toxicity, both alone or combined with other treatment modalities. It may contribute to prolong survival even when other therapies are excluded because of age and/or comorbidities. Further analyses and prospective trials enrolling elderly patients are needed to better define the risk/benefit ratio in this relevant group of neoplasms EP-1665 Protontherapy for intracranical and skull base tumors in elderly patients D. Scartoni 1 , D. Amelio 1 , S. Lorentini 1 , L. Widesott 1 , R. Righetto 1 , I. Giacomelli 1 , M. Cianchetti 1 , M. Schwarz 1 , M. Amichetti 1 1 Centro di Protonterapia, Protontherapy, Trento, Italy Purpose or Objective To report preliminary results of active beam scanning proton therapy (PT) for intracranical and skull base tumors in elderly patients (pts). Material and Methods Twenty-six elderly patients (age: ≥ 70 years) were treated with PT between January 2015 and February 2017. Median age was 76 years (range, 70-87) while KPS ranged between 60 and 100 (median, 90); 14 were female (53%) and 12 were male (47%). Fifteen (61%) patients were treated for a meningioma; three (12%) pts for a high grade glioma; three (12%) pts for a chordoma; one pts (3%) for a low grade glioma; one (3%) pts for a well- differentiated neuroendocrine carcinoma; one (3%) pts for a paragaglioma; one (3%) pts for a vestibular schwannoma and one (3%) pts for an anaplastic hemangioperycitoma. All the treatments were delivered at 1.8-2 GyRBE per fraction with a median total dose of 54 GyRBE (range 50-72 GyRBE). All pts were treated with active beam scanning PT using 3-4 fields with single field optimization technique. Treatment planning was based on morphological magnetic resonance imaging (MRI) with contrast enhancement medium administration, CT and PET images. Toxicity was assessed according to Common Terminology Criteria for Adverse Events version 4.0. Mean follow-up time was 8 months (range, 3-25). Results All pts completed the treatment without breaks. One pts discontinued the treatment because of tumor progression. Registered acute side effects include grade 1 (12%) and grade 2 (50%) skin erythema, grade 1 (3%) and grade 2 (50%) alopecia, grade 1 (42%) fatigue, grade 1 (12%) and grade 2 (7%) conjunctivitis, grade 1 (3%) and grade 2 (38%) pain, grade 1 (7%) and grade 2 (20%) headache, grade 1 (7%) and grade 2 (7%) skin hyperpigmentation. There were no grade 3 or higher acute toxicities. Registered late side effects include grade 1 (7%) and grade 2 (46%) alopecia, grade 1 (15%) fatigue, grade 1 (12%) headache, and grade 1 (3%) skin hyperpigmentation. There were no grade 3 or higher late toxicities.