ESTRO 37 Abstract book

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ESTRO 37

EP-1668 The influence of age on survival in elderly patients with resected PC undergoing adjuvant therapy. P. Trecca 1 , M. Fiore 1 , B. Floreno 1 , C. Rinaldi 1 , R. Coppola 1 , L.E. Trodella 1 , L. Trodella 1 , R.M. D'Angelillo 1 , S. Ramella 1 1 Campus-Bio Medico University, Radiotherapy Unit, Rome, Italy Purpose or Objective A significant proportion of pancreatic cancer (PC) patients is over the age of 70 years at diagnosis. Older patients with PC continue to remain poorly represented in clinical trials. The aim of this study was to determine if age affects outcomes in patients with resected An analysis of patients with upfront surgically resected pancreatic head cancer treated at our institution between 2005 and 2017 was performed to compare outcomes of patients ≥70 and <70 years. A retrospective review of 114 patients who underwent complete resection with macroscopically negative margins (R0-1) for invasive pancreatic adenocarcinoma was performed. Exclusion criteria included metastatic or unresectable disease at surgery, postoperative death and the use of neoadjuvant therapy. The primary endpoint was overall survival (OS). Results Sixty-six patients (39 males, 27 females) were included in the analysis. Forty-one patients aged<70 years (mean age 59 years) and 25 patients aged ≥70 years (mean age 75 years) were evaluated. Forty-nine patients (74.2%) received adjuvant radiochemotherapy, 17 patients (25.8%) received adjuvant chemotherapy alone. All patients received gemcitabine or fluoropyrimidine-based chemotherapy concurrently with radiotherapy. Overall, treatment protocols were well tolerated. The median follow-up was 31 months. For the entire cohort of patients no differences in survival was observed between patients receiving or not receiving adjuvant radiochemotherapy in terms of tumor diameter (p=0.36), tumor grade (p=0.5), surgical margins (p=0.75), perineural invasion (p=0.1) and lymph nodes positive disease (p=0.31). Moreover, the univariate analysis showed a trend towards decreased mortality with adjuvant chemoradiation (p=0.09). There was no statistically significant difference in survival between patients aged <70 years and older patients. Median survival and 3-year OS were 35.5 months and 45% in patients <70 years and 29.5 months and 44% in those ≥70 years (p=0.5). Conclusion The data suggest that outcomes of patients ≥70 years who undergo upfront surgical resection and adjuvant therapy are not inferior to younger patients. Treatment decisions should be based on physiologic rather than chronological age. EP-1669 Radiochemotherapy in locally advanced pancreatic cancer: an aged-based analysis C. Rinaldi 1 , M. Fiore 1 , B. Floreno 1 , P. Trecca 1 , R. Coppola 1 , L. Trodella 1 , R.M. D'Angelillo 1 , S. Ramella 1 1 Campus Biomedico University, Department of Radiation Oncology, Roma, Italy Purpose or Objective The purpose of this analysis is to evaluate the feasibility and efficacy of concurrent radiochemotherapy (RCT) with pancreatic head cancer. Material and Methods

or without induction chemotherapy for elderly patients with locally advanced pancreatic cancer (LAPC). Material and Methods A total of 52 patients enrolled in mono-institutional prospective studies were included. All patients were treated with gemcitabine-based RCT. Of these, 31 patients were treated with induction chemotherapy (GemOx or FOLFIRINOX). The radiation therapy total dose was 54-59.4 Gy with conventional fractionation. We stratified population into two groups: the first included patients aged <70 years, the second one those aged ≥70 years. Overall survival (OS), progression-free survival (PFS), local control (LC) and toxicity rates were recorded. Results Thirty-seven patients aged <70 years (mean age 61 years) and 15 patients aged ≥70 years (mean age 74 years) were evaluated. Nineteen patients (51%) of the first group underwent radical surgery compared with five patients (33.3%) of the second group. Only 11 patients (57.9%) aged <70 years were treated with adjuvant chemotherapy. Median OS and 1-yr OS were 21.5 months and 83% in patients <70 years and 11.5 months and 40% in those ≥70 years (p<0.01). Median PFS was significantly higher in the younger group (19.4 months vs 9.9 months; p<0.05). LC was high in both groups (1-yr LC 87% vs 88%). For the entire cohort, the treatment protocol was well tolerated with no significant difference in grade 3 or 4 acute toxicities between the groups. Conclusion These data suggest that RCT has a role in the management of elderly patients with LAPC. Nevertheless, strategies to optimize local control and patients’ selection for the combined approach may play an increasing role in improving outcomes. EP-1670 Feasibility of High Dose Hypofractionated Radiotherapy in Older Patients with Gynaecological Cancer G. Imseeh 1 , A. Taylor 1 1 Royal Marsden Hospital Trust & Institute of Cancer Research, Department of Imaging and Radiotherapy, London, United Kingdom Purpose or Objective Locally advanced and recurrent gynaecological cancers are a frequent cause of pelvic morbidity including bleeding and pain. For some patients, radical treatment is inappropriate due to frailty or patient choice. Attending hospital daily can be difficult and alternative regimens may be more acceptable to patients. The aim of this retrospective study is to assess the tolerability and efficacy of high dose hypofractionated palliative radiotherapy in treating gynaecological cancers. Material and Methods Using electronic patient records, we retrospectively identified patients who received palliative radiotherapy for a primary or locally recurrent gynaecological malignancy between July 2011 and December 2016. Analysis was restricted to patients who were aged ≥ 65 and planned to receive a total radiation dose of >25 Gy in >4 Gy per fraction. Data was collected and analysed on patient outcomes including symptom control, toxicity and survival. Results 25 patients were included in our analysis with a median age of 83 (range 67 – 101). Treated tumours by subsite were 12 endometrial, 6 cervical, 5 vaginal and 2 vulval. 1 patient had distant disease at time of treatment. The