Abstract book - ESTRO meets Asia

S104 ESTRO meets Asia 2018

Material and Methods Retrospective data were collected for bladder cancer patients receiving palliative pelvic RT between 2015 to 2017. These patients received RT for local control of disease, pain relief or haemostasis. Overall survival from the end of RT was analysed using log-rank test. Patients were stratified by age, TNM stage, performance status, co-morbidity status, previous chemotherapy and radiotherapy regimes. Patients were followed up at about 6 weeks after RT. Patients dying before, during or within 6 weeks of treatment were considered to receive futile treatment. Results 73 patients were planned to receive palliative pelvic RT. The median age was 78 years (53-95 years). The majority had transitional cell carcinoma (84%) and advanced stage (Stage III, IV and recurrent disease) (90%). The main indications were for local control (40%), pain control (29%) and haemostasis (28%). A variety of RT regimes were used: 8Gy/1 fraction (14%), 21Gy/3 fractions (30%), 20Gy/5 fractions (26%), 36Gy/6 fractions (1%), 27.5Gy/8 fractions (3%) and 30Gy/10 fractions (26%). About 40% of patients were of poor performance status (ECOG performance status 3 or 4) and had significant co-morbidities (ACE-27 score 2 or 3). 12% (n=9) of patients did not complete RT regime due to general deterioration or inpatient admission, while 4% (n=3) died prior to treatment. The median overall survival after last fraction of RT was 93 days (2-749 days). 26% (n=19) of patients died within six weeks after receiving palliative RT. About half (n=39) the patients reported their outcomes during clinic or telephone follow-up with median follow-up time of 46 days (14-113 days). 62% (n=24) of patients reported symptoms such as cystitis, diarrhoea, skin reaction, general deterioration or no improvement in pain relief. There were no significant differences in median overall survival with high comorbidity, advanced stage or age. Patients of better performance status (ECOG performance status 0-2) survived significantly longer than those with worse PS (140 days (108-171days) vs. 51 days (40-61 days), p value 0.000049. There was no significant difference in overall survival between single or fractionated RT (p value 0.098). Conclusion A third of patients either did not complete the planned RT course or died within 6 weeks of treatment. It is possible that these patients did not achieve maximal benefit from treatment while suffering side effects making this a futile treatment. It is of particular interest that patients with a better ECOG performance status survived longer despite there being no difference between the age groups. Patient selection and comprehensive assessment are crucial in preventing futile treatment. PO-254 Definitive intensity-modulated radiation therapy for ureteral cancer A. Sato 1 , Y. Tayama 1 , M. Omura 1 , K. Matsui 1 , K. Takino 1 , H. Hongo 1 , R. Shirata 1 , H. Hashimoto 2 , W. Yamakabe 1 , K. Saito 1 , I. Yoshida 1 , T. Ikeda 1 , G. Sato 1 , M. Hata 3 , T. Inoue 4 1 Shonan Kamakura General Hospital, Radiation Oncology, Kamakura, Japan 2 Shonan Fujisawa Tokushukai Hospital, Radiation Oncology, Fujisawa, Japan 3 Yokohama City University Graduate School of Medicine,

radiotherapy of intermediate and high risk localised prostate cancer and could be an effective modality to achieve cost effective treatment for patients and healthcare system. With data suggesting substantial increase in biochemical relapse-free survival, reduced acute morbidity and no increase in late toxicity, our results confirm that adding HDR-BT as a boost should be considered for intermediate and high-risk prostate cancer patients in future. PO-252 Clinical outcomes with hypofractionated IMRT in organ confined prostate cancer: An Indian experience M. Mondal 1 , J. Goswami 1 , S. Mallik 1 , S. Das 1 , A. Sen 1 , B. pal 1 , S. Das 1 , S. Palit 1 1 Narayana Superspeciality Hospital, Radiation Oncology, Howrah, India Purpose or Objective Recent evidences suggest that hypofractionated radiotherapy (HFRT) has comparable clinical outcome as conventionally fractionated radiotherapy in organ- confined prostate cancer. We hereby report our initial data of clinical outcomes of organ-confined prostate cancer patients treated with HFRT. Material and Methods 45 consecutive organ-confined prostate cancer patients (1 low- risk, 5 intermediate- risk, and 39 high-risk) received hypofractionated intensity modulated radiotherapy (HF- IMRT), from July 2012 to June 2017. The prescribed dose to the prostate was 77Gy/35 fractions (before 2014, n=8) or 60Gy/20 fractions (from 2014 onwards, n=37). Irradiation of pelvic lymph nodes was done where required. Androgen deprivation therapy was given for 6 months in intermediate risk and 24-36 months in high risk patients. Biochemical relapse free survival (bRFS) [Phoenix definition], prostate cancer-specific and overall survival (pCSS and OS) actuarial curves were assessed using Kaplan Meier survival curve. Acute and late toxicities were recorded according to the RTOG morbidity scoring Median follow was 26 months (range, 6-54 months). 6 biochemical relapses occurred (1 in intermediate and 5 in high risk group) of whom 3 died of distant metastasis. The 2-year actuarial bRFS was 92.3%, pCSS was 93.9% and OS was 91.5%. RTOG grade 2 or worse acute and late gastrointestinal toxicities were 20% and 13.3%; genitourinary toxicity were 8.9% and 11.1% respectively. Only 1 patient had Grade 3 rectal toxicity and none had Grade 3 bladder toxicity. Conclusion Hypofractionated Intensity modulated radiotherapy in our settings is well tolerated and has a comparable biochemical relapse rate and toxicity profile with that of the published literature. PO-253 Examining the(F)utility of palliative radiotherapy in advanced bladder cancer A. Ali 1 , Y.P. Song 1 , R. Conroy 1 , C. Coyle 1 , T. Elliot 1 , J. Logue 1 , A. Tran 1 , J. Wylie 1 , A. Choudhury 2 1 The Christie NHS Foundation Trust, Clinical Oncology, Manchester, United Kingdom 2 University of Manchester, Division of Cancer Sciences, Manchester, United Kingdom Purpose or Objective To investigate the efficacy of palliative pelvic radiotherapy (RT) for patients with advanced incurable bladder cancer and identify factors to prevent patients receiving futile treatment. system. Results Clinical: Urology-non-prostrate

Radiation Oncology, Yokohama, Japan 4 Shonan Kamakura General Hospital, Advanced Medical Center, Kamakura, Japan

Purpose or Objective The standard treatment for ureteral cancer is radical nephroureterectomy. Definitive radiation therapy is a treatment option for patients with contraindications to surgery such as old age and complications. However, no