Abstract book - ESTRO meets Asia

S107 ESTRO meets Asia 2018

Clinical: Palliation

given for lymphoma in 20 (12%) patients out of whom nineteen patients had Hodgkin’s disease. Head and neck and soft tissue was the site for 18 (11%) patients each. Twenty-three (14%) patients had RMS and 11 (7%) had non- RMS sarcoma. Only 10% patients had malignancy of epithelial origin. All the patients were planned according to pediatric treatment protocols used by pediatric oncologist. All the treatment volumes are peer reviewed by the team of doctors in radiation oncology and treatment plans double checked. Conclusion Radiation therapy for children in developing countries needs attention for quality treatment of potentially curable tumors. Since most of the children will be long term survivors, peer reviewed quality treatment planning and delivery is required at each step according to pediatric treatment protocols as per international standards. PO-259 Optic apparatus dose with conformal radiation therapy for para-meningeal rhabdomyosarcoma B.M. Qureshi 1 , S. Abrar 1 , A.N. Abbasi 1 , S. Naeem 1 , S. Resham 2 , S. Altaf 3 , A. Hafiz 1 , N. All 1 1 Aga Khan University, Radiation Oncology Section- Department of Oncology, Karachi, Pakistan 2 Aga Khan University, Department of Pediatrics & Child Health, Karachi, Pakistan 3 Aga Khan University, Pediatric Oncology Section- Department of Oncology, Karachi, Pakistan Purpose or Objective Rhabdomyosarcoma (RMS) arising in parameningeal location is considered to be an unfavourable site. Due to unavailability of surgical option, these tumors are labelled as clinical group III. Therefore the recommended local treatment modality is radiation therapy. We aim to document the doses to optic nerves and optic for para meningeal RMS treated with radiation therapy as local modality Material and Methods Parameningeal RMS receive systemic chemotherapy upfront according to Clinical Oncology Group protocol for intermediate risk rhabdomyosarcomas. Radiation therapy is often the local treatment of choice according the treatment protocol as these are difficult areas for surgical resection. Radiation treatment volumes are contoured based upon the initial extent of disease, therefore optic nerves and optic chiasma is often at risk. Results We retrospectively evaluated the radiation treatment plans for five patients who received complete treatment for non-metastatic, parameningeal RMS at our institute. All of them were planned for a total dose of 5040 cGy in 28 fractions with once daily fraction, five days a week. The average treatment volume was 329.52 cm 3 (146.6 – 423.2 cm 3 ). The maximum dose (D max ) to optic nerves ranged between 195.4 – 5410 cGy with average D max for these patients being 2231 cGy. The maximum dose to optic chiasm was between 264 cGy to 4387 cGy with average D max of 1889 cGy. The aim of all the plans to achieve 95% isodose line of prescribed dose to cover 95% of volume was achieved in all the patients Conclusion Radiation therapy for pediatric parameningeal RMS require precise conformal planning because of close proximity to optic apparatus. Appropriate use to treatment technique helps limit the dose to organ at risk within normal limit. This will help maintaining vision in these long-term survivors.

PO-260 Clinical and predictive factors of response to Whole Brain radiotherapy in metastatic lung cancer V. Pareek 1 1 Jupiter Hospital, Radiation Oncology, Mumbai, India Purpose or Objective Metastases in lung cancer especially to the brain is associated with poor outcomes and warrants palliative care in form of whole brain radiation therapy or best supportive care. Prognostic factors for overall survival are seen in many studies. Aim of this study was to identify clinical outcomes and assess predictive factors associated with treatment outcomes with WBRT in lung metastases. Material and Methods From 2009 to 2016, from the medical records of Jupiter Hospital, 95 patients were evaluated retrospectively for demographic and treatment and clinical outcome parameters. Univariate and multivariate analysis were assessed for the various impact of the parameters in the treatment outcomes. Various parameters assessed were age, Charlson comorbidity score, gender, marital status, use of chemotherapy, other metastatic sites, weight loss, BMI and edema and extent of edema/tumor ration (E/T). Results In the univariate analysis, poor outcomes were related to small cell lung cancer (p = 0.0006), E/T ratio > 1.5 (p <0.001), median tumor diameter <2 cm was associated with better prognosis. On Multivariate analysis, low Charlson comorbidity score, male gender, presence of extra-cranial metastases, weight loss >10% and higher BMI were associated with poorer outcomes. On subset analysis as per the risk factors, the median survival was 5.6 months’ vs 9.2 months in poor risk factors vs the better factors. Conclusion In view of end of life WBRT, in cases where outcomes are poor, they can be considered for best supportive care and these require quality of life assessments to predict the outcome comparison. PO-261 prognostic factors in hepatocellular carcinoma patients with bone metastases receiving radiotherapy Y. Choi 1 , S. Kim 1 , D.W. Kwak 1 , H.S. Lee 1 , W.J. Hur 1 1 Dong-A University Hospital, Radiation Oncology, Busan, Korea Republic of Purpose or Objective The survivals of hepatocellular carcinoma patients (HCC) with bone metastases (BM) were variable. This study was performed to identify the prognostic factors in HCC with BM. Material and Methods A total of 41 patients, treated with radiotherapy (RT) for BMs from HCC from 2014 to 2017, were enrolled retrospectively. Survival was produced with Kaplan-Meier method from the start of RT for BM. Pre-RT clinical features were evaluated, such as age, sex, performance status (PS), Child Pugh (CP) class, alpha-fetoprotein (AFP), T stage, size of HCC, status of HCC, tumor emboli, N stage, extra-osseous extension of BM, number of BM, metastases other than bones, and chemotherapy. Their influences on survival were analysed with log rank test, and the significant factors were considered for Cox multivariate proportional hazards regression model. Results Median follow-up was 6.0 months (range, 0.5-47.0 months). The median age was 63 years, and 35 patients were male (85.4%). AFP levels were elevated in 26 patients, and more than twice the normal level of AFP (AFPx2) were found in 24 patients. The median overall survival was 6.5 months, and 1-year and 2-year survival rates were 35.5% and 13.5%, respectively. Among the