Abstract book - ESTRO meets Asia

S20 ESTRO meets Asia 2018

Material and Methods Patients with biopsy-proven and radiographically metastatic pancreatic cancer were included and prospectively followed up from 2013 to 2017. Chemotherapy was delivered after SBRT with an interval of 3 weeks, which were required for 4 cycles. The regimens were gemcitabine plus nab-paclitaxel (GT group) or gemcitabine plus S-1 (GS group). The Chinese version of Brief Pain Inventory (BPI) and 5-level European quality of life 5-dimensions (EQ-5D-5L) were used in this study. Due to limited survival of patients with metastatic pancreatic cancer, questionnaires were completed before SBRT and right after the whole treatment. Patient-reported global changes and scores of questionnaires were assessed. To be simplified, all changes were stratified into “better”, “no change” and “worse” in the analysis. Data were analyzed with Spearman’s rank correlation, ordinal regression. Propensity score matched analysis were further performed to evaluate these two regimens. Results Seventy-five and eighty-nine patients received gemcitabine plus nab-paclitaxel and gemcitabine plus S-1, respectively. No differences of baseline characteristics were found between these two groups. No differences of BPI scores were found between pre- and post-treatment in each group, while only the post-treatment EQ-5D-5L score was higher than that at baseline in GS group (P<0.001). The response “better” of BPI was found in 15 and 38 patients in GT and GS group, respectively (P<0.001). On multinomial logistic regression, compared with GS group, the probability of GT group achieving “better” global change of BPI was 0.289 (P=0.015). The “better” change of EQ-5D-5L was found in 20 and 42 patients in GT and GS group, respectively (P<0.001). After multinomial analysis, compared with GS group, the probability of GT group gaining improvement of EQ-5D-5L was 0.334 (P=0.031). After propensity score matched analysis, more patients had improvement of BPI and EQ-5D-5L in GS group compared with GT group (n=24 vs. n=12, P=0.002; n=28 vs. n=16, P=0.002). No grade 3 or more radiation-induced toxicity occurred. More patients in GT group experienced grade 3 or more hematological and gastrointestinal toxicity than those in GS group (n=25 vs. n=16, P=0.024; n=17 vs. n=10, P=0.049). Conclusion GS may achieve better HRQOL than GT. Therefore, GS may be an alternative of GT for metastatic pancreatic cancer, especially for Asians. OC-051 Acute toxicity of hypofractionated radiation with simultaneous bed boost in breast cancer patients J. Luo 1 , K. Jin 1 , X. Wang 1 , Z. Yang 1 , J. Ma 1 , X. Chen 1 , X. Mei 1 , X. Guo 1 , X. Yu 1 1 Fudan University Shanghai Cancer Center, Department of Radiation Oncology, Shanghai, China Purpose or Objective The long-term safety and efficacy of hypofractionated whole-breast irradiation (HF-WBI) have been well established in many randomized trail. The updated ASTRO guidelines of fractionation for whole breast cancer irradiation have also indicated the most suitable patients for HF-WBI. However, the appropriate approach of tumor bed (TB) boost when HF-WBI is applied is less clear and little is known about the acute toxic effects experienced by patients treated with H-WBI and simultaneous boost of the tumor bed (TB). We herein assess the acute toxicity in patients treated with HF-WBI and simultaneous boost of the TB after breast conserving surgery. Material and Methods From April 2015 to June 2016, 370 patients enrolled on an IRB-approved prospective study to assess the efficacy and toxicity of HF-WBI combined with simultaneous boost of TB in patients with breast conserving treatment. All

patient received total dose of 40Gy/15Fx for whole breast, combined with simultaneous boost of 48Gy/15Fx to TB, 3.2Gy/Fx. Simple Intensity modulated radiotherapy (sIMRT) treatment planning were applied in the whole set of patients. The acute toxicity effects were assessed according to CTCAE 4.0. Results From April 2015 to June 2016, 370 patients with T1-2N0M0 tumors were consecutively and prospectively enrolled into study. The median age was 45 years old (range, 25-71 years). 276 (74.6%) patients were with T1 tumors and 94 (25.4%) patients were with T2 ones. Among of them, 222 (60%) patients received chemotherapy, including anthracycline, paclitaxel and platinum. 176 (74.6%) patients were hormone receptor positive and 242 (65.4%) patients received adjuvant hormone therapy. When the acute toxicity effects of radiotherapy were assessed, 113 (30.5%) and 70 (18.9%) patients suffered mild pain and pruritus in the irradiated breast. 36 (9.7%) and 8 (2.2%) patients experienced mild and moderate lymphedema of breast after radiation, respectively. 94 (25.4%) patients felt mild fatigue during the treatment. As for the radiation dermatitis, 257 (69.5%) and 27 (7.3%) patients showed Grade 1 and Grade 2 radiation dermatitis, respectively. Most of them showed skin erythema (53.2%) or day desquamation (38.9%). 16 (4.3%) patients had moist desquamation, mainly in the nipple and areola area. No Grade≥3 radiation dermatitis were observed. One patient experienced Grade 3 radiation pneumonitis. The median treatment time of radiotherapy was 20 days (range, 17-25 days). With a median follow-up time of 27 months, four patients experienced locoregional recurrences and three of them developed distant metastasis simultaneously (n=2) or sequentially (n=1). And another patients developed isolated bone metastasis without locoregional Hypofractionated whole breast irradiation combined with simultaneous boost of the tumor bed can be well tolerated in patients with early breast cancer in terms of acute toxicity. Long term follow up of local control need to be identified in the future. OC-052 clinical outcomes of triple negative breast cancer : a single institution study S. Ibrahim 1 , A. Arjunan 1 , P. Balakrishnan 1 , B.S. Mathew 1 , R.K. Raghavan 1 , K. Ramadas 1 1 Regional Cancer Centre, Department of Radiation Oncology, Trivandrum, India Purpose or Objective To analyse the triple negative breast cancer (TNBC) patients and find the overall survival (OS), the disease- free survival (DFS), the locoregional recurrence rate (LRR), the patterns of failure and the prognostic factors affecting the clinical oucomes in these patients Material and Methods A total of 704 patients with biopsy proven non-metastatic TNBC, treated between 1st January 2011 and 31st March 2014 at our institute, were identified from the hospital cancer registry. The case files were retrieved after approval from the institutional review board, and the details were collected using a structured proforma.The survival outcomes were estimated using the Kaplan Meier method and the prognostic factors were estimated using Cox proportional hazards regression model and Log Rank tests. Results With a median follow up of 48 months (0-72 mo),704 patients were analysed. All were females, mostly multiparous (96.6%), with slightly more premenopausal women (53.3%).With a median age of disease onset at 49 years, majority presented as Stage recurrence. Conclusion