Abstract book - ESTRO meets Asia

S45 ESTRO meets Asia 2018

Intermediate or High-risk disease (32.8% vs. 47.2%, p<.0001).

cases and cancer-specific death was observed in 6 (1.0%) patients. Overall 3-, 5- and 10-year BCR-free rate were 92.3%, 83.9% and 73.9%, respectively. Stage cT3b≤ was predictive factor of BCR (Hazard Ratio: 2.201, 95% CI 1.350-3.589, p=0.002). A total of 456 (74.6%) cases received ADT, consisted of only neoadjuvant ADT (N-ADT, median 7 months, n=293) and neo adjuvant plus concurrent adjuvant ADT (C-ADT, median 24 months, n=163). Patients with any ADT were significantly higher age than patients without any ADT (p=0.026) and had higher Gleason score (GS) (p=0.019) and higher % of cT3b≤ stage (p<0.0001). Despite of these worse backgrounds, significant 10-year BCR-free rate was observed in ADT group than no ADT group (78.1% vs 52.7%, average survival: 110.5 vs 89.1 months; Log-rank analysis, p=0.010). Although no statistical significant difference was observed, N-ADT group was better 10-year BCR-free rate than C-ADT group (80.4% vs 71.0%, average survival: 112.0 vs 97.2 months; p=0.294). This was partly due to the fact that C-ADT group had higher PSA compared to N-ADT group (average 44.5 ng/mL vs 34.9 ng/mL, p=0.015) as well as higher GS (8.2 vs 7.9, p=0.002). Consequently, C- ADT group was stratified with PSA and patients with PSA < 40 ng/mL had significantly better 10-year BCR-free rate than those with PSA ≥ 40 ng/mL (83.0% vs 49.0%, average survival: 102.8 vs 79.0 months; p=0.025). Conclusion IMRT has achieved long-term, adequate treatment efficacy even against high-risk prostate cancer. For patients with higher GS and cT stage, BCR-free survival is significantly better by the addition of N-ADT than by IMRT alone. Among N-ADT cases with higher GS, patients with PSA < 40 ng/mL might obtain full benefit of IMRT with continuing C-ADT to achieve better BCR-free survival. Stereotactic Radiotherapy Boost for Prostate Cancer J. Martin 1 , J. Bucci 2 , S. Arumugam 3 , S. Gallagher 1 , J. Smart 1 , M. Grand 3 , P. Greer 1 , S. Keats 3 , L. Wilton 1 , M. Sidhom 3 , D. Pryor 4 1 Calvary Mater Newcastle, Radiation Oncology, Newcastle- NSW, Australia 2 St George Hospital, Radiation Oncology, Kogarah, Australia 3 Liverpool Hospital, Radiation Oncology, Sydney, Australia 4 Princess Alexandra Hospital, Radiation Oncology, Brisbane, Australia Purpose or Objective High Dose Rate Brachytherapy Boost achieves excellent disease control for prostate cancer, at the cost of a significant urethral stricture rate. We wish to explore the potential to non-invasively deliver similar dose of radiotherapy using stereotactic techniques. Here we report early toxicity and PSA kinetics following a novel, linac-based, stereotactic radiotherapy (SBRT) boost for a prospective phase 2 multicentre study (PROMETHEUS ACTRN12615000223538). Material and Methods At five different centres, patients were treated with linac- based SBRT, 19-20 Gy in 2 fractions delivered one week apart, followed by conventionally fractionated IMRT (either 46 Gy in 23 fractions or 36 Gy in 12 fractions). MRI fusion for RT planning was mandated, as was rectal displacement during SBRT. Example axial and sagittal dose washes are shown in the figures. Toxicity was prospectively graded using the Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v4). OC-118 Preliminary Results of a Multicentre Study of

Conclusion Despite a decreasing incidence of newly diagnosed prostate cancer cases occurring annually in the United States, we have seen an increased percentage of aggressive prostate cancer at our high-volume hospital practice over time. Stratified before and after the 2012 release of the USPSTF recommendation to cease PSA screening, this data validates cancer registry series showing an associated stage migration towards more aggressive variants. Nearly half of the patients treated at our center now have Unfavorable intermediate or High - risk disease, with only roughly 25% harboring Low risk prostate cancer. As higher risk subtypes have poorer disease-free outcomes compared to lower risk disease, the long-term epoch-related effects on biochemical control, metastatic-free disease states, and prostate cancer specific survival will need to be assessed over time. While a strong correlation with the 2012 USPSTF recommendation is statistically compelling, competing factors which could also explain these findings should continue to be explored. OC-117 Improved long-term outcomes of IMRT with androgen deprivation therapy for high-risk prostate cancer Y. Horiguchi 1 , F. Tsukuda 1 , Y. Hama 2 , A. Ogata 1 , N. Sakamoto 1 , S. Koga 1 Purpose or Objective The optimum strategy of androgen deprivation therapy (ADT) on intensity-modulated radiation therapy (IMRT) for high-risk prostate cancer is still controversial. To evaluate this aspect, we compiled oncologic outcomes of IMRT for high-risk prostate cancer. Material and Methods A total of 1,387 Japanese prostate cancer patients underwent IMRT (76 Gy radiation to prostate) between 2007 and 2014 in our single institution. Fifty-nine patients with previous treatment with either radical prostatectomy, High-Intensity Focused Ultrasound or status of castration-refractory prostate cancer were excluded from the study. Among remaining 1,328 patients, 611 (46.0%) cases were categorized as high- or very high- risk prostate cancer of NCCN criteria, which comprised the current study cohort. Definition of recurrence is based on Phoenix criteria or initiation of salvage treatments. Kaplan-Meier method and Cox proportional hazard model was used to determine survival estimates and predictive factor of recurrence, respectively. Results Median age and initial PSA of 611 patients were 73 (range: 52-87) years and 18.2 (3.1-481.3) ng/mL, respectively. Median follow-up period was 71 (2-134) months. Biochemical recurrence (BCR) was occurred in 90 (14.7%) 1 Edogawa Hospital, Urology, Tokyo, Japan 2 Edogawa Hospital, Radiology, Tokyo, Japan