ESTRO 36 Abstract Book

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S526 ESTRO 36
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Material and Methods
Twenty patients with different sites and grades of Soft
Tissue Sarcoma underwent surgery and Intraoperative
catheter implantations in single plane in biopsy proven
Soft tissue sarcoma cases. These patients then underwent
High Dose Brachytherapy with Iridium – 192. The patients
received average dose of 3.5Gy per Fraction (Two
fractions per day 6 hours apart) with total dose of 35
Gy/10 Fr/5 Days and after completion of treatment were
followed up at 1 month and later every 3 monthly for 2
years; Followed by 6 monthly interval.
Results
The Patients were followed up for range of 6 – 42 months
(Median 25 months) and overall control rate was 72.72%.
The Local recurrence was noted in only one patient
(9.09%) and two patients developed distant metastases
(18.18%). The dosimetric outcomes were assessed and
results analyzed related to the dose to the surrounding
organs at risk. The quality of life parameters were also
assessed prior to treatment and later during follow ups
and results showed better quality of life parameters.
Conclusion
The results in our study suggested the importance of HDR
Brachytherapy in management of Soft Tissue Sarcoma. The
local control rate was 72.72 %. The dose of 35Gy over 10
fractions over 5 Days was found to be effective in local
control and limb salvage in case of Soft Tissue Sarcoma as
practiced at our Centre.
PO-0950 High-dose-rate brachytherapy treatment in
T1-T2 stage non-melanoma skin cancer patients.
M.A. González Ruiz1, J. Quirós Rivero1, M.F. Ropero
Carmona1, A. Ruiz Herrero1, M.C. Cruz Muñoz1, P. Simón
Silva1, J.J. Cabrera Rodríguez1, J.L. Muñoz García1, Y. Ríos
Kavadoy1 , F. García Urra1, P. Almendras Manzano2
1 Infanta Cristina Hospital, Radiation Oncology, Badajoz,
Spain
2 Infanta Cristina Hospital, Radiophysics, Badajoz, Spain
Purpose or Objective
To analyze the results in terms of overall survival (OS),
cancer specific survival (CSS), local control (LC), cosmesis
and toxicity in patients (pts) with non-melanoma skin
cancer (NMSC) treated with high-dose-rate brachytherapy
(HDR-BT) treatment, plesiotherapy modality; with radical
or adjuvant intention in our hospital.
Material and Methods
Retrospective study of 50 pts with 63 NMSC lesions, T1
(74%) and T2 (26%) stage treated from May 2015 to May
2016. HDR-BT treatment (6 Gy/fraction; total dose 42 Gy)
was used in 48 pts with an equivalent 2 Gy dose (EQD2) of
56 Gy. Median total dose of HDR-BT was 42.6 Gy (range
36-50). All the lesions for the selected cases were limited
3-4 mm depth. Treatment intention was radical in 86% pts
and adjuvant in 14% pts. The median age of the pts was 76
years-old (range 52-94); 64% males. Basal-cell carcinoma
(84%) and face (92,4%) were the most frequent histological
type and location respectively. The 34% of the lesions
were treated with Valencia applicators and 66% with
custom-made moulds. Kaplan-Meier curves have been
used for the statistical analysis of survival. Treatment-
related toxicity was assessed using RTOG and the NCI-
Common Terminology Criteria for Adverse Events
guidelines.
Results
The median follow-up was 18 months (range 7-45). The OS,
CSS and LC was 96%, 100% and 96% respectively. The
majority of pts had acute skin toxicity grade 1-2.
Conjunctival toxicity appeared in 10 % of the pts. Cosmetic
results were considered as excellent/good in all patients.
Conclusion
In patients with NMSC T1 and T2 stage HDR-BT treatment,
plesiotherapy modality is a good alternative treatment for
non-surgical patients. Plesiotherapy treatment provides
excellent results for local control and cosmesis which is a
safe and attractive treatment option.
PO-0951 Episcleral Brachytherapy for Uveal Melanoma
A. Ponte1, T. Teixeira1, I. Nobre-Góis1, J. Casalta-Lopes1,
P.C. Simões1, A. Cavaco1, J. Veríssimo 2, R. Proença2, M.
Borrego1
1Hospitais da Universidade de Coimbra, Serviço de
Radioterapia, Coimbra, Portugal
2Hospitais da Universidade de Coimbra, Serviço de
Oftalmologia, Coimbra, Portugal
Purpose or Objective
Uveal melanoma is the most common intraocular tumor in
the adult age, and the second most common after skin
melanoma, with an annual incidence rate of 4-10 per
million people. Until November 2013 portuguese patients
with uveal melanoma were sent abroad for treatment.
Different therapeutic approaches include enucleation,
proton therapy, episcleral brachytherapy (EBT), with
similar outcomes.
The purpose of this work was to evaluate treatment
response in patients with uveal melanoma submitted to
EBT.
Material and Methods
Included all patients with uveal melanoma treated in our
institution by the Radiation Oncology Department in co-
operation with the Ophthalmology Department, between
November 2013 and September 2016. Plaques with low
energy photon seeds (125I) were used. Dose prescription
was 85 Gy to the tumor apex. Response was evaluated by
ophthalmic ultrasound with serial lesion measurements
and treatment side effects were recorded. A type I error
of 0.05 was considered for inferential statistics.
Results
50 EBT procedures were done in 50 patients, with a
median age of 64 years, female gender (58,0%) and right
eye (62,0%) predominance. Initial median diameter and
thickness were 12,23 mm (5,92 to 18,70 mm) and 6,73 mm
(2,60 to 12,67 mm), respectively. No distant metastatic
disease was present at the time of diagnosis. Staging was
as follows: Stage IIB 50,0%, Stage IIA 44,0% and Stage IA
4,0%.
The median treatment time was 140,7 hours, with a
median prescribed dose of 85,90 Gy. A notched eye plaque
(ROPES15n) was used in 26,0% of cases. No complications
during implant procedure or treatment period were
registered.
The median follow-up was 10,5 months (1 to 33 months).
During this period, a significant reduction in thickness
(median difference of 2,035 mm, p<0,001) and diameter
(median difference of 2,43 mm, p<0,001) was recorded.
Radiation retinopathy was observed in 20,0% of patients,
treated by intra-ocular anti-VEGF injection in all cases.
Tumor relapse occurred in 2 patients (4,0%) and distant
spread in one of these. No cancer related death was
registered.
Conclusion
EBT is an effective and well tolerated eye sparing method
to treat patients with uveal melanomas. A progressive
significant reduction in tumors dimension was observed.
No severe late side effects was registered, although
follow-up time is still limited.