ESTRO 36 Abstract Book

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S623 ESTRO 36
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was observed between age subgroups, comparing younger
subgroup to the others (p=0.40 and p=0.60). The 2 and 5
year DFS of patients treated with mastectomy was 90% and
81.7% without significant difference between age
subgroups (p=0.51). The 2 year DFS in patients treated
with adjuvant RT was 91% and 89% in patients treated with
mastectomy alone. The 5 year DFS in patients treated with
adjuvant RT was 86% and 65% in patients treated with
mastectomy alone. No significant difference was detected
(p=0.26). The 5 year OS was 70% in patients aged 70-79
years; 55% in patients aged 80-89 years and 14% in patients
older than 90 years, with a significant difference
(p<0.001). The 5 year OS was 64% and 52% in patients
treated with or without adjuvant RT respectively, without
significant difference (p=0.12).
Conclusion
An higher percentage of patients aged between 70-79
years received RT after conservative surgery if compared
with the older subgroups. No difference was detected in
RT omission after mastectomy.
EP-1145 Troponin I for the detection of cardiac
toxicity in adjuvant breast cancer radiotherapy
K. Boudaoud1, H. Allioueche2, O. Haderbeche2, K. Sifi3, S.
Taleb4, C. Kourteli5 , K. Benmebarek3, M. Setta6, S.
Serradj6 , T. Filali7, A. Djemaa4, N. Abadi3
1 Scientific research laboratory of molecular biology and
genetics- Faculty of Medicine- UC3, Radiation oncology,
Constantine, Algeria
2 CHUC, Radiation oncology, Constantine, Algeria
3 Scientific research laboratory of molecular biology and
genetics- Faculty of Medicine- UC3, Laboratory of
biochemistry, Constantine, Algeria
4 Faculty of medicine- UC3, Radiation oncology,
Constantine, Algeria
5 University Constantine 1, Radiation oncology,
Constantine, Algeria
6 Faculty of Natural and Life Sciences- UC1, Department
of animal biology, Constantine, Algeria
7 Scientific research laboratory of molecular biology and
genetics- Faculty of Medicine- UC3, Medical oncology,
Constantine, Algeria
Purpose or Objective
Chemotherapy, targeted agents, hormone therapy and
radiation therapy improve survival for women with locally
advanced breast cancer but increases the risk for heart
failure and cardiomyopathy. Radiation induced heart
disease generally occurs with a latent period of 5–10 years.
Cardiac troponin I (cTnI) is highly sensitive and specific
biomarker of cardiac damage. Our aim was to evaluate the
early effect of breast cancer radiotherapy on serum high
sensitivity troponin I levels.
Material and Methods
A total of 28 patients with breast cancer who received
adjuvant 3D conformal radiation therapy (RT) were
included in a prospective, study. High sensitivity cardiac
troponin I (µg/ml) was analyzed from serum samples taken
before, during and after two or three radiation therapy
weeks. According to cTnI value (≤0.009 or >0.009 µg/ml),
patients were allocated into two groups; group A (>0.009
µg/ml) and group B (≤0.009 µg/ml) All patients underwent
left ventricular ejection fraction (LVEF, Echo)
examination before and after radiation therapy. Dose-
volume-histograms (DVH) for the heart were also
calculated.
Results
In the whole study population, cTnI was detectable
(>0.009 µg/ml) in 6 (21.42 %) patients before RT, in 5
(17.85 %) during RT and in 6 (21.42 %) patients after RT.
Patients with increased cTnI values (group A, N = 6) had
higher radiation doses for the heart (5.14 vs, 4.06 Gy). This
increase in the cTnI level was more marked in patients
with high blood pressure (33% vs, 4.54%), left-sided breast
cancer (66.66% vs, 50%), and those who had received
lymph nodes RT; (internal mammary chain (50 vs, 27.27%),
supra clavicular and infraclavicular lymph nodes (83.33 vs,
22.72%).
Conclusion
In spite of the limited patient number, our study shows
that circulating cTnI confirms subclinical myocardial
damage during and after breast cancer radiation therapy.
The role of cTnI as biomarker in predicting future
cardiovascular events in patients undergoing adjuvant
radiation therapy remains to be determined in large
studies and could become a useful research tool.
EP-1146 Acute toxicity of hypofractionation with SIB
in the radiation therapy for breast cancer
J. Fernandez-Ibiza1, J. Calvo1, O. Coronil1, S. San José1,
E. Puertas1, R. Robaina1, J. Casals 1
1Hospital Quiron Barcelona, Radiation Oncology,
Barcelona, Spain
Purpose or Objective
The aim of our study is to evaluate the tolerance and
acute/immediate toxicity of a ‘mild’ hypofractionation
with simultaneous integrated boost in the radiation
therapy after breast conserving surgery in women with
diagnosis of early breast cancer.
Material and Methods
Between January 2015 to October 2016, 100 women with
breast cancer diagnosis (Tis-T2, N0-1) were treated with a
hypofractionated simultaneous integrated boost (SIB)
after breast-conserving surgery, using IMRT, field-in-field
technique (FIF) or a mixed technique. Dose prescribed was
45,57 Gy (2, 17 Gy/fr.) in 21 fractions to the breast (+
supraclavicular fossa in 25p), and a simultaneous
integrated boost to the surgical bed to achieve 55, 86 Gy
(2, 66 Gy/fr.). All patients were treated with
chemotherapy (27, 9% were neoadjuvant), except 6 cases
of intraductal carcinoma. We registered the acute toxicity
at the end of the treatment, one week after and 6 weeks
after, prospectively, using the NCI-CTCAE v4.0 scale.
Results
The acute toxicity at the end of the treatment was grade
1 in 62% of patients, grade 2 in 38% of patients, and grade
3 in 1 patient. One week after the treatment, we observed
grade 0 in 2 patients, grade 1 in 54 patients , and grade 2
in 44%. Hence, we detected an increase of gradation
toxicity, only in 10 patients (10%), when the toxicity was
registered a week later. Finally, 6 weeks after the
radiation therapy; 67 % of the patients had recovered their
skin’s normal appearance, and 33 % of them persisted with
faint erythema (G1) or pigmentation. We collect other
parameters of acute toxicity as desquamation, observing
no desquamation in 51 % of the patients, dry desquamation
in 43% and moist desquamation in 6%.
Conclusion
This scheme of ‘mild’ hypofractionation with SIB, in the
postoperative radiation treatment of early breast cancer
after conserving-surgery, showed to be well tolerated and
feasible, and is associated with acceptable
immediate/acute skin toxicity. Longer follow up is needed
to demonstrate acceptable subacute and late toxicity.
EP-1147 Radiation induced oesophagitis in breast
cancer patients
K. West1, N. Coburn1, R. Beldham-Collins1,2, K. Tiver1, K.
Stuart2, V. Gebski2
1Nepean Cancer Care Centre, Nepean Hospital, Penrith,
Australia
2Crown Princess Mary Cancer Centre, Westmead
Hospital, Westmead, Australia