ESTRO 36 Abstract Book

650 / 1096

S634 ESTRO 36
_______________________________________________________________________________________________
considered as satisfactory or very satisfactory in 90% of
cases.
Lymphedema occurred in 17.1% of patients (minor: 14.4%,
severe: 2.7%), related to axillary radiotherapy (p<0.001)
and obesity (p=0.017).
Long-term pulmonary toxicity reached 4% and was related
to the irradiated volume. Among the 95 patients with
pulmonary comorbidities, 9% experienced increased
respiratory symptoms after radiation therapy; it is not
possible to distinguish between radiation toxicity and
respiratory disease evolution.
Late cardiac events were reported in 21 patients (2.7%),
of which 17 had received anthracyclines and 9
trastuzumab. Three patients developed ischemic heart
disease, within 5 to 7 years after radiotherapy; all of them
had received anthracyclines and were irradiated at the
left chest wall and LN, but also had many cardiovascular
risk factors (2 to 4).
Mean heart doses were 4.35Gy (2.1-6.6) and 1.7Gy (0.5-
2.9) and mean ipsilateral lung doses were 13.9Gy (10.8-
17) and 12.4 (8.6-16.1), in case of left and right chest wall
and LN irradiation respectively.
Conclusion
This series shows that our PMERT technique is well
tolerated at short and long term.
EP-1166 Patterns of post-operative radiotherapy in
breast cancer patients after neoadjuvant chemotherapy
K.M. Lopes1, T.B. De Freitas 1, H.A. Carvalho1, A.A.
Pereira2 , S.B. Silva2, S.R. Stuart1, M.S. Mano2, J.R.
Filassi 3, G.N. Marta4,5
1 Faculdade de Medicina da Universidade de São Paulo,
Radiation Oncology, Sao Pailo, Brazil
2 Faculdade de Medicina da Universidade de São Paulo,
Clinical Oncology, Sao Pailo, Brazil
3 Faculdade de Medicina da Universidade de São Paulo,
Breast Division, Sao Pailo, Brazil
4 Hospital Sírio-Libanês, Radiation Oncology, São Paulo,
Brazil
5 Instituto do Câncer do Estado de São Paulo ICESP -
Faculdade de Medicina da Universidade de São Paulo,
Radiation Oncology, Sao Paulo, Brazil
Purpose or Objective
Neoadjuvant chemotherapy (NCT) has the same results as
adjuvant chemotherapy in regard to disease-free survival
and overall survival and may also allow breast conserving
surgery for patients with locally advanced breast cancer.
Indications for adjuvant radiotherapy (RT), as well as
treatment targets after NCT are not yet well established.
The purpose of this study is to evaluate locoregional RT
indications and treatment targets in breast cancer
patients submitted to NCT.
Material and Methods
Retrospective study of 523 patients treated between
March 2010 and April 2015 that were submitted to NCT and
received post-operative RT. Demographics, tumor and
treatment characteristics were evaluated. The variables
were submitted to descriptive and frequencies analysis.
Comparisons of categorical variables among groups were
made with the Chi-square test. Significance level was set
at 5% (p < 0.05).
Results
The mean age was 50 years (range 22 to 84 years). Most
patients had stage cT3 or cT4 disease (74.6%) and
clinically positive lymph node(s) (81.5%). Luminal “like”
tumors comprised 45% of the patients and 27.9% were
triple negative. Biopsy for suspected axillary lymph node
was performed in 49.5% (32.8% of these were positive).
Conservative surgery was performed in 23.1%. All patients
received breast or chest wall irradiation; 91.5%
supraclavicular fossa (SCF) and axillary levels 2 and 3
irradiation, 1.4% only SCF; 8.7% underwent additional
axillary level 1 irradiation and 8.8% also received internal
mammary chain RT; boost was delivered in 21.4% of the
patients. Conventional fractionation (25 x 200 cGy) was
used in 96.6%. Indication of SCF and levels 2 and 3 axillary
lymph nodes irradiation was significantly related to
younger age (≤ 60 years)(p = 0.03), stage cT3 or cT4
(p = 0.027) and clinically compromised lymph nodes at the
time of diagnosis (p = 0.0001). Internal mammary chain
irradiation was also correlated to clinically positive lymph
nodes (p = 0.01) and stage ypT3 or ypT4 (p = 0.028).
Conclusion
RT indications and targets were based on tumors
characteristics pre-NCT. More advanced disease at the
time of diagnosis and age were the main determinants to
define RT to nodal targets independently of NCT response.
EP-1167 Accelerated Partial Breast Irradiation: A
single center analysis.
K. Nugent1, D. Kelly2, J. McCaffrey3, M. Maher4
1St Lukes Radiation Network, Radiation Oncology,
Dublin, Ireland
2Cork University Hospital, Medical Oncology, Cork,
Ireland
3Mater Misericordiae University Hospital, Medical
Oncology, Dublin 6, Ireland
4Mater Misericordiae University Hospital, Radiation
Oncology, Dublin 6, Ireland
Purpose or Objective
Our objective was to analyse the use of adjuvant
accelerated partial breast radiation (APBI) at our center
over a ten year period. We calculated the local recurrence
rates, median follow up and overall survival in breast
cancer patients who received APBI from 2006 to 2016 . In
this retrospective cohort, we obtained the
average tumour size, histology grade, hormone status and
lymphovascular invasion (LVI) presence in order to review
the breast cancer characteristics of the patients we
selected to treat with this modality.
Material and Methods
We conducted a single institution retrospective review of
all adjuvant breast cancer patients who received APBI
from between January 2006 to September 2016 . Patients
were identified from a prospectively-maintained dataset
of all patients commencing ABPI. A retrospective chart
review was conducted as to determine long term follow up
outcomes. The following patient details were recorded:
median follow up time, demographics, histology, node
status, surgery type, adjuvant treatment and local
recurrence. Primary outcome was loco-regional
recurrence noting if recurrences occurred within the
treated breast quadrant.
Results
During this period a total of 106 procedures were carried
out. The average mean age at time of treatment was 68.2
years. The mean tumour size was 14.65mm, all were
estrogen receptor positive and node negative. LVI was
present in 8% of the patient cohort. Median follow up was
65 months. The local recurrence rate within the treated
breast quadrant was 1.8% (95 CI 0.42-2.44) while the local
recurrence rate within the ipsilateral breast was 2.8% (95
CI 1.2-3.3). Overall survival was 97%.
Conclusion
Our findings suggest that APBI is a reasonable adjuavant
option for selected low risk breast cancer patients.
EP-1168 male breast cancer; a review of patients
treated from 2004 - 2013 (10yrs)
P. Scott1, V. Vanderpuye1, J. Yarney 1, N. Aryeetey1, H.
Ayettey1, M. Dadzie1, Z. Meles1
1Korlebu Teaching Hospital, National Centre for
radiotherapy and Nuclear Medicine, ACCRA, Ghana