ESTRO 36 Abstract Book

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S667 ESTRO 36
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We compare our results with previous evidence-based
recommendations.
Results
A total of 53 patients with SPN and no previous history of
cancer were operated. The mean size were 2.67cm; the
mean SUVmax was 7.16 and 94% had SUVmax over 2.
The clinical diagnosis before surgery were stage I NSCLC,
lung metastases and benign lesion in 58%, 26% and 16%
respectively. The diagnosis was confirmed in 89% of the
cases.
From the 31 lesions treated with clinical diagnosis of
NSCLC, it was confirmed pathologically in 27 (87%).
Conclusion
These results validate the clinical criteria of the lung
committee in the Hospital of Navarra, as the accuracy of
the diagnosis of stage I NSCLC was 87%, exceeding the
threshold of 85% previously recommended.
EP-1237 Heart dose as a risk factor for dyspnea
worsening after multimodality treatment for NSCLC
and MPM
A. Botticella1, C. Billiet2, G. Defraene3, S. Peeters3, C.
Draulans3, P. Nafteux4, J. Vansteenkiste5, K. Nackaerts5,
C. Dooms5 , C. Deroose6, J. Coolen7, D. De Ruysscher8
1 KU Leuven - University of Leuven, Oncology
Department- Laboratory of Experimental Radiotherapy,
Leuven, Belgium
2 Hasselt University, Faculty of Medicine and Life
Sciences, Hasselt, Belgium
3 KU Leuven - University of Leuven, Department of
Oncology- Laboratory of Experimental Radiotherapy,
Leuven, Belgium
4 KU Leuven - University of Leuven, Department of
Thoracic Surgery and Leuven Lung Cancer Group,
Leuven, Belgium
5 KU Leuven - University of Leuven, Department of
Respiratory Medicine Respiratory Oncology Unit and
Leuven Lung Cancer Group, Leuven, Belgium
6 KU Leuven - University of Leuven, Department Imaging
and Pathology- Nuclear Medicine and Molecular Imaging,
Leuven, Belgium
7 KU Leuven - University of Leuven, Department of
Radiology, Leuven, Belgium
8 Maastricht University Medical Centre- KU Leuven -
University of Leuven, Department of Radiation Oncology
MAASTRO, Maastricht, Belgium
Purpose or Objective
The purpose of our study is to quantify the influence of
heart dose on the early and late onset of dyspnea in a
cohort of non-small cancer (NSCLC) and malignant pleural
mesothelioma (MPM) patients having multimodality
treatment including radiotherapy (RT).
Material and Methods
Patient population consisted of: a) stage I-III MPM patients
who completed trimodality treatment (induction
chemotherapy, EPP and postoperative RT [PORT]); b)
stage III (ypN2) NSCLC patients treated with induction
chemotherapy, pneumonectomy or lobectomy (+PORT); c)
stage I-III NSCLC treated with RT with curative intent (+/-
chemotherapy).
In 121 patients with multimodality-treated NSCLC and
MPM the maximal dyspnea score (CTCAE 4.0) before RT, at
an early (<6 months) and a late (7-12 months) time point
were obtained.
Included patients needed to be clinically and
radiologically progression-free 9 months after the end of
RT. The difference (Δ) between the maximal dyspnea at
<6 months and at 7-12 months with the pre-RT dyspnea
was calculated.
Results
Forty-four percent (50/113) of the patients developed an
early worsening of at least 1 point in their dyspnea score
(Δdyspnea >1) after the end of RT. Independent predictors
of an early worsening were the mean heart dose (MHD)
(for Δdyspnea >1: OR=1.032, p=0.04) and the dyspnea
score before RT (for Δdyspnea >1: OR=0.40, p=0.0001; for
Δdyspnea >2: OR=0.35, p=0.05).
At the later time point, only the dyspnea score before RT
(OR: 0.40, p=0.001) was identified as predictor of for
Δdyspnea >1.
Conclusion
Our results, albeit exploratory, suggest that heart dose
may play a role in the early worsening of the dyspnea in a
heterogeneous cohort of patients having multimodality
treatment including RT, whereas baseline dyspnea plays a
major role for both early and later worsening.
Electronic Poster: Clinical track: Upper GI (oesophagus,
stomach, pancreas, liver)
EP-1238 Patterns of recurrence in patients of pT2
esophageal squamous cell carcinoma after radical
resection
Y.X. Wang 1, Y.H. Gao1,2, J. Li1, R. Qiu1, X.Y. Qiao1
1The Fourth Hospital of Hebei Medical University,
Department of Radiation Oncology, Shijiazhuang, China
2the 2th Central Hospital of Baoding, department of
Medical Oncology, Zhuozhou, China
Purpose or Objective
To retrospectively investigate the patterns of recurrence
and its related factors in patients of stage pT2N0-1M0
thoracic esophageal squamous cell carcinoma(ESCC) after
radical resection.
Material and Methods
From 2008 to 2011, 222 cases of stage pT2N0-1M0 thoracic
ESCCC with R0 resection were enrolled. There were 142
males and 80 females. There were 181 in pN1 and 41 cases
in pN1. 142 patients has treated with surgery alone and 80
with adjuvant postoperative chemotherapy (POCT).
Diagnosis of recurrence was primarily based on CT images.
Results
Follow-up ended at 30, Sep, 2014. The overall recurrence
rates was 35.1%. Locoregional recurrence (LR) was found
in 25.7% of patients, distant metastasis (DM) in 5.9%, and
LR plus DM in 3.6%, respectively. The LR occupied about
83.3% of any recurrence, and 87.7% of LR has occurred in
mediastinum (91.2% of it located in upper- mediastinum).
Multivariate Cox regression analysis showed that the
danger of total recurrence, LR and DM for stage pN1
patients was about 7.1, 6.5 and 3.1 folds in comparied
with stage pN0, respectively; the danger of total
recurrence in females was about 49.1% in compared with
males. But POCT could not influence total recurrence and
LR(P>0.05).
Conclusion
The recurrence rate was very high in stage pT2N0-1M0
thoracic ESCC after radical resection, the most common
site of recurrence was mediastinum (especially upper-
mediastinum), it was probably the main target of
postoperative radiotherapy. The recurrence was more
frequently occurred in stage pN1 and males. T2N0-1M0
thoracic ESCCC with R0 resection were enrolled. There
were 142 males and 80 females. There were 181 in pN1
and 41 cases in pN1. 142 patients has treated with surgery
alone and 80 with adjuvant postoperative chemotherapy
(POCT). Diagnosis of recurrence was primarily based on CT
images.
EP-1239 SBRT in patients with HCC/CCC or
oligometastatic liver disease
S. Gerum 1, C. Heinz 1, C. Belka1, M. Niyazi1, U.
Ganswindt1, F. Roeder1,2