ESTRO 36 Abstract Book

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S755 ESTRO 36
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Conclusion
Chemo-IMRT is feasible and well tolerated with acceptable
outcomes even in the subset of elderly patients with
locally advanced disease.
Electronic Poster: Clinical track: Other
EP-1412 Quality of life of patients after high dose
radiation therapy for thoracic carcinomas
C. Schröder1, R. Engenhart-Cabillic2, A. Buchali3
1 Universität Giessen, Klinik für Strahlentherapie und
Radioonkologie- Universitätsklinikum Giessen und
Marburg, Giessen, Germany
2 Universität Marburg, Klinik für Strahlentherapie und
Radioonkologie- Universitätsklinikum Giessen und
Marburg, Marburg, Germany
3 Ruppiner Kliniken GmbH, Klinik für Strahlentherapie
und Radioonkologie, Neuruppin, Germany
Purpose or Objective
Quality of life (QoL) is an important factor in patient care.
In this analysis we focused on QoL before and after radio-
(chemo-)therapy (RCT) in patients with thoracic
carcinomas and its influence on clinical follow up, survival
and the correlation with treatment related toxicities.
Material and Methods
81 curatively treatable patients with intrathoracical
carcinoma (NSCLC, SCLC, esophageal carcinoma) were
included in this analysis. They received radio-(chemo-)
therapy. Patients with NSCLC were treated with 74 Gy,
patients with SCLC with 60 Gy and those with esophageal
carcinomas with 66 Gy. Eligible patients received
chemotherapy according to intradepartmental standards.
For the analysis of the QoL the EORTC QLQ-C30 and the
EORTC QLQ-LC13 were used. QoL data was collected
before radiation treatment, 6 weeks, 12 weeks, 6 month
and 12 month after RT. Additionally factors were
analyzed, including clinical outcome, survival, treatment
induced side effects.
Results
The median follow up was 34,5 weeks. In total 49,4 % of
patients had a complete or partial remission and 16,0 % a
stable local disease. Local failure occurred in 24,7 % of
patients. Distant failure occurred in 44,4 % of patients.
Severe dysphagia occurred in up to 9 % of patients, up to
50 % experienced mild dysphagia. The overall rates for RT
induced pneumonitis (RP) were low with a maximum of 8
% 12 weeks after RT. The median survival time was 34
weeks with a range from 1 to 220 weeks. All functional
scales showed a variable course but maxed or at least
showed a recovery 12 weeks after RT. Symptoms with a
high mean symptom score (> 40) were fatigue, dyspnoea
and coughing. Insomnia, peripheral neuropathia, appetite
loss, dyspnoea (from QLQ-LC13) and all parameters for
pain had an intermediate mean score (10 – 40). There were
low mean scores of fewer than 10 for nausea and vomiting,
diarrhoea, sore mouth and haemoptysis. The GLM revealed
no statistically significant difference for any QLQ-C30
parameter over time. For the QLQ-LC13 statistically
significant differences over time were found for the
peripheral neuropathy (p = 0,011) and the dysphagia (p =
0,034). There was a highly significant correlation between
the clinical dysphagia and the dysphagia scores (p <
0,005). The correlation between clinical RP and the scores
for dyspnoea and coughing was significant at some follow-
up appointments. The EORTC QLQ-C30 and QLQ-LC13
scores did not prove to have a significant influence on the
overall survival or distant and local failure.
Conclusion
12 weeks after RT the scores of the QLQ-C30 functional
scales showed the highest scores or at least a temporary
recovery. The symptom scales accurately reflected the
common symptoms and treatment related toxicities.
There was a significant correlation between clinical
dysphagia and pneumonitis and associated QoL scores. QoL
did not prove to be a significant predictor for survival or
distant and local control.
EP-1413 IORT for treatment of recurrent tumors - A
single institution analysis.
T.M. Coelho1, R.C. Fogaroli1, A.C.A. Pellizzon1, D.G.
Castro 1, G.R.M. Gondim1, M.L.G. Silva1, M.J. Chen1, A.A.
Ambrosio 1
1Accamargo cancer center, Radiotherapy, Sao Paulo sp,
Brazi
Purpose or Objective
The incidence of recurrent retroperitoneal or pelvic
tumors (rRPT) varies from 20% to 77% in literature and
requires a multidisciplinary approach. Local control (LC)
with isolated salvage surgical resection is dismal, and
intraoperative radiotherapy (IORT) can be considered an
adjuvant treatment option for selected cases, in special
those with previous course of radiation.
This study assessed the feasibility, efficacy and morbidity
of IORT as adjuvant treatment of rRPT who underwent to
salvage surgical resection.
Material and Methods
41 patients with non-metastatic and isolated (one
anatomic site) rRPT were treated from 2004 to 2015. All
patients were treated with intraoperative electron beam,
except one patient who was treated with intraoperative
high dose rate brachytherapy. The mean doses were 16 Gy
(range 10-21) and 14Gy (range 9-20) for patients without
and with previous external beam radiation therapy
(EBRT), respectively. The dose was delivered with a 2cm
safe margin around the tumor bed. Seventeen (39%)
patients had additional EBRT (mean dose 45 Gy) after
surgery and IORT. Median survival times were calculated
using Kaplan-Meier analysis and differences in survival
between groups were tested using log-rank test. The Cox
proportional hazards regression model was used to
estimate the hazard ratio (HR) for potential predictors of
LC, overall survival(OS) and disease-specific survival(DSS).
A difference was considered statistically significant if
p≤0,05.
Results
Twenty-two (54%) patients had pelvic lesions and 19(46%)
had retroperitoneal disease. In addition, 3 patients had a
second course of RTIO for a second recurrent tumor in
different anatomical site, 31 patients (82%) had resection
R0 and 8 patients (18%) had resection R1. The most
common recurrent tumors were colorectal cancer