ESTRO 36 Abstract Book

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S273 ESTRO 36 2017
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techniques does improve data collection but for some
patient populations and studies this approach is not as
effective or financially possible. Furthermore, missing
PRO data may influence the ability to detect difference
within long term data. Missing data is rarely random with
participants from the poorest outcomes or highest
vulnerability not returning questionnaires so most likely to
create conclusions biased to complete cases [4]. Longer
term monitoring of radiotherapy effects requires
innovative ways of collecting data from patients. PROs
produce large data sets which need to be summarized and
or transformed. Multiple tools can provide an overlap in
items and domains scores. Clustering of symptoms across
tools and looking at change in symptoms over time rather
than cross sectional analysis approaches can be of benefit
[5]. Using data sharing and linkage approaches to access
and link PROs to wider data sets such as primary health
care records and resources used by patients may help in
addressing some of the knowledge gaps. Lack of
consistency in analysis techniques, volume of data and
missing values are challenges for researchers. Failure to
address these challenges and standardize PROs assessment
during clinical trials risks the introduction of bias and
devalues the importance of patient reported outcomes
within studies.
References 1
1. Cella, D. and A. Stone (2015). "Health-related quality
of life measurement in oncology." American Psychologist
70(2): 175-185.
2. Faithfull, S., et al. (2015). "Patient-reported outcome
measures in radiotherapy: clinical advances and research
opportunities in measurement for survivorship." Clinical
Oncology 27: 679-685.
3. Kyte, D., et al. (2016). "Current practices in patient-
reported outcome (PRO) data collection in clinical trials:
a cross sectional survey of UK trial staff and
management." BMJ Open(December).
4. Gomes, M., et al. (2016). "Addressing missing data in
patient reported outcome measures (PROMS):
implications for the use of PROMS for comparing provider
performance." Health Economics 25: 515-528.
5. Lemanska A, et al. (2014). "Predictive Modelling of
Patient Reported Radiotherapy-Related Toxicity by the
Application of Symptom Clustering and Autoregression."
412-422.
Proffered Papers: Oligometastatic disease
OC-0521 The role of SBRT in oligorecurrent and
oligoprogressive prostate cancer: a multi-institutional
study
L. Triggiani1, S. Magrini1, A. Bruni 2, F. Alongi 3, A. Magli4,
A. Bonetta5, L. Livi6, R. Santoni7, P. Borghetti1, M.
Maddalo1 , M.D. Rolando8, G. Ingrosso7, N. Pasinetti1, M.
Buglione1
1 Spedali Civili di Brescia, Department of Radiation
Oncology- University of Brescia, Brescia, Italy
2 AOU Policlinico di Modena, U.O. Radioterapia
Oncologica, Modena, Italy
3 Ospedale Sacro Cuore Don Calabria, Radioterapia
Oncologica, Negrar, Italy
4 Ospedale Santa Maria della Misericordia, S.O.C. di
Radioterapia Oncologica-, Udine, Italy
5 Ospedale di Cremona, U.O. Radioterapia-, Cremona,
Italy
6 A.O.U Careggi- Università di Firenze, SODc Radioterapia
Oncologica- DAI Oncologia-, Firenze, Italy
7 Policlinico Tor Vergata- Università di Roma2, U.O.C. di
Radioterapia-, Roma, Italy
8 Campus Biomedico, Radioterapia Oncologica, Roma,
Italy
Purpose or Objective
SBRT is a safe and effective treatment which could
postpone androgen deprivation therapy (ADT) in
oligorecurrent PC. Despite that, in literature there is a
lack of data about the role of SBRT in patients (pts) with
oligoprogressive castrate resistant PC (oligo-CRPC). Our
aim is to assess the feasibility and efficacy of SBRT in the
treatment of oligorecurrent PC in terms of biochemical
progression-free survival (BPFS) and ADT-free survival
(ADT-FS) and also in pts with oligo-CRPC, in terms of
distant progression free survival (DPFS) and second line
systemic-treatment-free survival (STFS).
Material and Methods
non-castrate pts with oligorecurrent disease detected
with Choline-PET or CT+Scintigraphy following
biochemical recurrence were treated with SBRT. BPFS and
ADT-FS were the primary endpoint. Secondary endpoints
were local control and toxicity. On the other hand, oligo-
CRPC pts detected with choline-PET or CT+scintigraphy
after PSA rise during ADT were enrolled in the analysis.
Primary endpoint were DPFS and STFS. Univariate analysis
was performed in order to assess factors influencing
outcome in both categories.
Results
100 pts with oligorecurrent PC (139 lesions; lymph nodes
84.2%, bones 15.8%) were treated from 03/2010 to
02/2016. After a median follow up of 20.4 months, 1yr-
and 2yrs-BPFS were 58.1% and 38.3%. 15 pts underwent a
second course of SBRT for a further oligoprogression: this
result in a median ADT-FS of 20.9 months with 1-, 2-, 3-
yrs ADT-FS of 67.4%, 47.3% and 31%. At univariate analysis,
low PSA-DT is related with a worse ADT-FS. LC rate was
88,2% at two years. No G3 toxicity was reported. 41 pts
with oligo-CRPC (70 lesions) were treated from 01/2010 to
04/2016. After a median follow up of 23.43 months, 1yr-
and 2yrs-DPFS were 43.2% and 21.6% with a median DPFS
of 11 months. 10 pts underwent a second course of SBRT.
At the time of analysis, 20 patients had started systemic
treatment (10 pts with Abiraterone or Enzalutamide and
10 pts with Docetaxel): median STFS was 22 months with
1-, 2-, 3-yrs STFS of 74.8%, 41.3% and 29.5%. No significant
correlations were found at univariate analysis. No toxicity
was registered.
Conclusion
SBRT for oligorecurrent PC is an effective treatment and
postpones palliative ADT for almost 2 yrs without toxicity.
SBRT has proven effective even in oligoprogressive CRPC
with a capacity to delay the start of systemic second line
therapies for almost 2 yrs.
OC-0522 Extracranial stereotactic Radiotherapy for
lymph nodal recurrences: a dose escalation trial
F. Deodato1, G. Macchia1, M. Ferro1, M. Ferro1, G. Torre1,
v. Picardi1, M. Nuzzo1, S. Cilla2, A. Ianiro 2, G. Tolento3, S.
Cammelli3, F. Romani4, A. Arcelli3,5, R. Frakulli3, L.
Giaccherini3, G. Siepe3, G.P. frezza5, A. Farioli6, S.
Mignona7, V. Valentini8, A.G. morganti3
1Fondazione di Ricerca e Cura “Giovanni Paolo II”,
Radiotherapy Unit, Campobasso, Italy
2Fondazione di Ricerca e Cura “Giovanni Paolo II”,
Medical Physic Unit, Campobasso, Italy
3University of Bologna, Department of Experimental-
Diagnostic and Specialty Medicine - DIMES, Bologna, Italy
4University of Bologna- S. Orsola-Malpighi Hospital,
Medical Physic Unit, Bologna, Italy
5Ospedale Bellaria, Radiotherapy Department, Bologna,
Italy
6University of Bologna, Department of Medical and
Surgical Sciences - DIMEC, Bologna, Italy
7Fondazione di Ricerca e Cura “Giovanni Paolo II”,
Oncology Unit, Campobasso, Italy
8Policlinico Universitario “A. Gemelli”- Università
Cattolica del Sacro Cuore, Department of Radiotherapy,
Rome, Italy