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S17

ESTRO 36 2017

_______________________________________________________________________________________________

testicular classic seminoma (CS) treated with RT and

prospectivelly evaluated by abdominal vascular

ultrasonography.

Material and Methods

Forty-two CS patients (median age 34 years, range 16-56)

who had undergone radical inguinal orchiectomy were

enrolled in this study. Twenty-six patients underwent

post-surgery RT (median total dose 25.2 Gy, range 25.05–

43.2), 2 of them also received chemotherapy (CHT), and

16 patients were treated with surgery alone or by surgery

followed by CHT (control group).For RT group, dose

volume histograms (DVHs) for contoured structures

(abdominal arteries and kidneys) were extracted and near

maximum dose (D

2%

) and mean dose (D

mean

) metrics

analyzed. The presence of stenosis in an abdominal vessel

and renal resistive index (RRI) were evaluated by

abdominal echo-color Doppler and considered as

indicators of vascular damage. The presence and severity

of stenosis was classified according to validated criteria

reported in table 1.

The average RRI (aRRI) over the left and right kidneys was

also computed. Statistical analysis was performed first

comparing RT group and control-group by Chi-square and

Mann-Whitney tests. For RT group, univariate logistic

regression analysis was performed by Spearman’s rank

correlation coefficient (Rs) to evaluate correlations

between different factors with the incidence of stenosis

and with RRI. The impact of artery dosimetric factors was

analyzed comparing the stenotic arteries versus normal

ones. Similarly, the kidney dosimetric analysis was

performed on each kidney separately. The area under the

Receiver Operator Characteristic (ROC) curve (AUC) was

used to evaluate the test accuracy.

Results

After a median follow-up of 77.4 months (range 48-120

months), stenosis was observed in 8 patients (31%) in the

RT group but none in the control group (p=0.016). A

significantly higher median aRRI was also observed in the

RT group compared with control group (0.63 vs 0.60,

p=0.032). Age at RT was the only clinical risk factor for

stenosis (Rs=-0.529, p=0.005). Artery mean dose was

correlated with stenosis [Rs=0.238, p=0.008, AUC=0.85,

95%CI 0.77-0.91] and kidney mean dose with dichotomized

RRI variable using its mean value (0.62) [Rs=0.417,

p=0.013, AUC=0.76, 95%CI 0.58-0.89], respectively. ROC

curves are displayed in figure 1.a and 1.b.

Conclusion

Late vascular damage represents a potential effect of

abdominal RT even at moderate-low radiation dose.

Younger age at irradiation as well as artery and kidney

mean doses are associated with increased risk.

Ultrasound-based follow-up may allow for early detection

of asymptomatic vascular radiation-induced damage,

helping to prevent severe vascular events.

Poster Viewing : Session 1: Haematology / Paediatrics /

Sarcoma

PV-0042 Fractionated-TBI schedules prior to allograft:

Study from the Acute Leukemia Working Party (EBMT)

Y. Belkacemi

1

, M. Labopin

2

, S. Giebel

3

, L. MiszyK

4

, G.

Loganadane

5

, M. Michallet

6

, G. Socié

7

, N. Schaap

8

, J.

Cornelissen

9

, I. Yakoub-Agha

10

, A. Nagler

11

1

Universite Paris Est Creteil, Radiation Oncology-

Hôpitaux Universitaires Henri Mondor- INSERM U955 Eq7,

Créteil, France

2

EBMT Paris study office, CEREST-TC- Paris- France.

Department of Hematology- Saint Antoine Hospital,

Paris, France

3

Maria Sklodowska-Curie Memorial Center Center and

Institute of Oncology-, Bone marrow transplantation and

Onco-hematology, Gliwice Branch, Poland

4

Maria Sklodowska-Curie Memorial Center and Institute

of Oncology, Radiation Oncology, Gliwice Branch, Poland

5

Universite Paris Est Creteil, Department of Radiation

Oncology- Hôpitaux Universitaires Henri Mondor, Créteil,