ESTRO 36 Abstract Book

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S287 ESTRO 36 2017
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2 Universidad catolica de valencia, facultad de
enfermeria, Valencia, Spain
Purpose or Objective
The increase in life expectancy also increases the
possibility of occurrence of tumors in elderly population.
Radical treatments in these patients may involve
functional impairment or complications, often rejected.
SBRT enables to apply a radical treatment in a few
sessions, with little side effects and good results, and
could be considered the technique of choice for certain
patients considered elderly or frail.
Our purpose was to assess survival in function of age and
performance status in a group of elderly cancer patients.
Material and Methods
We analyzed 44 lesions treated with SBRT, in 39 patients
aged 70-93 years (mean: 79.9; median: 80). Male: 32
(82.05%), female: 7 (17.95%).Performance status was
determined before treatment with Karnofsky Performance
Status Index (KPSI).
Results
Number of fractions:
Seven fractions in 1 case (2.27%)
Three fractions in 23 cases (52.27%)
Two fractions in 9 cases (20.45%)
One fraction in 11 cases (25%)
Survival:
Lost of follow up: 5 patients (12.82%).
<6 months: 4 patients (10’25%)
6-12 months : 10 patients (25’64%)
12-18 months : 6 patients (15’38%)
> 18 months : 14 patients ( 35’89%)
Performance status:
KPS >70 was registered in 26 patients (66.6%); ≤70 in 13
patients (33.3%)
Survival in KPSI ≤70:<6 months: 4 patients ( 11.76 %)
6-12 months : 4 patients (11.76 %)
12-18 months : 2 patients (5.88 %)
> 18 months : 2 patients ( 5.88 %)
Survival in KPSI >70:
<6 months: 0 patients
6-12 months : 6 patients ( 17.64 %)
12-18 months : 4 patients ( 11.76 %)
> 18 months : 12 patients ( 35.29 %)
Age and survival:
We divided the population in two groups of age, with a
cut-off in 80 years.
Group 70-80y:
<6 months: 1 patients (2.56%%)
6-12 months : 3 patients (7.69%)
12-18 months : 2 patients (5.12%)
> 18 months : 6 patients (15.38%)
Group ≥ 80y:
<6 months: 3 patients (7.69 %)
6-12 months : 7 patients (17.94 %)
12-18 months : 3 patients (7.69 %)
> 18 months : 9 patients (23.07%)
Conclusion
- Elderly patients treated with SBRT achieved a good
survival.
- A high KPS (>70) is better in terms of survival (35.29% vs
5.88% in >18 months).
- If we consider 80 years as more old patients, advanced
age appeared not to be worse than younger ones in terms
of survival (23% vs 15% in >18m).
- SBRT should be considered a good option of radical
treatment in elderly patients because of good results in
survival, which is better in patients with better
performance status.
OC-0545 Head and neck paragangliomas: preliminary
results of the Protontherapy Centre of Trento (Italy)
I. Giacomelli 1, D. Scartoni1, M. Cianchetti1, F. Dionisi1, D.
Amelio 1, S. Lemoine 1, F. Fellin 1, R. Righetto1, M.
Amichetti1
1Azienda Provinciale per i Servizi Sanitari APSS Trento,
U.O. di Protonterapia, Trento, Italy
Purpose or Objective
Paragangliomas (PGL) are rare usually benign, slow
growing but locally aggressive tumors, Overall and specific
Survival analyses reveal that most patients do not die of
PGLs thus local control and QoL are a meaningful endpoint
for comparative decision making. Proton therapy (PT) can
spare more healthy tissue than conventional and/or
intensity-modulated X-ray therapy (IMRT) and it can result
in fewer side effects. The aim of this study is to evaluate
PT safety, feasibility and dosimetric aspects in the
definitive treatment of PGL.
Material and Methods
From December 2015 to October 2016, six pts, five
females and one male, median age 55.5 years (range, 39-
88 years) were treated for histological or radiological
confirmed H&N PGL. Two patients (pts) had positive
familiar history for PGL1 syndrome. Three patients had
two PGLs treated, for a total of 9 PGLs. Locations were:
jugulotimpanic (2); timpanic (1); jugular (1); vagal (2);
carotid body (3). Maximum diameter ranged between 20
and 45 mm.. Five pts were irradiated with definitive
intent, one pt was treated postoperatively because of
gross residual disease; and one pt received PT for
recurrent disease. Acute and late toxicities were
evaluated according to the CTCAE scale version 4.0.
Quality of Life was evaluated using the EORTC QLQ-C30
and H&N35 questionnaires.
Results
All pts were treated with active beam scanning PT using
2-3 fields with single field optimization (SFO) technique
with a total dose of 50.0 GyRBE in 25 fractions of 2.0
GyRBE. Posterior beam arrangement was preferred when
allowed in order to spare as much as possible critical
structures: all pts had at least one or more posterior or
posterior-oblique beams, four had also one lateral beam
and two had one anterior-oblique beam. Median PTV (CTV
+ 4mm margin) volume was 63.85 cc, median ipsilateral
OARS doses were: temporomandibular joint 37.22 GyRBE,
choclea 36.72 GyRBE, parotid 22.30 GyRBE, superior
constrictor muscles 19.19 GyRBE, oral cavity 2.29 GyRBE,
hemimandible 7.67 GyRBE. All patients completed PT
without interruptions. No acute toxicity > G2 was
observed. Three pts experienced G2 skin toxicity and one
pt G2 external otitis. No late toixicity was observed at the
last follow-up. Two pts had improvement of symptoms
related to the disease: one pt had dysphonia improvement
one month after PT; in another pt improvement of VII
cranial nerve paresis and reduction of tinnitus were
observed. All pts reported stability or improvement in the
evaluation of their health status and QoL. At the time of
the analysis all patients are locally controlled
Conclusion
Proton therapy for PGLs is a safe, feasible, and well
tolerated treatment. The superiority in dose distribution
compared to X-ray therapy could translate in better
results in terms of long-term toxicity and QoL . A longer
follow-up is needed to confirm these favourable initial
results .
OC-0546 Video Launching during Irradiation – an
alternative to anesthesia in pediatric patients?
C. Palhetinha Aguas1, P. Humblet1, L. Renard1, A.
Vaandering 1, V. Roosen1, M. Coevoet1
1Cliniques Universitaires Saint Luc, Radiotherapy,
Brussels, Belgium
THIS ABSTRACT FORMS PART OF THE MEDIA PROGRAMME
AND WILL BE AVAILABLE ON THE DAY OF ITS PRESENTATION
TO THE CONFERENCE.
OC-0547 Acute and late morbidity in a Phase II trial of
adaptive radiotherapy for urinary bladder cancer