ESTRO 36 Abstract Book

349 / 1082

S334 ESTRO 36 2017
_______________________________________________________________________________________________
PO-0646 Nodular Lymphocyte Predominant Hodgkin’s
Lymphoma (NLPHL): Early Outcomes
N. Khanna 1, N. Kalyani1, J. Godasastry1, H. Menon2, M.
Sengar 2, N. Khattry2, U. Dangi 2, B. Arora2, T. Shet 3, S.
Gujral3, E. Sridhar3, V. Rangarajan4, S. Banavali2, S.
Laskar1
1 Tata Memorial Hospital, RADIATION ONCOLOGY,
Mumbai, India
2 Tata Memorial Hospital, MEDICAL ONCOLOGY, Mumbai,
India
3 Tata Memorial Hospital, PATHOLOGY, Mumbai, India
4 Tata Memorial Hospital, NUCLEAR MEDICINE, Mumbai,
India
Purpose or Objective
To evaluate treatment response, patterns of failure and
prognostic factors for patients with NLPHL treated at the
Tata Memorial Hospital (TMH).
Material and Methods
Between January 2007 & July 2013, 61 patients with
histologically proven NLPHL in the age group of 6-70yrs
(Median 30.5Yrs) were treated at TMH. Forty four (72%)
were males. Majority had Stage I [29 patients (47%)] &
Stage II [15 patients (25%)] disease. Fifteen (25%) had
bulky disease at presentation. Sixteen (26%) were treated
with Involved Field Radiation Therapy (IFRT) alone, 18
(30%) received Chemotherapy (CTh) alone, while 23 (38%)
received a combination of CTh followed by IFRT. Four
patients underwent surgery as the local treatment. The
IFRT doses were in the range of 20-36 Gy. Thirty five (80%)
patients received ABVD CTh. Five (8%) patients received
Rituximab. Primary MINE CTh was used for 4 (6%) patients.
Results
After a mean and median follow-up of 43 and 41 months,
the 5 year disease free survival (DFS) and overall survival
(OS) were 65% and 93% respectively. Complete response
(CR) at completion of primary treatment was 92%. At last
follow up 46 (75%) were alive without disease. Two (3%)
patients had residual disease, three (5%) patients each had
in-field, out of field relapse. Five (8%) had disseminated
relapse and one (2%) patient each had transformation to
DLBCL and second primary disease (carcinoma tongue).
Ten (66%) out of 15 patients with disease relapse received
salvage treatment (3 IFRT, 3 CTh, 1 both), of which 7 were
disease free at last follow up. Two patients have been
planned for autologous stem cell transplantation. On
univariate analysis, early stage (75% Vs 27%, p=0.07),
absence of B symptoms (67% Vs 57%, p=0.08) and use of
IFRT (69% Vs 60%, p=0.38) resulted in superior DFS. For
patients with early stage disease (stage I and II), there was
no difference in DFS between patients receiving IFRT
alone (87%) and CTh + IFRT (80%), however DFS was
inferior for patients who received only chemotherapy
(55%). All patients tolerated treatment well without any
grade III or IV toxicities.
Conclusion
NLPHL is associated with excellent overall survival. For
patients with early stage disease, IFRT alone results in
similar outcomes compared to CTh+IFRT. Early Stage at
presentation, absence of B symptoms and the use of IFRT
confers superior outcome.
PO-0647 Factors associated with pulmonary toxicity
after conditioning with total body irradiation
H.K. Byun1, H.I. Yoon1, H.J. Kim1, J. Cho1, C.O. Suh 1
Yonsei Cancer Center, Radiation oncology, Seoul, Korea
Republic of
Purpose or Objective
To evaluate clinical and therapeutic factors associated
with pulmonary toxicity and related to survival outcome
after myeloablative conditioning using fractionated total
body irradiation (TBI), followed by allogenic stem cell
transplantation (allo SCT).
Material and Methods
A total of 58 patients with 43 ALL, 8 AML, and 7 others (1
neuroblastoma, 1 ewing sarcoma, 3 lymphoma, 2 aplastic
anemia) who underwent fractionated TBI-based
myeloablative conditioning and allo SCT between January
2005 and December 2014 were reviewed retrospectively.
Total doses of TBI ranged from 8 Gy to 12 Gy, although
most of the patients (91 %) received 12 Gy in 1.5 Gy b.i.d.
fractions delivered using a dose rate of 7 to 19
cGy/minute. Patients with clinical symptoms were
considered having pulmonary toxicity only if they have
radiologic evidence or reduced pulmonary function and
were furtherly subdivided based on presence or absence
of concurrent infection detected through mediums such as
blood or bronchoalveolar lavage. The relationship
between the pulmonary toxicity and clinical factors were
investigated using univariate and multivariate analysis. In
addition, we also performed each survival analysis for
treatment-related mortality (TRM) and overall survival
(OS) rates.
Results
Overall pulmonary toxicities developed in 36 (62%)
patients, of which 16 (28%) were proven to have a
concurrent infection, and no pathogens were seen in 20
(35%). Median time to onset of pulmonary toxicity from
transplantation was 6 months (range 1-31) in patients with
infectious pneumonia and 7 months (range 0-26) in
patients with the idiopathic pneumonia syndrome (IPS).
The leading etiology of infectious pneumonia was bacteria
(75%), followed by fungus (37.5%) and virus (12.5%). On
univariate analysis, conditioning chemotherapy regimen
(p=0.028) was significantly related to infectious
pneumonia, while donor type (p=0.021) and transplanted
cell type (0.031) was significantly associated with IPS. On
multivariate analysis, only the donor type (matched
unrelated vs. matched sibling, p=0.021, HR 12.67, 95% CI
1.46-110.30) was an independent factor related to the IPS.
Conditioning chemotherapy regimen showed a trend
towards significance for the development of infectious
pneumonia. Other clinical factors did not have significant
impacts on the development of infectious pneumonia or
IPS. On survival analysis, patients with infectious
pneumonia showed significantly higher rates of TRM
(p=0.026) and lower OS rates (p=0.039), whereas patient
with IPS did not affect the rates of TRM or OS.
Conclusion
Our findings demonstrate that donor type, transplanted
cell type and conditioning chemotherapy regimen may
have an effect on post-transplant pulmonary toxicity
combined with fractionated TBI. Clinicians should consider
those clinical factors besides radiation-related factors in
deciding on a treatment strategy for individual patients.
PO-0648 Is age >60 unfavorable prognostic factor in
early stage upper aerodigestive tract NK/T-cell
lymphoma?
B. Chen1, Y. Li1, W. Wang1, J. Jin 1, S. Wang1, Y. Liu1, Y.
Song1, H. Fang1, H. Ren1, S. Qi 1, Y. Tang1, X. Liu1, Z. Yu1
1National Cancer Center / Cancer Hospital- Chinese
Academy of Medical Sciences & Peking Union Medical
College, Department of Radiation Oncology, Beijing,
China
Purpose or Objective
The purpose of this study was to determine the survival
and prognosis of patients with age>60 in early stage upper
aerodigestive tract NK/T-cell lymphoma (UADT-NKTCL) ，
and to estimate whether patients with age>60 have lower
survivals than with age≤60.
Material and Methods
Between December 1979 and December 2014, 544 patients
with Stage IE and IIE UADT-NKTCL were treated. Of them,
there were 58 patients with age>60. Radiotherapy was the
primary treatment for most of patients. Of those older
patients, 37 patients were treated with radiotherapy