ESTRO 36 Abstract Book

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S377 ESTRO 36 2017
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.
Results
The median follow-up was 33 months (range 2-68). The 5-
year biochemical disease-free survival (bFDS) rate was 90%
and overall survival (OS) was 86%. Acute genitourinary
(GU) toxicity grade 1 and 2 were 37% and 12% respectively,
but only 8 patients (2.4%) experienced acute urinary
retention (Grade 3). Acute gastrointestinal (GI) toxicity
grade 1 and 2 were 16% and 6% respectively. No grade 3 or
4 GI toxicity was observed. Late GU toxicity ≥ grade 3
included 7 patients (2.1%), and the incidence of late GI
toxicity ≥ grade 3 was 1% (3 patients) compatible with
rectal radiation proctopathy, as is showed in figure1.
Conclusion
Dose escalation with a single-fraction HDRB is feasible and
well tolerated. The profile of acute and late toxicity is
acceptable, although a longer follow-up is needed to
evaluate long-term outcome and toxicities.
PO-0727 Acute intestinal toxicity after whole-pelvis
IMRT for prostate cancer from the patient’s
perspective
B. Noris Chiorda 1, E. Garibaldi2, B. Saracino3, D. Cante4,
B. Avuzzi5, E. Villa6, J.M. Waskiewicz7, M. Gaetano8, F.
Munoz9, G. Girelli10, C. Sini11, T. Rancati5, F. Badenchini5,
C. Bianconi1, C. Fiorino11, C. Cozzarini 1
1San Raffaele Scientific Institute, Radiotherapy, Milan,
Italy
2Istituto di Candiolo - Fondazione del Piemonte per
l'Oncologia IRCCS, Radiotherapy, Candiolo TO, Italy
3Istituto Nazionale Tumori "Regina Elena", Radiotherapy,
Rome, Italy
4Ospedale Civile ASL TO4, Radiotherapy, Ivrea, Italy
5Fondazione IRCCS Istituto Nazionale dei Tumori,
Radiotherapy, Milan, Italy
6Humanitas Gavazzeni, Radiotherapy, Bergamo, Italy
7Comprensorio Sanitario di Bolzano, Radioterapia,
Bolzano, Italy
8Centro Aktis, Radiotherapy, Marano NA, Italy
9Ospedale Regionale 'U. Parini' - AUSL Valle d'Aosta,
Radiotherapy, Aosta, Italy
10Ospedale degli Infermi ASL BI - Biella, Radiotherapy,
Biella, Italy
11San Raffaele Scientific Institute, Medical Physics,
Milan, Italy
Purpose or Objective
The aim of this study was to thoroughly analyze patient-
reported acute intestinal toxicity (IT) from whole-pelvis
RT delivered by means of modern IMRT techniques (IM-
WPRT).
Material and Methods
A multi-Institutional, observational study registered at
ClinicalTrials.gov was started in 2014 with the aim of
assessing Intestinal, Hematological and Urinary toxicity
from IM-WPRT for prostate cancer. Acute IT is evaluated
by means of the 10 items of the Inflammatory Bowel
Disease Questionnaire pertaining to the Bowel Domain
(IBDQ-B) administered to patients (pts) at baseline and at
RT mid-point and end: bowel movements (item #1), loose
bowel movements (#5), abdominal cramps (#9) and pain
(#13), gas passage (#17), bloating (#20), rectal bleeding
(#22), urgency to defecate (#24), accidental soiling (#26),
nausea and feeling sick (#29). Each item is scored on a 1-
7 point scale (most severe symptoms=lower scores).
Analyses were performed on the worst variations (Δ) of
each item between baseline and RT mid-point or end. This
analysis pertains to 242 pts with complete data at all the
3 time intervals, treated with adjuvant, salvage or radical
intent (n=91, 104 and 47, respectively), with VMAT,
Tomotherapy or static-field IMRT (n=122, 90 and 30,
respectively). RT was delivered at conventional (CF, 1.7-2
Gy/fr,n=92) or moderate hypo-fractionation (HYPO, 2.15-
2.65 Gy/fr, median 2.35 Gy/fr, n=114). The median EQD2
(for α/β=3) to prostatic bed and prostate were 72.6 and
77 Gy, respectively; pelvic lymph-nodes/pelvic lymph-
nodal area were always treated with conventional
fractionation (range 50.4-56.1 Gy, median 51.8; daily
dose: 1.7-2 Gy/fr).
Results
Overall, IM-WPRT was well tolerated, with a median Δ with
respect to baseline of -2 points for item #1, of -1 points
for items # 5, 17 and 24, and 0 for the 6 remaining items
(Table 1, Fig. 1). Moreover, the consequent impairment of
Emotional, Social and Systemic Domains evaluated by the
IBDQ was exceptionally mild (Table 1). Nevertheless, the
Δ of all the 10 IBDQ-B at RT end with respect to baseline
was always statistically significant (p≤0.02) at the Analysis
of Variance (ANOVA). Interestingly, in the 134 patients
with complete data at 1 year, ANOVA highlighted a
persisting, significant (p≤0.04) Δ with respect to baseline