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imaging technique (MRI, Bone scintigraphy or CT) in 23.2%,
by another 18F-Ch-PET in 5% and with a biochemical
response after a specific treatment in 48% of them. Result
of the test was discordant in 9%. According to this data,
18F-Ch-PET has a Sensibility and Specificity of 97% and 81%
respectively.
Conclusion
18F-Ch-PET seems to be a very useful diagnostic test for
restaging recurrent PCa in selected group of patients,
allowing all relapse sites to be evaluated at once.
It can also modify treatment management in an important
percentage, identifying which ones can be offered a
potential curative treatment.
In our series, like in previous literature, PSA level, PSAvel
and PSAdt are strong predictive factors for positive 18F-
Ch-PET.
PO-0739 Phase II Trial of Dynamic Dosimetry for
prostate brachytherapy: correlation with post-implant
MRI/CT
Abstract withdrawn
Poster: Clinical track: Skin cancer / malignant
melanoma
PO-0740 Surgery versus Radiotherapy in Uveal
Melanoma: SEER Analysis using Propensity Score
Matching &IPTW
B.S. Jang
1
, J.H. Chang
2
, S.H. Oh
3
, Y.J. Lim
1
, I.H. Kim
4
1
Seoul National University Hospital, Department of
Radiation Oncology, Seoul, Korea Republic of
2
SMG-SNU Boramae Medical Center, Department of
Radiation Oncology, Seoul, Korea Republic of
3
SMG-SNU Boramae Medical Center, Department of
Biostatistics, Seoul, Korea Republic of
4
Cancer Research Institute- Seoul National University
College of Medicine, Department of Radiation Oncology,
Seoul, Korea Republic of
Purpose or Objective
The treatment of uveal melanoma includes surgery and
radiotherapy (RT). Utilization of RT has been increasing as
a strategy for organ preservation, but the survival
difference between two modalities has not been reported.
Material and Methods
Patients diagnosed with uveal melanoma from 2004 to
2013 were selected from Surveillance, Epidemiology, and
End Results (SEER) database. Propensity-score matching
with nearest neighbor 1:1 matching method and inverse
probability of treatment weighting (IPTW) using
propensity score were used to compare the survival
outcome between RT only and surgical resection alone for
the treatment of uveal melanoma.
Results
Overall, 3,291 patients were treated: 2,503 received RT
only (RT group) and 788 surgical resections only (surgery
group), respectively. After propensity-score matching,
437 patients were identified in each cohort (total N = 874).
The RT group had an improved crude 5-year overall
survival (OS) rate compared with the surgery group (76 %
vs. 60 %, P-value < 0.001) and the 5-year cancer-specific
survival (CSS) rate (89% vs. 72 %, P-value < 0.001),
respectively. Compared to the surgery group, the RT group
was associated with improved OS [hazard ratio (HR) =
0.51, 95% confidence interval (CI) = 0.39 – 0.66, P-value <
0.001] and CSS [HR = 0.37, 95% CI = 0.25 - 0.54, P-value <
0.001] in multivariate Cox proportional hazard analysis,
respectively. The survival benefit of the RT group
maintained after adjustment with IPTW, both in OS
[adjusted HR (AHR) = 0.45, 95% CI = 0.36 - 0.56, P-value <
0.001] and CSS [AHR = 0.27, 95% CI 0.27 - 0.51, P-value <
0.001].
Conclusion
To our knowledge, the present study is the first to
demonstrate the survival difference according to the
treatment modality in uveal melanoma, using both
propensity-score matching and weighting methods with
the SEER database. The current study suggests that RT
might provide a survival advantage over surgery in the
treatment of uveal melanoma.
PO-0741 Ipilimumab and stereotactic radiosurgery
with cyberknife in melanoma brain metastases
V. Borzillo
1
, R. Di Franco
1
, S. Falivene
1
, A. Martino
2
, V.
Ravo
1
, G. Totaro
1
, F.M. Giugliano
3
, P.A. Ascierto
4
, A.M.
Grimaldi
4
, L. Festino
4
, E. Simeone
4
, V. Vanella
4
, F.
Cammarota
1
, D. Giannarelli
5
, P. Muto
1
1
Istituto Nazionale Tumori Fondazione Pascale,
Radioterapia, Napoli, Italy
2
Seconda Università degli Studi di Napoli, Dipartimento
di Diagnostica per Immagini e Radioterapia, Napoli, Italy
3
European Medical Imaging Fondazione Muto-onlus,
Radiation Oncology, Casavatore- Naples, Italy
4
Istituto Nazionale Tumori Fondazione Pascale, Struttura
Complessa Oncologia Medica Melanoma Immunoterapia
Oncologica e Terapie Innovative, Napoli, Italy
5
Istituto Nazionale Tumori Regina Elena Roma,
Biostatistical Unit, Roma, Italy
Purpose or Objective
Ipilimumab(Ipi), an anti-cytotoxic T-lymphocyte-
associated antigen
4(CTLA-4) monoclonal antibody, has
been shown to improve survival in patients(pts) with
advanced melanoma. However, there is a lack of data
about the efficacy of Ipi in pts with brain metastases(BMs),
as well as about its combination with radiotherapy(RT) and
the right sequence of both treatments. The purpose of this
study was
to evaluate overall survival(OS), local
control(LC)
of
the
lesion
treated,
and
intracranial control(IC) in pts with melanoma BMs (MBMs)
treated with
stereotactic
Radiotherapy(SRT)/radiosurgery(SRS) with Cyberknife®
and Ipi
Material and Methods
From December 2012 to May 2016 we treated 63 pts(34
M,29 F) with MBMs. The median age was 61 years (28-81y).
52pts received Ipi: 24 prior-RT(IPI PRE-RT), 7 concomitant-
RT and 21 post-RT(IPI POST-RT).11 not received Ipi(NO
IPI). Ipi was administered intravenously at a dose of 3
mg/kg over 90 min every 3 weeks for 4 doses. We treated
120 lesions whit median diameter size of 8 mm (2-42 mm).
67 SRS(dose range 10-24Gy) and 23 SRT(dose range 18-
24Gy). We evaluated the local response according to
RECIST criteria. We assessed LC as the sum of CR, PR and
SD, IC, and median OS from the date of the SRS/SRT
procedure.
Results
The median follow-up (FU) was 7 months (m) (range 0-26).
55 pts for a total of 109 lesions were evaluable for FU. The
median OS for all pts was 9.7 m and the median OS of 52
pts who received Ipi and RT was 10 m vs 9.7 m of 11 pts
IPI NO(P=0.82). The median OS for single group was: 9.7 m
for NO-IPI, 7.7 m for IPI PRE-RT, 9.7 m for IPI CONC RT and
11.5 m for IPI POST-RT (p=0.95). The 1-year OS was 41%
for IPI POST-RT, 32% for IPI PRE-RT, 36% for NO-IPI and 33%
for IPI CONC RT
.
The 1-year LC of all pts lesions was 43.2%,
and the 1-year LC of pts who received Ipi+RT was 48% vs
25% of pts NO IPI(p=0.06).The 1-year LC for single group
was 72% for IPI PRE-RT, 36% for IPI POST-RT, 25% for NO-
IPI and 33% for IPI CONC RT(p=0.08). The 1-year IC of all
pts was 40.1%, and the 1-year IC of pts who received Ipi
and RT was 41.5% vs 50% of pts NO IPI.