ESTRO 36 Abstract Book

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S390 ESTRO 36 2017
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utilization of hypofractionation. Our data suggests that
treatment directives may be a useful approach in
overcoming resistance to other hypofractionated
treatment paradigms. Further palliative treatment
directive use is planned within our institution for other
sites (lung, pelvis). We believe that widespread
examination and adoption of evidence-based directives
can be used to improve value and reduce overtreatment
in palliative oncologic care.
Poster: Clinical track: Elderly
PO-0748 Efficacy of radiotherapy for painful bone
metastases in elderly patients
J. Cacicedo1, A. Gomez-Iturriaga1, L. Sanchez2, A.
Navarro3, V. Morillo4, P. Willisch5, C. Carvajal6, E.
Hortelano7, J. Lopez-Guerra 8, A. Illescas9, F. Casquero6,
O. Del Hoyo6, R. Ciervide10, L. Martinez-Indart11, P.
Bilbao6
1 Hospital Universitario de Cruces, Radiation Oncology-
Cruces University Hospital, Baracaldo-Vizcaya, Spain
2 Univesrsity of the Basque country, Medicine Faculty,
Barakado, Spain
3 Instituto Catalán de Oncologia, Radiation Oncology,
Hospitalet Barcelona, Spain
4 Hospital de Castellón, Radiation Oncology, Castellón,
Spain
5 Hospital Meixoeiro, Radiation Oncology, Vigo, Spain
6 Hospital Universitario de Cruces, Radiation Oncology,
Barakaldo, Spain
7 Hospital Txagorritxu, Radiation Oncology, Vitoria, Spain
8 Hospital Virgen del Rocio, Radiation Oncology, Sevilla,
Spain
9 Hospital Virgen Macarena, Radiation Oncology, Sevilla,
Spain
10 Hospital Sanchinarro, Radiation Oncology, Madrid,
Spain
11 Cruces University Hospital, Clinical Epidemiology Unit,
Barakaldo, Spain
Purpose or Objective
Elderly frequently receive different medical treatments
than younger patients because of fear of higher toxicity
and expected lower effectiveness. Painful bone
metastases have a major impact on quality of life of
cancer patients. We investigated whether age is a
predictor for pain response after radiotherapy (RT) for
painful bone metastases.
Material and Methods
Between June 2010 and June 2014, 204 pati ents from ten
Radiation Oncology Departments in Spain parti cipated in
a prospective observational study* to evaluat e the flare
effect in patients with bone metastasis undergoing
palliative RT. The pre-treatment evaluation con sisted of
a full history and physical examination, administration of
Brief Pain Inventory (BPI) and record of analgesic
consumption within the previous 24 h.
A follow-up visit was scheduled 4-weeks after the end of
the RT. At this time the BPI was again administered, and
analgesic consumption was recorded.
From this cohort, 128 patients (62.7%) completed the BPI
at the first visit and in the follow-up (4-weeks after RT),
and therefore were evaluable for treatment response in
the present study. Pain response was measured using the
International Bone Metastases Consensus from 2002. Worst
pain was recorded using the Brief Pain Inventory (BPI):
ranged from 0–10.
To identify which variables predicted pain response and
in particular to determine whether age is a predictor, Cox
proportional hazard models were used. The preselected
baseline variables, were age (cohorts ≤65(A)/65-
75(B)/>75(C) ), gender, Eastern Cooperative Oncology
Group (ECOG) performance status scale (0-1/≥2), pain
score (≤4/5–7/8–10), treatment schedule (single
fraction/multiple), primary tumor (prostate / breast /
lung / other cancer types), presence of visceral
metastases (yes/no), concomitant systemic chemotherapy
(yes/no) and concomitant bisphosphonates (yes/no).
Results
Table 1 shows patient characteristics. Median age was 66
years (38-89). Overall treatment response (including
partial and complete responses) was 61.7%.
According to univariate analysis pain response was
significantly better in patients > 75(C) years: 53.6% in (A)
versus 60.9% in (B) (OR, 1.3; 95% CI, 0.6-2.9; p=0.459) and
80.8% in (C) (OR, 3.6; 95% CI, 1.2-11.0; p=0.022). Patients
receiving multiple fractions presented better response
(70.5%) that those receiving a single fraction (49.5%) of 8
Gy (OR, 2.8; 95% CI, 1.2-6.1; p=0.01 ). Moreover, patients
presenting a pain score of 8-10 before RT presented better
response (70.8%) than those with a pain score <8 (50%)
after palliative RT (OR, 2.4; 95% CI, 1.1-5.0; p= 0.017). No
other factors previously mentioned were found
statistically significant.
The multivariate analysis showed that only the treatment
schedule (p = 0.005) and the pain score >8 before RT (p =
0.011) were independent factors for pain response.The
age was not found a statistically significant factor.
Conclusion
Older patients have a remarkable benefit from palliative
RT. A higher age should not be a reason to withhold
palliative RT.
PO-0749 Early impact of pulmonary SBRT on Quality of
Life: Benefit for patients with low initial QoL/GHS
S. Adebahr1,2, M. Hechtner3, N. Schräder1, T. Schimek-
Jasch1, K. Kaier4, V. Duncker- Rohr5, F. Momm5, J.
Gärtner6, A.L. Grosu1,2, U. Nestle1,2
1University Medical Center Freiburg, Department of
Radiation Oncology, Freiburg, Germany
2German Cancer Consortium DKTK, Partner Site Freiburg,
Freiburg, Germany