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S522
ESTRO 36 2017
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PO-0951 Episcleral Brachytherapy for Uveal Melanoma
A. Ponte
1
, T. Teixeira
1
, I. Nobre-Góis
1
, J. Casalta-Lopes
1
,
P.C. Simões
1
, A. Cavaco
1
, J. Veríssimo
2
, R. Proença
2
, M.
Borrego
1
1
Hospitais da Universidade de Coimbra, Serviço de
Radioterapia, Coimbra, Portugal
2
Hospitais da Universidade de Coimbra, Serviço de
Oftalmologia, Coimbra, Portugal
Purpose or Objective
Uveal melanoma is the most common intraocular tumor in
the adult age, and the second most common after skin
melanoma, with an annual incidence rate of 4-10 per
million people. Until November 2013 portuguese patients
with uveal melanoma were sent abroad for treatment.
Different therapeutic approaches include enucleation,
proton therapy, episcleral brachytherapy (EBT), with
similar outcomes.
The purpose of this work was to evaluate treatment
response in patients with uveal melanoma submitted to
EBT.
Material and Methods
Included all patients with uveal melanoma treated in our
institution by the Radiation Oncology Department in co-
operation with the Ophthalmology Department, between
November 2013 and September 2016. Plaques with low
energy photon seeds (
125
I) were used. Dose prescription
was 85 Gy to the tumor apex. Response was evaluated by
ophthalmic ultrasound with serial lesion measurements
and treatment side effects were recorded. A type I error
of 0.05 was considered for inferential statistics.
Results
50 EBT procedures were done in 50 patients, with a
median age of 64 years, female gender (58,0%) and right
eye (62,0%) predominance. Initial median diameter and
thickness were 12,23 mm (5,92 to 18,70 mm) and 6,73 mm
(2,60 to 12,67 mm), respectively. No distant metastatic
disease was present at the time of diagnosis. Staging was
as follows: Stage IIB 50,0%, Stage IIA 44,0% and Stage IA
4,0%.
The median treatment time was 140,7 hours, with a
median prescribed dose of 85,90 Gy. A notched eye plaque
(ROPES15n) was used in 26,0% of cases. No complications
during implant procedure or treatment period were
registered.
The median follow-up was 10,5 months (1 to 33 months).
During this period, a significant reduction in thickness
(median difference of 2,035 mm, p<0,001) and diameter
(median difference of 2,43 mm, p<0,001) was recorded.
Radiation retinopathy was observed in 20,0% of patients,
treated by intra-ocular anti-VEGF injection in all cases.
Tumor relapse occurred in 2 patients (4,0%) and distant
spread in one of these. No cancer related death was
registered.
Conclusion
EBT is an effective and well tolerated eye sparing method
to treat patients with uveal melanomas. A progressive
significant reduction in tumors dimension was observed.
No severe late side effects was registered, although
follow-up time is still limited.
Poster: Radiobiology track: Normal tissue biology of the
heart
PO-0952 Integral heart dose and lymphocytopaenia in
lung cancer patients treated with radical radiotherapy
N. Joseph
1
, A. McWilliam
2
, K. Haslett
2
, J. Kennedy
2
, C.
Faivre-Finn
2
, A. Choudhury
2
1
General Hospital Polonnaruwa, Clinical Oncology,
Polonnaruwa, Sri Lanka
2
The Christie NHS Foundation Trust, Clinical Oncology,
Manchester, United Kingdom
Purpose or Objective
Optimal radiation dose delivery in lung cancer patients is
limited by the risk of toxicity to adjacent organs especially
the heart, lung and spinal cord. Post-treatment
lymphocytopaenia is a recognised complication in patients
undergoing thoracic radiotherapy and if severe, can lead
to opportunistic infections. We hypothesised that a higher
integral heart dose is associated with post-treatment
lymphocytopaenia in patients with small cell lung cancer
(SCLC) and non-small cell lung cancer (NSCLC) treated
with radical radiotherapy.
Material and Methods
138 patients (103 NSCLC and 32 SCLC) treated with radical
radiotherapy were included in this study. Concurrent
chemotherapy was administered in 85/135 patients.
Prescribed dose to planning target volume ranged from
41.4 to 72 Gy with a median of 66 Gy. Lymphocyte counts
prior to treatment and up to 100 days post-treatment were
obtained. The integral heart dose was derived by using the
product of mean dose and volume. A linear mixed effects
model, incorporating the following variables: integral
heart dose, integral heart dose per fraction, baseline
lymphocyte count, time from start of treatment and use
of concurrent chemotherapy was used to analyse the
effect on post-treatment lymphocyte counts
Results
The median integral heart dose in the cohort was 14.5
Litres-Gy (range 4-35.6). Integral heart dose (p=0.03) and
time from start of therapy (p < 0.001) were negatively
correlated with post-treatment lymphocyte counts while
integral heart dose per fraction (p=0.05) and baseline
lymphocyte count (p<0.001) were positively correlated.
Use of concurrent chemotherapy was not statistically
significant in the model.
Conclusion
Total integral heart dose predicts a lower post-treatment
lymphocyte count in lung cancer patients treated with
radical radiotherapy. The positive correlation with higher
integral heart dose per fraction suggests that fractionation
has an adverse effect on post-radiotherapy lymphocyte
counts.
Poster: Radiobiology track: Radiobiology of the
intestinal track
PO-0953 Proteome profiles in PDAC patients with local
recurrence after postoperative radiochemotherapy
L. Bolm
1
, V. Oria
2
, L. Kaesmann
3
, P. Bronsert
4
, U.F.
Wellner
5
, O. Schilling
6
, D. Rades
3
1
University of Luebeck, Department of Radiation
Oncology- Department of Visceral Surgery, Lübeck,
Germany
2
University of Freiburg, Department of Molecular
Medicine and Cell Research, Freiburg, Germany
3
University of Luebeck, Department of Radiation
Oncology, Luebeck, Germany
4
German Cancer Consortium DKTK and German Cancer
Research Center DKFZ, Department of Pathology,
Heidelberg, Germany
5
University of Luebeck, Department of Visceral Surgery,
Luebeck, Germany
6
German Cancer Consortium DKTK and German Cancer
Research Center DKFZ, Institute of Molecular Medicine
and Cell Research- Freiburg, Heidelberg, Germany
Purpose or Objective
Complete surgical resection remains the only curative
option in patients with pancreatic ductal adenocarcinoma