ESTRO 36 Abstract Book

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S44 ESTRO 36 2017
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Calculation of the prognostic score
ECOG PS 2-4 2 points
No systemic treatment 2 points
Pleural effusion and/or metastases 2 points
On intravenous antibiotics during last 2 weeks 1 point
ESAS appetite worse than median 1 point
ESAS pain while not moving worse than median 1 point
Conclusion
The presence of pain while not moving and reduced
appetite (below/above median) predicted significantly
shorter survival. The score identified 4 groups with clearly
different prognosis and should be examined in additional
independent cohorts. Future research should include
patient-reported symptoms because they were more
important than primary tumor type, age and other
baseline parameters.
PV-0088 Half body irradiation schedule in patients
with multiple bone metastases: a phase I-II trial
M. Ferro1 , F. Deodato1, F. Dello Iacovo 1, G. Macchia 1, S.
Di Santo1, M. Nuzzo1, S. Cilla2, A. Farioli3, A. Zamagni4, L.
Ronchi 4, A. Arcelli4,5, S. Mignona6, R. Frakulli4, E. Farina4,
S. Cammelli4, G.P. Frezza5, V. Valentini7, A .G. Morganti4
1 Fondazione di Ricerca e Cura “Giovanni Paolo II”,
Radiotherapy Unit, Campobasso, Italy
2 Fondazione di Ricerca e Cura “Giovanni Paolo II”,
Medical Physics Unit, Campobasso, Italy
3 University of Bologna, Department of Medical and
Surgical Sciences - DIMEC, Bologna, Italy
4 University of Bologna, Radiation Oncology Center-
Department of Experimental- Diagnostic and Specialty
Medicine - DIMES, Bologna, Italy
5 Ospedale Bellaria, Radiotherapy Department, Bologna,
Italy
6 Fondazione di Ricerca e Cura “Giovanni Paolo II”,
Oncology Unit, Campobasso, Italy
7 Policlinico Universitario “A. Gemelli”- Università
Cattolica del Sacro Cuore, Department of Radiotherapy,
Rome, Italy
Purpose or Objective
To evaluate the efficacy of an half-body irradiation (HBI)
schedule on pain relief in multiple bone metastases cancer
patients. The secondary aim was to evaluate the safety of
this short course hypofractionated treatment.
Material and Methods
From August 2003 to February 2016, patients with
widespread symptomatic bone metastases and no previous
history of large field radiotherapy were enrolled. The pain
score (pain evaluation obtained by multiplying severity ×
frequency) and the drug score (analgesic assumption
evaluation obtained by multiplying severity×frequency) as
well as the visual analog scale (VAS) for pain were used to
record and monitor pain. Data on pain status and
dosage/frequency of analgesic consumption were
recorded before treatment (baseline evaluation) and
during follow-up. HBI encompassed the lower half body
(pelvic bones, lumbo-sacral vertebrae and upper third of
femurs). Prostate cancer metastases received 15 Gy/3Gy
fraction along 5 days. Skeletal metastases due to other
primary tumors received accelerated HBI (3 Gy fractions
twice daily, 6–8 h apart, on 2 consecutive days, up to 12
Gy).
Results
258 patients (M/F 102/156; median age: 64; range 29-95)
were enrolled and completed the treatment. After HBI, a
significant reduction of pain, as evaluated by VAS, was
recorded (pre- treatment versus post- treatment mean
VAS: 5.4 versus 2.7, CI 2.2-3.2; p=0.0001). Moreover, 62
patients (24%) had complete pain relief and 64 patients
(25%) showed more than a 30% VAS reduction. Overall
response rate for pain was 53% (CI 0.95: 46.2% - 60.4%). In
182 patients (71%) Pain and Drug scores before and after
treatment were valuable. Statistical analysis showed a
significant reduction of Pain and Drug scores especially
concerning patients with the highest scores before
treatment (Chi squared test: p=0.001). In particular, 26
patients (14%) achieved a Drug Score’s reduction and 40
patients (22%) discontinued analgesic therapy. Nineteen
percent of all series exhibited no treatment related
complications, and an additional 79% experienced only
mild or moderate (transitory) toxicity. As a whole, Grade
> 3 toxicity (severe) was seen in four patients (2%):
haematologic G3 (1 pt) and gastro-intestinal G3 (2 pts).
Only 1 Grade 4 haematologic toxicity was registered. 111
patients (43%) presented pain flare’s phenomenon.
Conclusion
HBI is safe and effective, providing long lasting pain
reduction in patients with multiple bone metastases.
PV-0089 Relation between pain control and bone
mineral density change in bone metastases
H. Kobayashi1, H. Takagi1, K. Tanaka1, T. Matsuyama1, K.
Yamazaki1, M. Matsuo2, T. Yanase1, M. Tanaka1
1Ogaki Municipal Hospital, department of radiotherapy,
Ogaki, Japan
2Ogaki Municipal Hospital, department of nursing, Ogaki,
Japan
Purpose or Objective
External beam radiation therapy is an effective technique
for bone metastases. The main roles of radiotherapy are
relief of pain and stabilizing metastatic bones. In
achieving pain control in patients with bone metastases,
pain relief is usually obtained in 70% of patients by using
a variety of dose fraction schemes. However the role of
radiotherapy in stabilizing is unclear. The purpose of this
study is to investigate the relationship between the pain
control effects of radiotherapy and bone mineral density
change after the after the compression of radiotherapy
Material and Methods
Data from 102 patients who underwent radiation therapy
because of lytic bone metastases lesions from January
2015 to December 2015 were retrospectively reviewed.
Forty patients (sixty-two lesions) received computed
tomography (CT) scans prior to initiation and at least
twice after radiation therapy. The most common primary
site was breast accounting for 14 (35%). Liver, lung,
esophagus and rectal tumors accounted for 11 (27.5%), 8
(20%), 3 (7.5%), and 2 (5%) patients, respectively. Percent
change in bone attenuation between pre-radiation
therapy and post-radiation therapy were computed for
irradiated metastatic bone (IMB) lesions and irradiated
non-metastatic bone (INMB). Pain intensity was self-
assessed by patients using a scale graduated from 0 to 10.
Patients were asked for the scale at least once a week
from the beginning of radiotherapy till 3 weeks after