ESTRO 36 Abstract Book

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S658 ESTRO 36 2017
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pneumectomy (12%), sleeve resection (7%), others (7%). In
90% of patients resection was complete, 10% had
microscopically involved margins.The median duration
between resection and start of PORT were 51 (23-212)
days. PORT was applied in 95% of patients by means of 3D-
conformal planning, in 5% with IMRT. Median duration of
PORT were 39,5 (16-51) days with a median total dose of
52,6 (45-60) Gy. 22% of the patients had a locoregional
progression median 7 (2-52) months after PORT, of these
54% within the irradiated area which had recieved median
50 (45- 59,4) Gy. 62% of patients developed distant
metastases median 15,5 (0-88) months after PORT. 75% of
patients died, most due to tumor progression (62%).
Median actuarial overall survival was 32 (1-88) months,
median progression free survival 11 (1-53) months. The
evaluation of risk factors for survival and of toxicity data
is ongoing.
Conclusion
These preliminary data show that a fifth of patients after
PORT will develop a locoregional recurrence, which
complys with data in the literature, and imply that doses
of around 50 Gy may not be sufficient to prevent
locoregional recurrence in these patients.
EP-1231 Early Clinical outcome of the first lung SBRT
program in a developing country
S. Wadi-Ramahi1, J. Khader 2, F. Abu Hijli2, H.
Ghatasheh2, A. Sulaiman2
1 King Faisal Specialist Hospital and Research Center,
Biomedical Physics, RIyadh, Saudi Arabia
2 King Hussein Cancer Center, Radiation Oncology,
Amman, Jordan
Purpose or Objective
The stereotactic body radiation therapy (SBRT) program at
our institution was established through cooperation with
an internationally renowned institution and it went
clinical in 2012. Until the present day, it stands as the only
SBRT program in the entire country with patient
population that has increased dramatically in the past few
years due influx of refugees from regional conflicts. Here,
we will present the early clinical outcome of patients
treated for lung tumors with SBRT.
Material and Methods
10 patients were treated to date in the SBRT service. All
patients underwent 10-phase 4DCT and PET-CT scans. The
internal target volume (ITV) was constructed from the
minimum intensity projection (MIP) dataset and
expanded, if needed, following PET findings. 5mm margin
was added to create the PTV. All patients received a dose
scheme of 48Gy/4 fractions except for 2 who received
60Gy/8 fractions due to toxicity concerns. Lung
heterogeneity correction was used during planning on
Pinnacle3 (Philips, Netherlands) and treatment delivery
was done on Precise linacs (Elekta, Sweden). Positioning
was done by using CBCT imaging on every fraction. After
completion of SBRT the patient is seen in 2 weeks for
clinical evaluation and follow up (FU) for possible acute
side effects. The FU is both clinical and radiological with
alternating CT Chest and PET/CT scans every 3-4 months
for the first 2 years and 6 months interval afterwards.
Results
All patients treated were males, with age ranging from 50-
84 years old, mode of 79. All patients were unfit for
surgery except for one who refused surgery. Table 1
summarizes the patients’ data showing histology, tumor
size, location, and status after last FU. Eight out of ten
patients have shown either regression or no evidence of
disease (NED) since last FU, while 2/10 have stable
disease. One death occurred 15 months from treatment
due to unrelated causes, the patient was NED in his last
FU. The longest FU period so is 54 months for the first
patient treated.
Conclusion
The newly established SBRT clinical service in our country
serves as the only such treatment for inoperable lung
tumor for a population of about 10 million, including 2.7
million refugees. We have started recruiting inoperable
lung patients to the service at a slow pace to gain more
confidence and experience before admitting larger
numbers. One of the major unforeseeable difficulties was
the long term follow up, this is partly a result of
heterogeneity in patient population. Albeit the short FU,
early clinical results are encouraging with most treated
patients showing tumor regression or NED.
EP-1232 Patient-reported toxicity in twice-daily (BID)
versus once-daily (OD) chemoradiotherapy for LS-SCLC
J. Lodeweges1, A. Niezink1, H. Elzinga1, E. Haan-
Stijntjes1, N. Dollekamp1, O. Chouvalova 1, J. Ubbels1, M.
Woltman-van Iersel1, A. Van der Leest1, J. Langendijk1, J.
Widder1
1University Medical Center Groningen, Radiation
Oncology, Groningen, The Netherlands
Purpose or Objective
Survival results for limited-stage-SCLC are more
favourable for accelerated BID compared with OD
chemoradiotherapy (CRT) to nominally equal doses
(Turrisi et al. NEJM 1999), but were not further improved
by escalating once-daily doses from 45 Gy to 66 Gy
(CONVERT-trial). However, concerns regarding acute
toxicity with BID CRT do exist. We report prospectively
assessed patient-reported outcome measures (PROMs) on
dysphagia and dyspnea from an institutional cohort where
patients receive BID CRT as preferred treatment, and OD
in case of adverse patient- or tumour-related baseline
factors suggesting they would not tolerate the accelerated
schedule.
Material and Methods
All consecutive patients with LS-SCLC treated with
VMAT/IMRT or 3D-CRT between 2013 and 2016 within our
prospective data registration program (clinicaltrials.gov)
were included. The BID schedule was given in 3 weeks to
45 Gy (30*1.5 Gy), OD CRT was given in 5 weeks to 45–50
Gy (25*1.8–2.0 Gy), concurrent or sequential cisplatin-
etoposide was scheduled with both regimens. The primary
endpoint was PROM-dysphagia within (acute) and after 3
months of inclusion (late). Secondary endpoints were
PROM-dyspnea, physician-rated dysphagia, radiation
pneumonitis, and survival. Toxicities were related with
esophageal and pulmonary DVH-parameters, respectively.
Results