ESTRO 36 Abstract Book

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S666 ESTRO 36 2017
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calculated. Univariate analysis was perform out to
determine impact of total dose, GTV at treatment, use of
systemic chemotherapy, primary tumour type, baseline
liver function status, age and viral marker status on
normal liver volume and liver function during follow up.
Reduction in liver volume at follow-ups were analysed
with paired t-test. p value of <0.05 was considered
significant.
Results
Thirteen patients received either SBRT or HDRT. Out of
these 6/7 patients with HCC received TACE prior to RT
initiation and all received sorafenib while 3/4 with CCA
received gemcitabine and cisplatin concurrently with
radiation. Another 2 were treated for LM. The Median BED
was 59.5 Gy (48 - 85.5 Gy). The follow up scans were
performed at 1 month and 4 monthly thereafter. The
median normal liver volume at baseline, 1st, 2 nd and 3rd
follow up was 1105 (423-2100) cc, 918 (614 - 1899) cc, 778
(490 - 1746) cc and 816 (576 - 2101) cc for the entire
cohort and 1098 (423 – 2100) cc, 886 (614 – 1899) cc, 778
(490 - 1746) cc and 750 (576 – 1136) cc for patients with
primary hepatic malignancy (PHM). The reduction in liver
volume was statistically significant at 4 months (p=0.05)
in entire cohort. In PHM cohort, at 4 and 8 months
reduction in liver volume were found significant (p=0.05
and p=0.05, respectively). Deterioration of Childs score
was presented in 2/13 patients. This loss in liver function
could represent ongoing radiation effects on
compensatory liver hypertrophy or hepatocyte
regeneration. However no correlation was seen between
child score deterioration and loss of liver volume.
On univariate analysis, the higher normal liver volume at
baseline irradiated shows statistically significantly higher
loss of liver volume (p=0.005). None of other tumour or
treatment related factors had impact on liver volume
changes.
Conclusion
The reduction in liver volume at follow up does not
correlate with any tumour or treatment parameters other
than normal liver volume at baseline. This ongoing loss of
hepatic function and reduced hepatocyte regeneration
after hepatic radiation needs further investigation.
EP-1250 Prognostic impact of post-surgery and post-
adjuvant therapy in resected pancreatic
adenocarcinoma
G.C. Mattiucci1, A. Arcelli2,3, F. Bertini2, F.A. Calvo4, M.
Falconi5 , G.P. Frezza3, A. Guido2, J.M. Herman6, R.C.
Miller7, V. Picardi8 , G. Macchia8, W.F. Regine9, N.
Sharma9, M. Reni10, A. Farioli11, A.G. Morganti 2, V.
Valentini1
1 Policlinico Universitario "A. Gemelli"- Università
Cattolica del Sacro Cuore, Department of Radiotherapy,
Rome, Italy
2 University of Bologna, Radiation Oncology Center-
Department of Experimental Diagnostic and Speciality
Medicine - DIMES, Bologna, Italy
3 Ospedale Bellaria, Radiotherapy Department, Bologna,
Italy
4 Hospital General Universitario Gregorio Maranon-
Complutense University, Department of Oncology,
Madrid, Spain
5 Università Politecnica delle Marche, Department of
Surgery, Ancona, Italy
6 Johns Hopkins University School of Medicine,
Department of Radiation Oncology and Molecular
Radiation Sciences, Baltimore, USA
7 Univeristy of Virginia, Department of Radiation
Oncology, Charlottesville, USA
8 Fondazione di Ricerca e Cura "Giovanni Paolo II",
Radiotherapy Unit, Campobasso, Italy
9 University of Maryland Medical Center, Department of
Radiation Oncology, Baltimore, USA
10 S. Raffaele Scientific Institute, Department of
Oncology, Milan, Italy
11University of Bologna, Department of Medical and
Surgical Sciences - DIMEC, Bologna, Italy
Purpose or Objective
Prognosis of pancreatic adenocarcinoma (PAC) is so dismal
that annual mortality and incidence rates overlap. Several
studies suggested that preoperative CA19.9 (prCA19.9)
could be a useful prognostic marker in patients treated
with surgery +/- adjuvant therapies. The purpose of this
study was to determine whether post-surgical CA19.9
(poCA19.9) or post-adjuvant CA19.9 (paCA19.9) or a
change in prCA19.9 to poCA19.9 could predict pattern of
failure in terms of local control (LC) and metastasis-free
survival (DMFS).
Material and Methods
We performed a multicenter retrospective study and we
selected for this analysis 67 pts Antigen Lewis positive
(prCA19.9 > 5U/ml), judged to be secretors of CA19.9. We
used the Kaplan-Meier method and the log-rank test to
investigate differences in LC and DMFS between groups
defined based on clinical and pathological factors,
different poCA 19.9 cutoff (37, 100 U/mL), paCA 19.9
cutoff (37 U/mL), and differences (%) between prCA19.9
and poCA19.9 levels.
Results
Demographic data and results are shown in Table 1.
Median follow-up (FU) was 18 months (2-225). At
univariate analysis, levels of poCA19.9 >37 U/ml (p=
0.009) or >100 (p< 0.001) and levels of paCA19.9 >37 U/ml
(p= 0.009) were significantly associated with a worse
DMFS. A change in prCA19.9 to poCA19.9 did not impact
LC and DMFS. CRT did not impact pattern of failure in the
whole patients population. Only in patients with poCA19.9
> 37 U/ml CRT significantly affected LC (63.6% for patients
treated with CRT vs 40.0% for patients not treated with
CRT; p = 0.008).
Conclusion
Monitoring CA19.9 seems a useful parameter to modulate
the management of PAC patients in terms of choice of
adjuvant treatment and follow-up intensity.
EP-1251 Safety and Efficacy of Preoperative
Chemoradiotherapy in Patients with Locally Advanced
EGJ Cancer
Y. Li1, X. Li1, Y. Zhang1, J. Geng 1, Y. Cai 1, Z. Li2, K. Hu 3,
J. Yu 4, J. Jin5, D. Zhao 6, B. Qu7, L. Chen 8, J. JI2
1Key laboratory of Carcinogenesis and Translational