710 / 1082
S694
ESTRO 36 2017
_______________________________________________________________________________________________
Lymphocyte-
to-Monocyte
ratio (LMR)
112
4.6
(1.14-
12.5)
<5.
0 vs
≥5.
0
8 vs 2
56.5
vs
63.8
,036
(4.42)
Neutrophil-to-
Lymphocyte
ratio (NLR)
131
3.8
(0.11-
22.6)
<2.
5 vs
≥2.
5
2 vs
10
63.5
vs
56.3
,008
(7.1)
Platelet-to-
Lymphocyte
ratio (PLR)
129
160
(11.8-
647.0)
<30
0 vs
≥30
0
9 vs 3
61.5
vs
33.0
.000(1
3.4)
Platelet*Neutr
ophils-to-
Lymphocyte
(SII)
129
906.5(2
7.2-
5094.3)
<20
00
vs
≥20
00
9 vs 3
61.4
vs
40.9
.003(9.
1)
Conclusion
Preoperative NLR, LMR, PLR and SII are predictive factors
for Overall Survival in endometrial carcinoma. To our
knowledge, this is the first publication describing
predictive value of SII in endometrial carcinoma.
Electronic Poster: Clinical track: Prostate
EP-1308 A prospective trial of hypofractionation
salvage radiation therapy after radical prostatectomy
P. Bulychkin
1
, S. Tkachev
1
, A. Nazarenko
1
1
Federal State Budgetary Institution “N. N. Blokhin
Russian Cancer Research Center”- the Ministry of Health
of the Russian Federation, Department of radiation
oncology, Moscow, Russian Federation
Purpose or Objective
to estimate and compare local control (LC), disease – free
survival (DFS), overall survival (OS) and toxicity
of hypofractionation (HF) and classical fractionation (CF)
salvage radiation therapy (SRT) in treatment of patients
with biochemical and clinical recurrences of prostate
cancer (PCa) after radical prostatectomy (RP).
Material and Methods
patients with biochemical and clinical recurrences of PCa
after RP were divided in two groups. The first one is a
group of patients who were treated by HF SRT. HF
radiotherapy have been prescribed to the regional
lymphatic nodes to 46.8 Gy of 1.8 Gy, to the prostate bed
to 61.1 Gy of 2.35 Gy and to recurrent lesions detected by
multi-parametric magnetic resonance imaging (MRI) 65 Gy
of 2.5 Gy in 26 fractions using simultaneous integrated
boost (SIB). The second one is a group of patients who
were treated by CF SRT. CF radiotherapy have been
prescribed to the regional lymphatic nodes to 44 Gy, to
the prostate bed to 66 Gy and if region of clinical
recurrence identified to 72 Gy in 33 – 36 fractions.
Results
median follow up for all 92 patients was 40 (12 – 78)
months. OS – 100%. LC – 100%. The rates of 1, 2 and 3 year
DFS were 96 %, 91 % and 86 %. The rates of 1, 2 and 3 year
DFS were 98%, 95 % and 89 % in group of patients who were
treated by HF SRT. The rates of 1, 2 and 3 year DFS were
95%, 87% and 84% in group of patients who were treated
by CF SRT. We have not received statistical significance in
DFS between the two groups (p = 0.125). On multivariate
analysis, PSA doubling time ≤ 6 months (p = 0.035) and
PSA > 0.5 ng/ml before SRT (p = 0.037) statistical
significance associated with biochemical failure. We
received a trend to an increase number of patients with
symptoms acute gastrointestinal (GI) (p = 0.057) and
genitourinary (GU) (p = 0.07) toxicities 2 grade in the
group of HF SRT. But we have not received statistical
significance in late (3 and more months) GI and GU
toxicities between two groups.
Conclusion
post-prostatectomy SRT, when using CF, requires 33 – 36
fractions. We would like to suggest a new differentiated
approach of hypofractionation radiotherapy for patients
with recurrence PCa after RP which demonstrates
encouraging efficacy at 3 years without increasing level of
late toxicities and reduces the length of treatment by
from 21% – 28%.
EP-1309 Is it necessary to make a re-plan during IMRT
for prostate cancer due to change in prostate size?
O. Tanaka
1
, H. Komeda
2
, T. Iida
1
, M. Tamaki
2
, K. Seike
2
,
T. Yokoyama
1
, D. Kawaguchi
1
, S. Hirose
1
, S. Fujimoto
2
1
Gifu Municipal Hospital, Department of Radiation
Oncology, Gifu, Japan
2
Gifu Municipal Hospital, Department of Urology, Gifu,
Japan
Purpose or Objective
Intensity-modulated radiotherapy (IMRT) is a widely used
treatment modality for prostate cancer. The technique
helps deliver the prescribed dose to the target volume
with minimal radiation exposure of the organs at risk
(OAR).
Gunnlaugsson et al. reported a significant increase in
mean prostate volume (14%) at mid-point of the
radiotherapy course as compared to that at baseline. The
increase in mean prostate volume tended to persist during
the radiotherapy course; the mean prostate volume at the
completion of the radiotherapy was 9% higher than that at
baseline. The increase in prostate volume was most
pronounced in the anterior-posterior and cranio-caudal
axes.
However, most of the data used emanated from studies
conducted in Europe and America, while data based on
Asian population has been largely lacking. Tanaka et al.
measured prostatic size prior to prostate cancer
brachytherapy and reported mean prostate volume of
approximately 16 cc (including data from patients who had
received neoadjuvant hormonal therapy). The
implications of change in prostate size for IMRT planning
in patients with small prostate glands are not known.
Therefore, we evaluated the relatively small changes in
size of prostate during IMRT using MRI.
Material and Methods
A total of 24 consecutive patients with prostate cancer
were enrolled in the study. None of the patients received
hormone treatment (neoadjuvant therapy) either prior to
or during the course of radiotherapy. Two gold fiducial
markers were placed on the prostate before a CT/MRI
examination at 3 weeks. MR imaging was performed at
three timepoints. The initial MRI was performed prior to
the start of radiotherapy. Second MRI was performed at 38
Gy (range: 36–40 Gy), which represented the halfway point
of the radiotherapy course. The last MRI was performed at
the completion of the radiotherapy course.
An example of the time course of prostate volume change.