ESTRO 36 Abstract Book

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S697 ESTRO 36 2017
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The outcomes of 42 completed NaF PET/CT studies are
outlined in Table 1. One patient underwent a NaF PET/CT
for staging of an unknown primary.
Conclusion
Accurate staging by way of adjunctive imaging is
important in the newly diagnosed patient cohort to aid
decisions regarding suitability for prostatectomy or radical
radiotherapy. Advanced staging beyond CT TAP and bone
scan is becoming more important in the metastatic setting
as more treatments become available. Determining the
burden of metastatic disease to direct treatment is also of
great importance.
Our figures showed that NaF PET CT changed the
management of 60% of patients overall.
A recurring theme, particularly in groups with first
suspected osseous metastases or suspected progression of
known osseous metastases, was that although NaF PET CT
was successful in finding more osseous metastases,
oftentimes patients were either not fit for, or refused,
further treatment. In addition a number of patients had
already commenced chemotherapy, ADT or hormonal
therapy prior to NaF PET CT, often based on rising PSA
level. In a significant number of cases also patients did not
have up to date standard staging i.e. bone scan and/or CT
thorax abdomen pelvis within three months of NaF PET,
which may have sufficed instead of advanced imaging in
certain cases.
NaF PET/CT is a useful additional imaging investigation in
clarifying the presence or absence of bone metastases in
scenarios of diagnostic uncertainty and it aided the
decision-making process regarding further therapeutic
strategies. However, care needs to be taken to use
advanced imaging in those where there is diagnostic
uncertainty and where treatment options still exist.
EP-1314 Changes in hormonal therapy during the first
24 months of treatment: a longitudinal cohort study
C. Hennequin1, D. Rossi2, M. Zerbib3, J.L. Moreau4, A.
Ruffion5 , Y. Neuzillet6, T. Lebret 6
1 Hôpital Saint-Louis, Department of Radiation Oncolgy,
Paris, France
2 Hôpital Nord, Urology department, Marseille, France
3 Hopital Cochin, Urology Department, Paris, France
4 Centre d'Urology, Urology department, Nancy, France
5 Centre Hospitalier Lyon Sud, Urology Department, Lyon,
France
6 Hôpital Foch, Urology department, Suresnes, France
Purpose or Objective
Data are limited showing changes in patients’ use of
androgen deprivation therapy (ADT) in routine clinical
practice. The objective of the study was to describe the
number and type of modifications of ADT during the first
24 months of treatment.
Material and Methods
In this non-interventional, longitudinal cohort study, we
assessed the number and type of modifications of ADT
during the first 24 months of treatment in France. At
baseline and every 6 months, we collected clinical,
biological and therapeutic data and any changes of ADT
modality.
Results
Between July 2011 and January 2015, 891 pts were
evaluable at 24 months. Mean age was 74.1±8.7 years.
Indications for ADT were: biochemical relapse after local
treatment (21.4%), adjuvant to radiotherapy (RT) (31.6%),
metastases (24.2%) and locally advanced tumour without
local treatment (20.6%). Gleason score was >7, 7(4+3), 7
(3+4) and <7 in 33.6%, 23.1%, 26% and 17.3%, respectively.
For the subgroup treated with ADT adjuvant to RT (279
pts), mean age was 71.4±6.9 yrs, and 72.8% had at least
one comorbidity. Gleason score was >7, 7(4+3), 7 (3+4) et
<7 in 28.2%, 23.5%, 32.5% and 15.9% of pts respectively.
At 24 months, modification of ADT was reported by 43.8%
of the whole population and by 37.6% of the subgroup
treated with ADT adjuvant to RT. The main types of
modification (% of whole population) concerned the
formulation (molecule or duration of action) (61.3%),
duration of ADT (10.5%), switch to intermittent treatment
(10.0%), addition of chemotherapy (5.6%) or second line
hormonal manipulation (9.0%). Modifications of ADT
according to indications are summarized in table below.
Clear explanation for adaptations was given for only 110
patients (whole population): disease progression: 55.5% ;
patient request: 26.4%, tolerance: 12.7% and failure of
castration: 7.3%.
Conclusion
Change of initial modality of ADT is frequent in the first
24 months of treatment (43.8%) and numerically more
frequent in presence of metastases or biochemical relapse
than when ADT is added to RT. Surprisingly, the main type
of modification is formulation. The main reported reason
for modification is disease progression
.
EP-1315 Prostate cancer lymph nodal disease: SBRT
only or extensive prophylactic irradiation and boost?
A. Fodor1, C. Sini2, C.L. Deantoni1, C. Fiorino2, C.
Cozzarini 1, B. Noris Chiorda1, I. Dell'Oca1, M. Picchio3, P.
Mangili2, E. Incerti3, R. Calandrino2, L. Gianolli3, N.G. Di
Muzio1
1San Raffaele Scientific Institute, Department of
Radiation Oncology, Milan, Italy
2San Raffaele Scientific Institute, Medical Physics, Milan,
Italy
3San Raffaele Scientific Institute, Department of Nuclear
Medicine, Milan, Italy
Purpose or Objective
Sensitivity and specificity of choline PET/CT is high on a
per patient basis, but not on a per lesion basis (positive
lymph nodes may be underdiagnosed). We report the
outcome of salvage radiotherapy, delivered with
TomoTherapy®(TT), in prostate cancer (PCa) patients
(pts) previously submitted to radical prostatectomy and
presenting persistent/ relapsing PSA and positive(+)
lymph-nodes(LN) at 11 C-choline PET/CT(PET), treated
with prophylactic TT on LN areas (pelvic/lombo-aortic,
LA) and simultaneous integrated boost(SIB) on PET+ LN.
Material and Methods
From March 2007-May 2013, 36 PCa pts treated with
radical prostatectomy (RP) +/- pelvic/LA LN
dissection(LND), and presenting +LN at PET, were treated
with TT. Analysis was restricted to oligometastatic
treatment-naïve PCa pts satisfying published selection
criteria for SBRT (Ost et al, Eur Urol 2016), including also