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S712
ESTRO 36 2017
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questionnaire at 3months 6months and then every 6
months. A minimally clinically important change (MCIC)
definition was triggered if the EPIC QOL score at each time
point decreases > 0.5 SD, where SD is the standard
deviation of baseline scores.
Results
Thirty-three patients (NCCN 6.0% low IR, 45.5% high IR and
48.5% HR) completed the planned treatment with a
median follow-up of 13.8 months (IQR 12.1, 18.8). The
incidence of worst toxicities is shown in Table 1. The 3
grade 3 GU patients were due to temporary urinary
catheterization in the acute period following HDR-BT.
Mean (95% SD) EPIC urinary QOL scores were 82.5 (16.5),
83.2 (12.9) and 83.7 (16.3) at baseline, 3 months and 12
months and the bowel scores were 95.9 (3.8), 92.6(8.2)
and 90.5 (8.3), respectively. Proportion of patients
experiencing MCIC at 3 months and 12 months were 20.8%
and 14.3% for urinary domain, 47.8% and 53.9% for bowel
domain; respectively.
DOMAIN
TIMING
GRADE
2(%)
GRADE
3(%)
QOL
MCIC(%)
GENIOURINARY
Acute 45.2% 9.7%
20.8%
Late 12.9% 0%
14.3%
GASTROINTESTINAL
Acute 9.7%
0%
47.8%
Late 0%
0%
53.9%
Conclusion
This novel treatment protocol incorporating MRI dose
painted HDR brachytherapy boost and SABR pelvic
radiation for intermediate- and high-risk prostate cancer
in combination with ADT is feasible and well tolerated in
the acute setting.
EP-1342 Salvage stereotactic body radiotherapy for
lymph node oligorecurrent prostate cancer
G. Fanetti
1
, C. Fodor
2
, D. Ciardo
2
, L. Santoro
3
, C.M.
Francia
1
, M. Muto
4
, A. Surgo
4
, D. Zerini
2
, G. Marvaso
2
, G.
Timon
5
, P. Romanelli
2
, E. Rondi
6
, S. Comi
6
, F. Cattani
6
,
D.V. Matei
7
, M. Ferro
7
, G. Musi
7
, F. Nolè
8
, O. De Cobelli
7
,
P. Ost
9
, R. Orecchia
10
, B.A. Jereczek-Fossa
1
1
European Institute of Oncology - University of Milan,
Department of Radiation Oncology, Milan, Italy
2
European Institute of Oncology, Department of
Radiation Oncology, Milan, Italy
3
European Institute of Oncology, Department of
Epidemiology and Statistics affiliation at the time of the
study, Milan, Italy
4
European Institute of Oncology - University of Milan,
Department of Radiation Oncology affiliation at the time
of the study, Milan, Italy
5
European Institute of Oncology, Department of
Radiation Oncology affiliation at the time of the study,
Milan, Italy
6
European Institute of Oncology, Unit of Medical Physics,
Milan, Italy
7
European Institute of Oncology, Department of Urology,
Milan, Italy
8
European Institute of Oncology, Department of Medical
Oncology- Division of Urogenital and Head & Neck
Tumours, Milan, Italy
9
Ghent University Hospital, Department of Radiation
Oncology, Ghent, Belgium
10
European Institute of Oncology - University of Milan,
Department of Medical Imaging and Radiation Science,
Milan, Italy
Purpose or Objective
To evaluate the PSA response, progression free survival
(PFS), local control and toxicity of stereotactic body
radiotherapy (SBRT) for lymph-node (LN) oligorecurrent
prostate cancer.
Material and Methods
We retrospectively reviewed 95 patients with LN
oligorecurrent prostate cancer treated between 05/2012
and 10/2015. We evaluated biochemical response with
PSA dosage every 3 months after SBRT: considering the
pre-SBRT PSA as reference, a decrease in PSA of more than
10% identified responder patient, whereas an increase of
more than 10% identified a biochemical progression. The
other cases were classified as PSA stabilization. In case of
PSA increase during the follow-up, imaging was performed
to evaluate clinical progression. Toxicities were assessed
with clinical examination every 6-9 months: acute
toxicities were reported in the first 6 months after SBRT.
Results
A hundred twenty-seven lesions were treated in 95
patients with a median dose of 24 Gy given in 3 fractions.
Median pre-SBRT PSA was 3.5 ng/mL. Seventy patients
were treated for a single lesion, 25 for 2-4 lesions. In 9
patients SBRT was performed as a re-irradiation. In 35
patients androgen deprivation therapy (ADT) was added to
SBRT. Median follow-up was 18.5 months
.
One patient was
not valuable due to short follow-up. Biochemical
response, stabilization and progression were observed in
64 (68.1%), 10 (10.6%) and 20 (21.3%) out of 94 patients.
In the 57 patients treated with salvage SBRT alone (with
no concomitant therapy), biochemical response,
stabilization and progression were observed in 38 (66.7%),
9 (15.8%) and 10 (17.5%) cases, respectively. In 17 patients
(29.8%) with progressive disease after SBRT, ADT started
in a median time of 7.2 months (range 2.4–32.1). Clinical
progression was observed in 31 patients (33.0%) after 15
months (median time). In-field progression occurred in 12
lesions (9.4%). 2-year local control and PFS rates were 84%
and 30%, respectively (fig. 1-2). Age>75years correlated
with better biochemical response rate. Age>75years,
concomitant ADT administered up to 12 months and pelvic
LN involvement correlated with longer PFS. Acute toxicity
included urinary (6 and 1 G1 and G2 events, respectively)
and rectal events (1 G1 event). Late toxicity included
urinary (2 G1 and 3 G2 events). All toxicities were reported
in patients treated for pelvic LN. No toxicity were
reported in patients with extra-pelvic LN. At the time of
the analysis, 32 (34.0%) patients are alive with no
evidence of disease, 60 (63.8%) are alive with clinically
evident disease, 2 patients (2.1%) died.