729 / 1082
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ESTRO 36 2017
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Conclusion
SBRT is safe and offers excellent in-field control. At 2
years after SBRT, 1 out of 3 patients is progression-free.
Further investigation is warranted to identify patients who
may benefit most from SBRT and to define the optimal
combination
with
ADT
EP-1343 Is stereotactic body radiation therapy a viable
option for elderly patients with prostate cancer?
C. Franzese
1
, G. D'agostino
1
, L. Di Brina
1
, L. Cozzi
1
, T.
Comito
1
, D. Franceschini
1
, F. De Rose
1
, P. Navarria
1
, E.
Clerici
1
, A. Ascolese
1
, A. Tozzi
1
, C. Iftode
1
, S. Tomatis
1
,
M. Scorsetti
1
1
Istituto Clinico Humanitas, Radiotherapy and
Radiosurgery, Rozzano Milan, Italy
Purpose or Objective
Data regarding the treatment of elderly patients with
prostate cancer show that Radiotherapy (RT) is
associated with a cancer specific mortality risk reduction
of 2.6% at 10 years, even after adjusting for several
confounders including 12 comorbid conditions. The aim
of the present study is to evaluate the efficacy and
toxicity of Stereotactic body radiation therapy (SBRT) in
a group of elderly patients affected by low and
intermediate risk prostate cancer.
Material and Methods
Patients aged ≥ 75 years, with biopsy-confirmed prostate
cancer were enrolled. Inclusion criteria were: initial
prostate-specific antigen (PSA) ≤ 20 ng/ml, Gleason Score
≤ 7, International Prostate Symptom Score ≤ 7. Gantry-
based SBRT was performed with Volumetric Modulated Arc
Therapy in its RapidArc form and flattening filter free
beams. The treatment schedule was 35 Gy in five fractions
delivered on alternate days. The PTV included the
prostate for low risk and prostate plus seminal vesicles for
intermediate risk, with a 5 mm margin in all other
directions. Toxicity was recorded according to CTCAE
criteria v4.0. Biochemical failure was calculated according
to the Phoenix definition. The Expanded Prostate Cancer
Index Composite questionnaire was used to record health-
related quality of life.
Results
From May 2012 to April 2016, 50 patients were enrolled.
Twenty-five patients were classified in low risk group and
25 in intermediate risk group. Mean age was 78 years old
(range 75 – 84); Gleason score was 6 in 26 and 7 in 24
patients. Median initial PSA was 6,43 (range 2,6 – 17).
Median follow-up was 26 months. Acute toxicity was mild.
Rectal toxicity was reported as grade 1 in 5 (10%) cases
and grade 2 in 1 (2%) cases; grade 1 and grade 2
genitourinary toxicity was described in 13 (26%) and 14
(28%) patients, respectively. In the late setting, 3 (6%)
patients reported rectal grade 1 toxicity. Genitourinary
late effects were reported as grade 1 in 13 (26%) patients
and grade 2 in 2 (4%) patient. Regarding outcome, median
nadir PSA was 0.51 ng/ml (range 0.01 – 3.12). Trend of PSA
is reported in Figure 1. No biochemical relapses were
observed during follow-up and all patients are alive at the
moment of the analysis.
Conclusion
Gantry-based SBRT with VMAT and FFFs can be considered
an effective, non-invasive and safe approach for elderly
patients affected by prostate cancer at low and
intermediate risk. Randomized trials comparing SBRT with
other approaches in this setting are necessary.
EP-1344 Long-term quality of life after high-dose-rate
brachytherapy boost for prostate cancer
W. Busser
1
, I. Korfage
2
, S. Aluwini
1
1
Erasmus MC Cancer Institute, Radiation Oncology,
Rotterdam, The Netherlands
2
Erasmus Medical Center, Public Health, Rotterdam, The
Netherlands
Purpose or Objective
Quality of life (QoL) of patients treated for prostate
cancer (PCa) is relevant because of the long survival of
these patients. We aimed to report late toxicity
incidences and generic and PCa-specific health-related
QoL and to investigate associations between toxicity and
QoL in patients treated with high-dose-rate brachytherapy
(HDR-BT) boost combined with external beam
radiotherapy (EBRT).
Material and Methods
264 low- and intermediate risk PCa patients were treated
between 2000-2007 with single implant HDR-BT boost (3x6
Gy) combined with EBRT (25x1.8 Gy). Of these, 171
patients with QoL data available with 6-10 years follow-up
(FU) were included. Late grade ≥2 gastrointestinal (GI) or
genitourinary (GU) toxicity was evaluated using physicians
charts and EORTC-RTOG toxicity questionnaire at 3, 6 and