740 / 1082
S724
ESTRO 36 2017
_______________________________________________________________________________________________
difference in bPFS between uIR patients and fHR patients
(p = 0.462). Rates of PSA recurrence in uHR patients were
significantly different from fHR, as noted above, as well
as with fIR (p = 0.031) while not from uIR (p=0.070).
Conclusion
When taking into account clinical sub-stages and biopsy
core involvement there was not a significant difference in
bPFS between unfavorable IR patients and favorable HR
patients where only one HR risk factor is present. The
presence of a single HR risk factor may not be as
detrimental to prognosis as previously thought, while
multiple IR risk factors or significant core involvement
may alter outlook for patients in the IR group. Due to the
median follow up of this study biochemical recurrence was
used as the primary endpoint which makes direct
comparison to studies using prostate cancer specific
mortality difficult; additional evaluation using such
endpoints is warranted.
EP-1365 Pure Hypofractionated Radiotherapy for the
Treatment of Low- to Intermediate-Risk Prostate Cancer
R. Stephens
1
, D. Gopaul
2
, D. Panjwani
2
, M. Lock
3
1
Grand River Regional Cancer Centre, Oncology,
Kitchener, Canada
2
Grand River Hospital, Oncology, Kitchener, Canada
3
London Health Sciences Centre, Oncology, London,
Canada
Purpose or Objective
Radiotherapy for prostate cancer may benefit from
hypofractionation
1-13
. Conventional radiotherapy for
prostate cancer involves delivering daily 1.8 -2.0 Gy
fractions over 9 weeks. All of the hypofractionation
studies completed to-date involve delivering fewer
fractions of 2.5-3.1 Gy daily for 4 to 5 weeks (i.e., they
are accelerated).
The purpose of our prospective phase II clinical trial was
to determine whether the use of hypofractionated
radiotherapy schedules (i.e., fewer, larger fractions)
without acceleration could lead to reductions in the
incidence of late toxicity symptoms, while still retaining
benefits in disease control.
Material and Methods
Prostate cancer patients at Grand River Regional Cancer
Centre were screened for the study, and those that met
eligibility criteria were enrolled. Written informed
consent was obtained. Radiation therapy was delivered
using either 3DCRT or IMRT. Patients were categorized as
low risk or intermediate risk according to D'Amico
criteria
14
. Low risk patients received a total dose of 50 Gy
/ 15 fx over 7 weeks, and intermediate risk patients
received 60 Gy / 20 fx over 8 weeks. Neoadjuvant or
adjuvant ADT was not used.
Follow-up involved bi-annual PSA measurements and
toxicity grading. Freedom from biochemical failure (FFBF)
was determined using the Phoenix definition
15
. Late
toxicity scoring was based upon RTOG/EORTC Late
Radiation Morbidity Criteria
16
.
Using Microsoft® Office Excel® 2007 (Microsoft, Redmond,
WA) demographic information and outcome frequencies
were analysed. Actuarial analysis for freedom from
biochemical failure (FFBF), late gastrointestinal (GI)
toxicity, late genitourinary (GU) toxicity, freedom from
evidence of metastatic disease, and overall survival were
generated using in IBM® SPSS® Statistics Version 21.0 (IBM
Corporation, North Castle, NY).
Results
There were 216 prostate cancer patients that met
eligibility criteria and were enrolled in the study. 209
patients were included in the long-term analysis after 10
years of follow-up. The median follow-up was 6.5 years.
Of the 209 patients enrolled, 53 patients were categorized
as low risk and 156 patients as intermediate risk. Table 1
summarizes the incidence of outcome events at the end of
the 10-year follow-up period.
Actuarial analysis (Figure 1) provided 5 year rates of late
GI toxicity ≥ RTOG grade 2 of 4.3% in low risk patients and
7.5% in intermediate risk patients. Late GU toxicity rates
were 8.6% in the low risk group and 7.6% in the
intermediate group. 5 year FFBF rates were 85.1% in low
risk patients and 80.1% in intermediate risk patients. The
5 year freedom-from-evidence-of-metastatic disease rates
for low and intermediate risk prostate cancer patients
were 4.2% and 4.8%, respectively.
Conclusion
Compared to accelerated hypofractionated schedules
2-11
,
hypofractionation without acceleration resulted in similar
rates of late GI toxicities, late GU toxicities, and 5 year
FFBF rates (see Table 1).
Electronic Poster: Clinical track: Urology-non-prostate
EP-1366 Radiotherapy aimed at functional preservation
in patients with small cell carcinoma of the bladder.
H. Akamatsu
1
, K. Nakamura
2
, T. Ebara
3
, K. Inaba
4
, S.
Itasaka
5
, K. Jingu
6
, Y. Kosaka
7
, T. Murai
8
, K. Nagata
9
, T.
Soejima
10
, S. Takahashi
11
, T. Toyoda
12
, S. Toyoshima
13
, K.
Nemoto
1
, T. Akimoto
14
1
Yamagata University School Faculty of Medicine,
Department of Radiation Oncology, Yamagata, Japan
2
Hamamatsu University School of Medicine, Department
of Radiation Oncology, Yamagata, Japan
3
Gunma Prefectural Cancer Center, Department of
Radiation Oncology, Ota, Japan
4
National Cancer Center Hospital, Department of
Radiation Oncology, Tokyo, Japan
5
Kurashiki Central Hospital, Department of Radiation
Oncology, Kurashiki, Japan
6
Tohoku University Graduate School of Medicine,
Department of Radiation Oncology, Sendai, Japan
7
Kobe City Medical Center General Hospital, Department
of Radiation Oncology, Kobe, Japan
8
Nagoya City University, Department of Radiation
Oncology, Nagoya, Japan
9
Ishikiriseiki Hospital, Department of Radiation
Oncology, Higashi Osaka, Japan
10
Hyogo Cancer Center, Department of Radiation
Oncology, Akashi, Japan
11
Kagawa University Hospital, Department of Radiation
Oncology, Kita-gun, Japan
12
NTT Medical Center Tokyo, Department of Radiation
Oncology, Tokyo, Japan
13
Toyama Prefectural Central Hospital, Department of
Radiation Oncology, Toyama, Japan
14
National Cancer Research Hospital East, Department of
Radiation Oncology, Kashiwa, Japan
Purpose or Objective
Small cell carcinoma of the bladder (SCCB) is extremely
rare, accounting for less than 1% of malignant tumors in
the urinary tract. Because of its rarity, standard therapy
has not been established. We conducted the first national
survey in Japan on radiotherapy aimed at functional
preservation in patients with small cell carcinoma of the
bladder.
Material and Methods
Data were obtained for treatments and outcomes in
patients with a diagnosis of SCCB who received
radiotherapy aimed at functional preservation in the
period from 1990 to 2010. A multi-center retrospective
analysis of 15 eligible cases was performed.
Results
The median age of the patients was 72 years (range: 44-
93 years), and the median follow-up period was 17.4
months (range: 2.7-117.8 months). The median dose was
55 Gy (range: 40.0-61.0 Gy), and a median of 2.0 Gy
(range: 1.2-2.0 Gy) was given per fraction. Initial CTV
(clinical treatment volume) in most cases was the whole