ESTRO 36 Abstract Book

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S740 ESTRO 36 2017
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Material and Methods
Treatment results of 40 patients (8 female, 32 male) in
median age 60 years (from 40-84 years), with primary
cutaneous T-cell lymphoma (mycosis fungoides), stage IB-
III, treated between 2001 and 2013 were reviewed. All
patients were symptomatic. The median total dose was
32Gy (range 12-40Gy), applied with 1,5 Gy per day four
times weekly for the whole skin.
Results
The median follow-up was 60 months. A clinical complete
response was documented in 29 (72.5%) and a partial
response in 11 patients (27.5%). The clinical response
significantly influenced on the overall survival (OS)
(p=0.002) and progression-free survival (PFS) (p<0.001).
The mean OS was 76 months. The mean PFS was 48.9
months and the actuarial one-, two- year PFS were 67.5%,
55%. The statistically significant correlation was found
between partial and total remission time and the stages
of lymphoma (p=0.015). The side effects were observed in
all patients during the treatment and include: erythema,
skin dryness and desquamation, pruritus, onycholysis and
alopecia.
Conclusion
For palliation of symptomatic cutaneous lymphoma, total
skin electron beam therapy is well tolerated and an
efficient treatment.
EP-1400 Quality of Life in Responders after Palliative
Radiation Therapy for Painful Bone Metastases
L.C. Mendez1, J.L. Padilha2, K.M. Lima 3, E. Chow1, F.Y.
Moraes 4, M.D.P.E. Esteves5, M.F. Silva2, G.N. Marta6,7
1 Sunnybrook Odette Cancer Centre- University of
Toronto-, Radiation Oncology, Toronto, Canada
2 Universidade Federal de Santa Maria, Radiation
Oncology, Santa Maria, Brazil
3 Faculdade de Medicina da Universidade de São Paulo,
Radiation Oncology, Sao Paulo, Brazil
4 Princess Margaret Cancer - University of Toronto,
Radiation Oncology, Sao Paulo, Canada
5 Instituto do Câncer do Estado de São Paulo ICESP -
Faculdade de Medicina da Universidade de São Paulo,
Clinical Oncology, Sao Paulo, Brazil
6 Hospital Sírio-Libanês, Radiation Oncology, São Paulo,
Brazil
7 Instituto do Câncer do Estado de São Paulo ICESP -
Faculdade de Medicina da Universidade de São Paulo,
Radiation Oncology, Sao Paulo, Brazil
Purpose or Objective
Bone metastases cause pain, suffering and impaired
quality of life (QOL). Palliative radiotherapy (RT) is an
effective method in controlling pain, reducing analgesics
use and improving QOL. This study goal was to investigate
the changes in QOL scores among patients who responded
to RT.
Material and Methods
A prospective study evaluating the role of radiation
therapy in a public hospital in São Paulo-Brazil recorded
patients’ opioid use, pain score, Portuguese version of
QLQ-BM22 and QLQ-C30 before and 2 months after
radiotherapy. Analgesic use and pain score were used to
calculate international pain response category. Overall
response was defined as the sum of complete response
(CR) and partial response (PR). CR was defined as pain
score of 0 with no increase in analgesic intake whereas PR
was defined as pain reduction ≥ 2 without analgesic
increase or analgesic reduction in ≥25% without increase
in pain at the treated site.
Results
From September 2014 to October 2015, 25 patients with
bone metastases responded to RT (1 CR, 24PR). There
were 8 male and 17 female patients. The median age and
ECOG of the 25 patients was 57 years old (range 22 to 89)
and 2 (range 0 to 3), respectively. Patient’s primary
cancer site was breast (11), prostate (5), lung (2), others
(7). For QLQ-BM 22, the mean scores of 4 categories at
baseline were: Pain site (PS) 39, Pain characteristics (PC)
61, Function Interference (FI) 49 and Psycho-social aspects
(PA) 57. At 2 month follow up, the scores were PS 27, PC
37, FI 70 and PA 59. Statistical significant improvement
(p<0.05) was seen in PS, PC, FI but not PA. In the QLQ-
C30, the mean scores were not statistically different for
all categories, except for pain that demonstrated a 29
point decrease in the pain score domain (69 to 40).
Conclusion
Responders to RT at 2 month presented improvement in
BM22 and C30 pain domains, and also improvement in
functional interference if BM22 questionnaire. Patients
with painful bone metastases may receive palliative
radiation therapy to improve both pain and QOL.
EP-1401 SBRT for solitary extracranial metastases from
gynecologic malignancies
M.C. Repka1, N. Aghdam1, S. Suy1, S.P. Collins 1, W.
Barnes 2, B.T. Collins1
1Georgetown University Hospital, Department of
Radiation Medicine, Washington, USA
2Georgetown University Hospital, Division of Gynecologic
Oncology, Washington, USA
Purpose or Objective
Solitary extracranial metastases from gynecologic
malignancies have historically been treated with either
surgery or conventional radiation therapy. We report
mature local control, toxicity, and survival for patients
who received five-fraction stereotactic body radiation
therapy (SBRT) at our institution.
Material and Methods
Patients presenting with biopsy-proven, solitary, small (<5
cm) extracranial metastasis from a gynecologic primary
cancer, treated with robotic SBRT, were retrospectively
reviewed. Vaginal cuff recurrences or multiple sites of
disease were considered exclusion criteria for this
analysis. Patients were stratified by the presence or
absence of sarcomatous histology. The Kaplan-Meier
method was used to estimate local control and overall
survival. Durable local control was defined as lasting ≥12
months. Toxicity was scored per the CTC-AE v4.0.
Results
Twenty patients were treated over a five year period from
July 2007 to July 2012 for solitary extracranial metastases
from gynecologic malignancies. Sixteen patients were
noted to have non-sarcomatous histology (six uterine and
ten ovarian primary tumors), while four tumors were
identified as sarcoma (all uterine primaries). No patients
with solitary cervical cancer metastases were identified.
Metastases involved the liver, lung, abdomen, spine,
pelvis, and extremity. Thirteen patients had fiducials
placed for tumor tracking; abdominal and spine
metastases were tracked with a fiducial-less spinal
tracking system. The median gross tumor volume (GTV)
was 42.5 cc (range: 5 - 273 cc). The median dose delivered
to the GTV was 35 Gy (range: 30 - 50 Gy) over 5 to 9 days
(median: 6 days). At a median follow-up of 56 months
(range: 6 - 108 months), the 5-year local control and
overall survival rates were 71.2% and 47.5% respectively.
However, when stratified by histology, the local control at
5 years was 93.7% in patients with classical histology
versus 25.0% in patients with metastatic gynecologic
sarcoma (p < 0.01) and only 50.0% of the sarcoma patients
experienced durable local control. No grade 3 or higher
toxicity was observed during or following treatment.
Conclusion
Five-fraction SBRT is a versatile, well-tolerated, and
highly effective treatment option for small extracranial
gynecologic metastases with an excellent 5-year local
control of 93.7% in patients with classical ovarian and
uterine primary tumors. However, patients with
metastatic uterine sarcoma may require a more aggressive
or alternative treatment approach.