ESTRO 36 Abstract Book

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S754 ESTRO 36 2017
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In this modern era of precision radiation therapy
treatment planning, peer review of the planning process
has a vital role. Peer review of treatment plans among
radiation oncologist improves the process and
recommended changes can be incorporated in the the
treatment plans in a timely manner. The study shows that
the review of treatment plans is a necessary quality step
in radiation therapy and can be done on a weekly basis for
all the patients. Hence, the quality of planning is improved
in a resource limited university hospital.
EP-1428 Stereotactic body radiotherapy for isolated
metastasis from different primitive tumors
A. Lancia1, G. Ingrosso1, A. Carosi1, L. Di Murro1, E.
Giudice1, S. Cicchetti1, P. Morelli1, C. Bruni1, D. Di
Cristino1, A. Murgia1, A. Cancelli1, I. Turturici1, A.
Iadevaia1 , R. Santoni1
1 Tor Vergata University Hospital, Department of
Diagnostic Imaging- Molecular Imaging- Interventional
Radiology and Radiotherapy, Roma, Italy
Purpose or Objective
The oligometastatic state identifies a subset of patients
who might be amenable to curative therapy. In this
specific group of patients, Stereotactic Body Radiation
Therapy (SBRT) has been shown to reach high levels of
local tumor control through the delivery of high doses of
radiation in few fractions, without the development of
significant toxicity. Any meaningful improvement in
survival remains debatable.
Material and Methods
From July 2007 to March 2016, 78 patients were treated
at our Department with Stereotactic Radiotherapy for
isolated body metastasis. The most frequent primary
tumor was prostate cancer (28.2%), followed by colorectal
cancer (23.1%), and lung cancer (20.5%). All patients
received a radical treatment to the primary tumor site .
Median time from primary tumor treatment to SBRT for
oligometastatic disease was 30.3 months (range 1.07-
232.3). No patient had synchronous metastases at the time
of SBRT. Median age at diagnosis of oligometastatic
disease was 70 years (range 47-88). Median Karnofsky
Performance Status (KPS) was 90 (range 70-100). Patients
were also evaluated in terms of Charlson Comorbidity
Score (CCS). The most used SBRT dose fractionation
scheme was 35 Gy in 5 fractions. Overall Survival (OS),
Cancer-Specific Survival (CSS), and Local Control (LC)
were calculated from the end date of SBRT to the end of
follow-up; Progression-Free Survival (PFS) was calculated
from the end date of SBRT to the first clinical progression.
Treatment related toxicity was evaluated using the CTCAE
version 4.0.
Results
Median follow-up was 22.68 months (range 1.9-95.73).
One year and 2 years LC were 91% and 89%, respectively.
At the time of analysis, thirty-one patients (39.7%) were
free from local and systemic progression: one and 2-year
PFS were 85% and 72%, respectively. CSS at one year was
93% and it was 85% at two years. One and 2-year OS were
92% and 82%, respectively . At the univariate analysis, we
found that KPS ≥ 80 was a statistically significant
prognostic factor for OS, and PFS (p=0.001 for both). OS
was also influenced by the primitive tumor (p=0.006). 8
(10.2%) patients developed acute toxicity >2, while 5
patients (6.4%) developed late toxicity >2.
Conclusion
SBRT is a safe and effective management option for the
control of oligometastatic disease . This therapeutic
approach can have an important role in delaying disease
progression. Toxicity seems to be moderate in most cases
EP-1429 maintaining efficacy of low-dose radiotherapy
on pain and function in degenerative skeletal diseases
B. Alvarez1, A. Montero1, E. Sanchez1, R. Ciervide1, F.
Aramburu2, M. Hernández1, M. López1, S. Rodríguez2, M.
Valero 2, J.J. Valero1, M. García-Aranda1, E. Calvo2, O.
Hernando1, X. Chen1, R. Alonso3, P. García de la Peña2,
C. Rubio1
1Hospital universitario hm madrid sanchinarro, Radiation
Oncology, Madrid, Spain
2Hospital universitario hm Madrid sanchinarro,
rheumatology, Madrid, Spain
3Hospital universitario hm puerta del sur, radiation
oncology, madrid, Spain
Purpose or Objective
to evaluate feasibility and duration of response induced by
low dose radiotherapy (RT) in patients with painful
degenerative diseases comprising enthesiopathies or
osteoarthritis refractory to any conventional treatment.
Material and Methods
From April 2015 to October 2016, 53 patients with painful
skeletal disorders of different locations were treated; 16
(30%) patients were monitored for more than six months.
The pain was evaluated before radiotherapy and 6 weeks
after treatment according to the visual analogue pain
scale (VAS) and the requirements of daily oral analgesic
intake.
All patients underwent CT simulation and were treated in
a conventional linac. PTV included the affected joint and
periarticular soft tissues. Prescribed dose to the PTV was
6 Gy at 1Gy/fraction each two days. If needed, a second
course similar to the previous was delivered after 6-8
weeks.
Results
All 16 patients were women and the average age was 68
years old. Five treatments were located on hands, 4 on
knees, and the 6 remaining at diverse joints. A second
course of 6 Gy was required by 50% of patients. Pre-RT
median pain score according to VAS was 7.5 (range 4-9);
median post-RT pain according to VAS was 1 (range 0-4).
There was a reduction of more than 4 points in all
patients. Eighty-one per cent of patients reported
subjective clinical improvement of their joint pain; 38% of
patients reduced their analgesic intake, 6% maintained the
same and 31% discontinued oral analgesic.
Conclusion
Our results support the efficacy and safety of low-dose
anti-inflammatory radiotherapy as an alternative
treatment for painful osteoarticular degenerative
diseases. Pain response and functional improvement
maintained for long time in a substantial proportion of
patients on follow-up.
EP-1430 Venous thromboembolism in radiation
oncology: retrospective trial
M. Cherkashin1, N. Berezina1, N. Vorobyov1, E. Pinelis2
1Dr Berezin Medical Center, Oncology, Saint-Petersburg,
Russian Federation
2Albert Einstein College of Medicine, Respiratory Care,
New York, USA
Purpose or Objective
Venous thromboembolism (VTE) prevention in oncology
patients during external beam radiation therapy (RT) in
outpatient setting is the challenging question. There is no
clear statement from international societies (ASCO, ESMO,
ACCP) and os far it is unclear if RT is an independent risk
factor for VTE. Last years a couple of published trials have
reported some VTE cases in this group of patients, but lack
of evidence is the common problem. The objective of this
study is the clear assessment of VTE incidence in these
patients
Material and Methods
In retrospective analysis 3280 patients' medical records
were included (1612 with RT and 1668 with
chemotherapy). Inclusion criteria were: RT in outpatient