1
646 COMPARATIVE STUDY BETWEEN H~BODY IRRADIATION AND STRON- TIb~ 89 FOR THE PALLIATION OF MULTIPLE PAINFUL BONE METASTASES FROM PROSTATIC CANCER O. Antnnndnn, D.ADostolou, N. Koliarakis, M. Synodinou, P. Karageorgis, N. Throuvalas Radiation Oncology Department, Metaxa's Cancer Hospital, Piraeus, Greece Purpose:The present study compares the efficacy and safe- ty of the administration of Strontium 89 to bemibody ir- radiation (HBI) for pain palliation due to widespread bone metastases from prostatic carcinoma, in patients who had failed hormone manipulation. Material and Methods: Between 1991-1995 126 eligible pa- tients with painful multiple bone metastases from pro- state cancer assessed by bone scan and/or X-ray were in- cluded in this study. 57 Pts received intravenous in- jection of Sr 89 at a dose of 150 MBq and 68 underwent HBI as a single fraction of 6 Gy upper half and/or 8 Gy lower half. Patients were followed up to assess pain improvement at index sites. The evaluation was done at 6 weeks after the end of the treatment and at 3 months. The intake of conventional analgesics was estimated. Results: In the comparison of bemibody irradiation and Strontium89 both treatments effectively reduced existing bone pain. The pain improvement was significant in 72~ of the HBI patients versus 56Z of the Sr 89, the diffe- rence was not significant. Pain relief was achieved 48 hours after HBI versus 7-10 days in the Sr 89 group. At 3 months 66~ of the patients treated with HBI were free of newly painful sites versus 68T. of those receiving Sr 89. Hematological toxicity concerning platelet count and white blood cell count was more important in the Sr 89 group. Conclusions: HBI and Sr 89 appear to be effective in palliating bone pain from metastatic prostate cancer. No benefit w~s seen in either treatment in delaying oc- curenee of new sites of pain. 648 ESTIMATION OF SURVIVAL OF PATIENTS (pts) WITH BLADDER CANCER (BC) REFERRED FOR PALLIATIVE RADIOTHERAPY C. Kamby, L. Sengelov Department of Oncology, Copenhagen University Hospital in Hedev, Denmark. Generally, pts with advanced BC have a short survival. When referring pts for palliative radiotherapy the short life expectancy and the morbidity as well as the adverse effect of treatment should be considered. Aim: to assess performance status (PS) and evaluate prognostic factors for survival of pts with BC referred for palliative radiotherapy. Material and methods: review of the records of 53 pts with locally advanced BC (49%) and distant metastases (51%). PS was blindly assessed four times based on firmation up to the date of admission, and the relation to survival were compared with other prognostic factors. Results: median time of observation was 62 months (range, 3-202 months). Median survival was 52 days (range, 6-109). Intra- and interobserver Kappa coefficients of PS were 44- 76% and 40-63%. All four assessments were significantly related to survival. Cox analyses showed that liver metastases and PS were independent prognostic factors. Estimated survival at 6 months was 24-58% for pts with PS-<I, 5-10% for pts with PS=2, and 0-2% for pts with PS>2. The median survival was 56-110 days (PS_<I), 45-68 days (PS=2), and 17-36 days (PS>2). Conclusion: assessment of PS based on clinical records alone is a reliable and reproducible method, which can be used to estimate survival. The poor survival ofpts with PS>I emphasizes the need for careful selection radiotherapy in these pts. SI65 647 EPIDURAI, ~TI'&STASI~ (EM).RADIOHIFI~PE[IT[C IKAN6GF]'qENT. Sant-hlz F. Vila A, Pedro A, Fernfindez-Velilla E. Hill~ A. Ituiz V. Hoya L M. Centro de Radioterapia y Oncologia. C/ Pla16.21. 08006 BARCELONA (Spain). BACKGROIIND AND PURPOSE: As il is well known. EM is an oncological emergency. Early therapy usually results in the relieve or the symptoms. MATERIAL AND METHODS: A total of 148 patients were studied (M/F ratio 56/92). Prltrary bcatiens were: breast 23%, haematdogic malignancios 19%, lung 17.5%, prostate 11.5%, unknown primary tumours II% and other hlmours 8%. A 60% of the patients were Postner 0-2. Ooe hundred and twenty-fiv~ patients r~ceJx,cd radiotl~yapy (RT) as unique treatment, using different fraetionation schedules (30 patients with accelerated R]" schedule and high dexametasone doses). Twenty-three patioats underwent surgery befo.re RT. RESULTS: Pain relieve was obtained in 76% of eases. A total of t25 palit~[s received RT as unique tr'e~l_ment with ml iV13equivalent dose ->30 Gy: among those, 48% were walking at the time of treatment and 64% did so a month after it. Not statistical differences were noted between the various therapeutic schemes. Breast cancer, prostatic cancer, lympbomas and malignant myelomas are the most responsiveness tumours (p=0.03l). CONCI,t ISIONS: I- Early diagnosis is the most important prognostic factor. 2- In such patients a minimal dose of 30 Gy is necessary. Breast canoer, prostatic cancer, lymphomas and malignant myelomas show better results and better survival. 4- Surgery improves motor function but not survival. 649 ORBITAL METASTASIS : RADIATION THERAPY RESULTS (w/wo CHEMOTHERAPY). M BENMILOUD, H. HAMIDOU, F. PENE, L. SCHWARTZ, E TOUBOUL. M. SCHLIENGER. M. HOUSSET Radiation Therapy Department H6pital Tenon AP-HP, Paris (France) Purtx3se/Obiective Evaluate radiation therapy results in orbital metastasis of malignant tumors. Materials and methods Twenty-one patients were successively treated in our department from 1978 to 1992.There were 10 men (sex ratio : 0.9). Mean age was 64 years (range: 35-83 y). Breast and bronchial were the main primaries (respectively 33% and 19%). There were 2 melanomas and 2 unknown primary (9.5% each). There were 10 uveal metastasis and 15 orbital content metastasis (55%) among 25 treated eyes. Metachronous metastasis occurred in 13 (62%) between 3 months to 10 years (mean 44 months, mnd 36 months) after treatment of their primary. Orbital metastasis was unique site metastasis in 5 patients (24%) ; other sites of metastasis included bone, liver and lung. Chemotherapy was combined with radiation therapy in 14 patients (66%). Radiation therapy delivered 8 to 55 Gy (mean 30.8 Gy) with 2.2 to 6.0 Gy per fraction (mean 3.3), using photons and/or electrons of a linear accelerator, through lateral and/or anterior field. Results Local control could not be evaluable in 4 patients(19%). A stabilisation has been observed in 7 (33%) and a regression in t 1 (52%). Quality of life relative to impairment of visual function could not be assessable in this retrospective study.Thirteen patients were dead of disease (62%), 8 days to 55 months (median 10 months) aRer radiotherapy of their orbital metastasis. Three patients were dead with intercurrent disease. Cause of death was unknown in 2. One patient was lost to follow-up. Two patients are alive NED. Conclusion Radiation therapy in combination with chemotherapy is an effective treatment in orbital metastasis of malignant tumors, as it gave a stabilisation or a regression in 18 of our 2t patients (85%). As orbital metastasis occurred in most cases in polymetastatic patients, prognosis could not be influenced by this therapy.

648Estimation of survival of patients (pts) with bladder cancer (BC) referred for palliative radiotherapy

  • Upload
    l

  • View
    214

  • Download
    2

Embed Size (px)

Citation preview

646

COMPARATIVE STUDY BETWEEN H~BODY IRRADIATION AND STRON- TIb~ 89 FOR THE PALLIATION OF MULTIPLE PAINFUL BONE METASTASES FROM PROSTATIC CANCER

O. Antnnndnn, D.ADostolou, N. Koliarakis, M. Synodinou, P. Karageorgis, N. Throuvalas Radiation Oncology Department, Metaxa's Cancer Hospital, Piraeus, Greece

Purpose:The present study compares the efficacy and safe- ty of the administration of Strontium 89 to bemibody ir- radiation (HBI) for pain palliation due to widespread bone metastases from prostatic carcinoma, in patients who had failed hormone manipulation. Material and Methods: Between 1991-1995 126 eligible pa- tients with painful multiple bone metastases from pro- state cancer assessed by bone scan and/or X-ray were in- cluded in this study. 57 Pts received intravenous in- jection of Sr 89 at a dose of 150 MBq and 68 underwent HBI as a single fraction of 6 Gy upper half and/or 8 Gy lower half. Patients were followed up to assess pain improvement at index sites. The evaluation was done at 6 weeks after the end of the treatment and at 3 months. The intake of conventional analgesics was estimated. Results: In the comparison of bemibody irradiation and Strontium89 both treatments effectively reduced existing bone pain. The pain improvement was significant in 72~ of the HBI patients versus 56Z of the Sr 89, the diffe- rence was not significant. Pain relief was achieved 48 hours after HBI versus 7-10 days in the Sr 89 group. At 3 months 66~ of the patients treated with HBI were free of newly painful sites versus 68T. of those receiving Sr 89. Hematological toxicity concerning platelet count and white blood cell count was more important in the Sr 89 group. Conclusions: HBI and Sr 89 appear to be effective in palliating bone pain from metastatic prostate cancer. No benefit w~s seen in either treatment in delaying oc- curenee of new sites of pain.

648

E S T I M A T I O N O F SURVIVAL O F PATIENTS (pts) W I T H B L A D D E R C A N C E R (BC) R E F E R R E D F O R P A L L I A T I V E

R A D I O T H E R A P Y

C. Kamby, L. Sengelov Department of Oncology, Copenhagen University Hospital in Hedev,

Denmark.

General ly , pts with advanced BC have a short survival. When referring pts for palliative radiotherapy the short life expectancy and the morbidity as well as the adverse effect of treatment should be considered. Aim: to assess performance status (PS) and evaluate prognostic factors for survival of pts with BC referred for palliative radiotherapy. Material and methods: review of the records of 53 pts with locally advanced BC (49%) and distant metastases (51%). PS was blindly assessed four times based on firmation up to the date of admission, and the relation to survival were compared with other prognost ic factors. Results: median time of observation was 62 months (range, 3-202 months). Median survival was 52 days (range, 6-109). Intra- and interobserver Kappa coefficients of PS were 44- 76% and 40-63%. All four assessments were significantly related to survival. Cox analyses showed that liver metastases and PS were independent prognostic factors. Estimated survival at 6 months was 24-58% for pts with PS-<I, 5-10% for pts with PS=2, and 0-2% for pts with PS>2. The median survival was 56-110 days (PS_<I), 45-68 days (PS=2), and 17-36 days (PS>2). Conclusion: assessment of PS based on clinical records alone is a reliable and reproducible method, which can be used to estimate survival. The poor survival o fp t s with PS>I emphasizes the need for careful selection radiotherapy in these pts.

SI65

647

EPIDURAI, ~TI'&STASI~ (EM). RADIOHIFI~PE[IT[C IKAN6GF]'qENT.

Sant-hlz F. Vila A, Pedro A, Fernf indez-Vel i l la E. Hill~ A. Ituiz V. Hoya L M. C e n t r o de R a d i o t e r a p i a y Oncologia . C / Pla16.21. 08006 BARCELONA (Spain) .

BACKGROIIND AND PURPOSE: As il is well known. EM is an onco log ica l e m e r g e n c y . Ea r ly t h e r a p y u s u a l l y r e s u l t s in the rel ieve or the s y m p t o m s . MATERIAL AND METHODS: A total of 148 p a t i e n t s were s t u d i e d (M/F r a t i o 56/92) . P r l t r a ry b c a t i e n s were: b r ea s t 23%, haematdog ic malignancios 19%, l ung 17.5%, p r o s t a t e 11.5%, u n k n o w n p r i m a r y t u m o u r s II% and o t h e r h lmours 8%. A 60% of the pa t i en t s were Pos tner 0-2. Ooe hundred and twenty-fiv~ patients r~ceJx, cd radiotl~yapy (RT) a s u n i q u e t r e a t m e n t , u s i n g d i f f e r e n t f r a e t i o n a t i o n s c h e d u l e s (30 p a t i e n t s with a c c e l e r a t e d R]" s c h e d u l e a n d high dexametasone doses) . T w e n t y - t h r e e pa t ioa t s u n d e r w e n t s u r g e r y befo.re RT. RESULTS: Pain r e l i eve was o b t a i n e d in 76% of ea se s . A total of t25 palit~[s received RT as unique tr'e~l_ment with ml iV13 equivalent dose ->30 Gy: among those , 48% were wa lk ing a t t he time of t r e a t m e n t a n d 64% did so a month a f t e r it. Not s t a t i s t i c a l d i f f e r e n c e s we re no ted be tween the v a r i o u s t h e r a p e u t i c s chemes . B r e a s t c a n c e r , p r o s t a t i c c a n c e r , l ympbomas a n d ma l ignan t myelomas a r e the most r e s p o n s i v e n e s s t u m o u r s (p=0.03l) . CONCI,t ISIONS: I- Ea r ly d i a g n o s i s is the most i m p o r t a n t p r o g n o s t i c f a c t o r . 2- In s u c h p a t i e n t s a minimal dose of 30 Gy is n e c e s s a r y .

Breast canoer , p ro s t a t i c cancer , lymphomas a n d malignant myelomas show b e t t e r r e s u l t s a n d b e t t e r s u r v i v a l . 4- S u r g e r y i m p r o v e s motor f u n c t i o n bu t not s u r v i v a l .

649

ORBITAL METASTASIS : RADIATION THERAPY RESULTS (w/wo CHEMOTHERAPY).

M BENMILOUD, H. HAMIDOU, F. PENE, L. SCHWARTZ, E TOUBOUL. M. SCHLIENGER. M. HOUSSET Radiation Therapy Department H6pital Tenon AP-HP, Paris (France)

Purtx3se/Obiective Evaluate radiation therapy results in orbital metastasis of malignant tumors. Materials and methods Twenty-one patients were successively treated in our department from 1978 to 1992.There were 10 men (sex ratio : 0.9). Mean age was 64 years (range: 35-83 y). Breast and bronchial were the main primaries (respectively 33% and 19%). There were 2 melanomas and 2 unknown primary (9.5% each). There were 10 uveal metastasis and 15 orbital content metastasis (55%) among 25 treated eyes. Metachronous metastasis occurred in 13 (62%) between 3 months to 10 years (mean 44 months, mnd 36 months) after treatment of their primary. Orbital metastasis was unique site metastasis in 5 patients (24%) ; other sites of metastasis included bone, liver and lung. Chemotherapy was combined with radiation therapy in 14 patients (66%). Radiation therapy delivered 8 to 55 Gy (mean 30.8 Gy) with 2.2 to 6.0 Gy per fraction (mean 3.3), using photons and/or electrons of a linear accelerator, through lateral and/or anterior field. Results Local control could not be evaluable in 4 patients(19%). A stabilisation has been observed in 7 (33%) and a regression in t 1 (52%). Quality of life relative to impairment of visual function could not be assessable in this retrospective study.Thirteen patients were dead of disease (62%), 8 days to 55 months (median 10 months) aRer radiotherapy of their orbital metastasis. Three patients were dead with intercurrent disease. Cause of death was unknown in 2. One patient was lost to follow-up. Two patients are alive NED. Conclusion Radiation therapy in combination with chemotherapy is an effective treatment in orbital metastasis of malignant tumors, as it gave a stabilisation or a regression in 18 of our 2t patients (85%). As orbital metastasis occurred in most cases in polymetastatic patients, prognosis could not be influenced by this therapy.