Oncology Vol 28 No 1S

(P112) Single-Institution Experience With Intrabeam IORT for Treatment of Early-Stage Breast Cancer

April 15, 2014

Preoperative and postoperative patient and tumor characteristics for breast cancer patients treated at New York Presbyterian Hospital, Weill Cornell Medical College with Intrabeam intraoperative radiation therapy (IORT) are reported.

(P110) Breast Cancer Before Age 40: Current Patterns in Clinical Presentation and Local Management

April 15, 2014

Although uncommon in women less than 40 years old, breast cancer in younger women may have unique biologic and treatment implications. The purpose of this study was to evaluate treatment of breast cancer in young women with respect to previously established clinical predictors of local therapy choice.

(P111) Accelerated Partial-Breast Irradiation With Multicatheter High-Dose-Rate Brachytherapy: Feasibility and Results in a Private Practice Cohort

April 15, 2014

Results and outcomes of use of multicatheter interstitial high-dose-rate (HDR) brachytherapy (BT) to deliver accelerated partial-breast irradiation (APBI) in a large cohort of women treated in a three-physician private practice setting over 10 years and 9 months are reported.

(P115) Breast Cancer Laterality Does Not Influence Overall Survival in a Large Modern Cohort: Implications for Radiation-Related Cardiac Mortality

April 15, 2014

Radiotherapy for left-sided breast cancer has historically been associated with an elevated risk of cardiac mortality, based upon studies in the era predating computed tomography (CT)-based treatment planning. This study assessed the impact of tumor laterality on overall survival (OS) in a large cohort treated with modern techniques to determine if left-sided treatment is still associated with a heightened risk of cardiac mortality.

(P116) Bilateral Immediate DIEP Reconstruction and Postmastectomy Radiotherapy: Experience at a Tertiary Care Institution

April 15, 2014

Although autologous and immediate reconstruction has potential advantages when compared with delayed and implant-based reconstruction for patients with breast cancer (BCA), concerns exist for potential increased complications and technical difficulty in the delivery of postmastectomy radiotherapy (PMRT).

(P118) Metadherin Overexpression Is Associated With Improved Locoregional Control After Mastectomy

April 15, 2014

Breast cancer patients who develop a recurrence in the chest wall after mastectomy represent a high-risk subgroup that may benefit from early identification and more aggressive treatment. Traditional clinicopathologic factors have been proven useful for prognosis, but there remains a need to identify molecular markers with prognostic significance.

(P120) Immediate Versus Delayed Reconstruction After Mastectomy in the United States Medicare Breast Cancer Patient

April 15, 2014

Although recent data have been published regarding trends surrounding mastectomy with reconstruction for breast cancer, little data exist about predictors of immediate vs delayed reconstruction and the prevalence of reconstruction where it is traditionally contraindicated, such as inflammatory breast cancer and stage IV disease.

(P121) Trend in Age and Racial Disparities in the Receipt of Postlumpectomy Radiation Therapy for Stage I Breast Cancer: 2004–2009

April 15, 2014

Significant effort has been expended over the past decade to reduce racial disparities in breast cancer care. Whether disparities in receipt of appropriate radiotherapy care for breast cancer persisted despite these efforts is unknown, as is the impact of being eligible for Medicare.

(P122) Streamlining Referring Physicians Orders With ‘Reflex Testing’ Significantly Decreases Time to Resolution for Abnormal Screening Mammograms

April 15, 2014

Patients with abnormal screening mammogram (abSM) often experience prolonged wait times for additional testing to resolve the cause of the abnormality. The purpose of this study was to initiate an intervention, termed ‘reflex testing’ (RefT), and analyze pre- and post-RefT timelines to determine if, where, and in whom RefT resulted in significant decreases in timelines for resolution of abSM of patients undergoing routine screening in an accredited community hospital-based breast center.

(P123) National Trends in the Local Management of Early-Stage Paget Disease of the Breast

April 15, 2014

Due to the rarity of Paget disease (PD), the role of breast conserving surgery (BCS) and radiation therapy (RT) is not fully defined. The specific aims of this analysis are to study national patterns of care in the local management of PD and to determine breast cancer–specific survival (BCSS) by type of treatment in a large population-based cohort.

(P124) Effect of Inhomogeneity on Cardiac and Lung Dose in Partial-Breast Irradiation Using HDR Brachytherapy

April 15, 2014

Recent expert consensus statements have endorsed use of accelerated partial-breast irradiation (APBI) in select groups of low-risk women with early-stage breast cancer. APBI in the form of balloon brachytherapy is increasingly selected as a method of radiation treatment (RT).

(P125) Breast Cancer Outcomes With Anthracycline-Based Chemotherapy for Residual Disease Burden After Full-Dose Neoadjuvant Chemotherapy and Surgery Followed by Radiation Treatment

April 15, 2014

In breast cancer, the primary site residual burden of disease (PRBD) after neoadjuvant chemotherapy has been shown to correlate with poor prognostic outcomes. Currently, there is no established standard of care to offer patients with residual disease, in terms of adjuvant systemic treatment after full-dose neoadjuvant chemotherapy.

(P126) Student Institute to Stimulate Interest in Radiological Sciences Academic Careers (SISIRSAC): A Novel Near-Peer Mentoring Approach

April 15, 2014

The World Health Organization predicts that 26.4 million new cancer cases will be reported in 2030 alone. It is necessary to establish an effective mentoring paradigm in radiological science, not just for medical students (MS) but also for high school (HS) and college undergraduate (UG) students, to promote a greater general awareness of the study of oncology as well as its therapeutic implementation.

(P127) One-Year Experience of Electronic Brachytherapy for the Treatment of Nonmelanoma Skin Cancer

April 15, 2014

There are over 3.0 million cases of nonmelanoma skin cancer (NMSC) diagnosed each year in the United States. Multiple treatment options exist for the treatment of these patients. We describe the outcomes of patients treated at a large private dermatology practice with electronic brachytherapy (eBx) who had a minimum follow-up duration of 1 year.

(P129) Electronic Brachytherapy for Nonmelanomatous Skin Cancer: Report of First 565 Lesions

April 15, 2014

Electronic brachytherapy for skin cancer is now available without the need for room shielding. Advances in radiobiology and radiotechnology permit the treatment course to be given in eight fractions over 4 weeks. This report describes the experience with our first 565 treated lesions.

(P131) The Role of Radiation Therapy in the Management of Neurogenic Heterotopic Ossification

April 15, 2014

Patients who sustain brain and spinal cord injuries are at risk for developing neurogenic heterotopic ossification (NHO), the formation of bone in extraskeletal soft tissue. The purpose of this study was to review the experience and to report the outcome of eight consecutively irradiated joints in four patients with NHO.

(P132) Stereotactic Radiosurgery to Five or More Brain Metastases in Melanoma Patients

April 15, 2014

Linear accelerator–based stereotactic radiosurgery (SRS) is a treatment option for melanoma patients who have developed brain metastases. Few data are available on treatment of patients with ≥ 5 lesions. We sought to determine the effectiveness of SRS in patients with ≥ 5 melanoma brain metastases.

(P133) Variation in Insurance Status by Patient Demographics and Tumor Site Among the Top Twenty-Five Causes of Cancer

April 15, 2014

In the United States, an estimated 48 million individuals live without health insurance. The purpose of this study is to explore differences in key factors associated with insurance status among non-Medicare-aged adults diagnosed with the top 25 incident cancers using the Surveillance, Epidemiology, and End Results (SEER) public-use database.

(P134) Can a Radiation Oncology Social Media Website Be Used to Convey Reliable Radiation Oncology Information?

April 15, 2014

As the volume of radiation oncology information increases, the ability to gather and critically appraise high-quality information in order to answer clinical questions becomes increasingly challenging for radiation oncologists. Sharing knowledge about new information and practice variations is instrumental to high-quality radiation oncology practices.

(P135) Dose Escalation Using Conventional Versus IMRT Planning for Hypofractionated Palliative Radiation of Lumbosacral Bony Metastases

April 15, 2014

The standard approach for palliation of bone metastasis (BM) is conventionally planned radiation (CRT). Randomized studies have shown the equivalence of hypofractionated vs conventionally fractionated regimens; yet, reported pain control is poor with either approach, resulting in some degree of pain relief in only 50% to 80% of cases and complete response in 15% to 60% of cases.

(P136) Uniting Publication Database Functions Across Three Existing Complex Organizations

April 15, 2014

NRG Oncology is a member of the National Cancer Institute (NCI) National Clinical Trials Network program and was created by the integration of three adult cooperative groups: the National Surgical Adjuvant Breast and Bowel Project (NSABP), the Radiation Therapy Oncology Group (RTOG), and the Gynecologic Oncology Group (GOG). The Publications Working Group, has begun the amalgamation of three publications databases into one to track progress in manuscript development and to provide access to a comprehensive bibliography that incorporates the past/current research of all three legacy groups.

(P140) Comparison of Split-Field IMRT With Whole-Field VMAT and IMRT for Locally Advanced Head and Neck Cancer

April 15, 2014

Advances in intensity-modulated radiation therapy (IMRT) head and neck target delineation and treatment planning have led to improved sparing of organs at risk (OARs). In this study, we compare three IMRT techniques for the treatment of common cases of oropharyngeal squamous cell carcinoma.

(P141) Dosimetric Comparison of Volumetric-Modulated Arc Therapy With Step-and-Shoot Intensity-Modulated Radiation Therapy for Prostate Cancer

April 15, 2014

Step-and-shoot intensity-modulated radiation therapy (IMRT) and variable-dose-rate volumetric modulated arc therapy (VMAT) are two common treatment techniques for the definitive treatment of prostate cancer. In order to compare these two techniques in modern practice, we analyzed two cohorts of patients treated at our institution who were matched for PTV, prescribed dose, and patient characteristics.

(P142) Complementary and Alternative Medicine in Radiation Oncology Training: From a Resident’s Perspective

April 15, 2014

Today’s health care system is evolving in its approach to the management of an ethnically diverse population, as it continues to struggle with the imperative of providing cost-effective care. This study attempts to assess the level of knowledge and interest current residents have in CAM teachings, with the goal of eventually incorporating such evidence-based study into training curriculum.

(P144) Prospective Assessment of Patient-Specific Pulmonary Radiation Pneumonitis

April 15, 2014

Radiation pneumonitis (RP) is a significant toxicity following thoracic radiotherapy, with no method to predict individual risk. Our lab had previously shown that pulmonary metabolic response rate (PMRR) is highly predictive of RP in lung cancer. In this prospective study, we used PMRR as a surrogate marker to predict radiation-induced lung toxicity in lung cancer patients receiving thoracic radiotherapy.

(P094) Retrospective Analysis of Patients With Locally Advanced Unresectable Pancreatic Cancer (LAUPC) Treated With Chemotherapy Alone or Chemotherapy Combined With Radiation Therapy: The Indiana University Simon Cancer Center (IUSCC) Experience

April 15, 2014

A retrospective study was performed to investigate potential prognostic indicators and evaluate treatment outcomes in patients diagnosed with locally advanced unresectable pancreatic cancer (LAUPC), treated with chemotherapy alone (C), concurrent chemoradiation therapy (CRT), induction C followed by concurrent chemoradiation (C-CRT), CRT followed by chemotherapy (CRT-C), or C-CRT followed by C (C-CRT-C).

(P146) Clinical Outcomes From Frameless Stereotactic Radiosurgery of Arteriovenous Malformations Using High-Resolution 3-Dimensional Rotational Angiography

April 15, 2014

Cerebral arteriovenous malformation (AVM) is defined as an abnormal collection of vessels with multiple enlarged feeder arteries and dilated venous outflow, associated with risks of blood shunting and hemorrhage. Treatment options include surgery, embolization, or stereotactic radiosurgery (SRS).

(P147) Long-Term Outcomes of High-Dose-Rate Interstitial Brachytherapy for Gynecologic Malignancies

April 15, 2014

In this study, we perform a single-institution retrospective analysis of outcomes of patients treated with high-dose-rate interstitial brachytherapy (HDR-ISBT) for gynecologic malignancies. Locoregional control (LRC), disease-free survival (DFS), overall survival (OS), and long-term toxicity were evaluated.

(P096) Preoperative Radiation Dose Escalation for Rectal Cancer Improves Tumor Downstaging Without Significant Increase in Toxicity: A Matched-Pair Analysis

April 15, 2014

We sought to explore a potential dose-response relationship with tumor downstaging after neoadjuvant chemoradiation therapy for rectal cancer. To this end, we conducted a case-control analysis of 152 patients treated preoperatively, with and without a concomitant boost.

(P098) Dose-Painting Technique in SBRT of Hepatocellular Carcinoma of Unfavorable Locations: Feasibility and Outcomes

April 15, 2014

Stereotactic body radiotherapy (SBRT) is increasingly utilized for the treatment of inoperable hepatocellular carcinoma (HCC) alone or in combination with other local treatment modalities. However, proximity to bowel often precludes the ability to deliver the full prescription dose to the planning target volume (PTV). In this study, we evaluate our experience using the technique of radiation therapy (RT)–dose-painting (DPRT) to decrease the dose received to critical structures with the PTV.

(P148) The Use of Updated Dosimetric Guidelines and Independent Dose-Volume Histogram Analysis Improves Treatment Planning for Men Treated With Rapidarc Intensity-Modulated Radiation Therapy for Clinically Localized Prostate Cancer

April 15, 2014

We updated our evidence-based dosimetric guidelines for treatment of men with clinically localized prostate cancer and introduced independent dose-volume histogram (DVH) analysis using MatLab. In doing so, we sought to evaluate whether the interventions above would translate into improvement in dosimetric endpoints for organs at risk (OARs).

(P099) A Multidisciplinary Approach to the Management of Patients Diagnosed With Stage IV Anal Canal Cancer: A Multi-institutional Retrospective Study

April 15, 2014

This retrospective study presents the results of a multidisciplinary approach adopted in two cancer centers where patients diagnosed with stage IV SCC of the anal canal (liver-predominant disease) and a good performance status (ECOG 0–2) were offered a full course of concomitant chemoradiation followed by cisplatin-based palliative chemotherapy.

(P149) Collimator Design and Optimization for an Ir-192 Based Small-Animal Irradiator

April 15, 2014

Small-animal irradiation is a critical part of translational studies in radiation oncology. The ability to deliver a small, highly focused radiation field allows for evaluation of radiation effects, as well as quantification of acute and late toxicities, in an assortment of tissues.

(P150) Assessment of Acute and Late Toxicities of Intracranial Stereotactic Radiosurgery in Multiple Sclerosis Patients

April 15, 2014

Several reports over the last few decades have documented treatment-related toxicity or acceleration of demyelination in patients with multiple sclerosis (MS) treated with external beam radiotherapy. We propose to conduct a study investigating the acute and late toxicities of radiosurgery in MS patients in order to determine the risks associated with this modality in MS patients.

(P151) Poor Long-Term Sexual Recovery With Neoadjuvant Androgen Deprivation Therapy (NADT) Plus Radiotherapy: Results of a Multicenter, Prospective Study

April 15, 2014

Long-term effects of neoadjuvant androgen deprivation therapy (NADT) with radiotherapy (RT) on patient-reported health-related quality of life (HRQOL) have not been characterized in prospective multicenter studies. We evaluated the effects of NADT on HRQOL for 2 years among patients undergoing RT for newly diagnosed prostate cancer.

(P103) Socioeconomic Status and Overall Survival Following Hepatocellular Carcinoma Diagnosis in an Urban Academic Cancer Center

April 15, 2014

Hepatocellular carcinoma (HCC) is a leading cause of cancer death worldwide, the incidence of which is increasing in the United States. In this report, we analyze predictors of overall survival (OS) for a large cohort of patients diagnosed with HCC at an urban academic cancer center.

(P154) Variation in Severity of Acute Skin Toxicity by Race and Ethnicity in a Prospective Cohort of Patients Receiving Postmastectomy Radiation

April 15, 2014

Risk factors for radiation-induced skin toxicity (ST) are poorly understood, and there are limited data examining the relationship between race/ethnicity and the development of ST. We evaluated risk factors for radiation-induced ST in a racially and ethnically diverse cohort of patients receiving postmastectomy radiation therapy (PMRT) for breast cancer.

(P143) Advanced Glycation Endproducts: The Sweet Tooth of Radiation Toxicity

April 15, 2014

The therapeutic index of treating cancer with ionizing radiation (IR) can be increased by minimizing normal tissue toxicity. Unfortunately, the therapies that have been developed to date have had limited efficacy. Therefore, identifying novel targets to protect normal tissue is essential during treatment.

(P018) Micronucleus Score in Buccal Smear of Premalignant Lesions of Oral Cancers in Smokers

April 15, 2014

Oral squamous cell carcinoma encompasses 90% of all oral malignancies. It is considered the sixth most common malignancy and is a major cause of cancer morbidity and mortality worldwide. Early detection of premalignant lesions or cancerous oral lesions would improve the survival to a greater extent.

(P019) Fractionated Robotic Stereotactic Radiosurgery for the Treatment of Benign Meningioma

April 15, 2014

Fractionated stereotactic radiosurgery (SRS) may offer several benefits in the treatment of symptomatic or growing meningioma but has not been examined extensively in the literature. Our primary aim was to describe the rates of tumor control and side effects in patients treated with CyberKnife SRS for meningioma.

(P021) Long-Term Survival in Patients With Brain Metastases: Fact or Fallacy?

April 15, 2014

A typical patient with a brain metastasis (BM) dies within an average of 8 months following the initial treatment of his or her brain tumor(s). Cause-specific mortality is rarely assessed or recorded, and the BM is often assumed to be the culprit.

(P022) Modern Management of Lymphoepithelioma of the Head and Neck

April 15, 2014

Lymphoepithelioma is a rare tumor of the head and neck region, the optimal management of which remains to be defined. We evaluated and report on management outcomes from a large cohort of patients with modern management for this diagnosis.

(P023) The Importance of Surgery and the Role of Radiation Therapy and Chemotherapy for Treatment of Oral Tongue Cancer

April 15, 2014

Oral tongue cancers have been classically managed with upfront surgical resection, whereas radiation therapy (RT) and chemotherapy (CT) have been generally reserved in the adjuvant setting for patients who possess high-risk features and those with unresectable disease. We wanted to determine the role of RT, surgery, and CT for patients with oral tongue cancer.

(P024) Proton Radiotherapy for Midline CNS Lesions: A Class Solution

April 15, 2014

Midline and central lesions of the brain requiring conventional radiation therapy (RT) present complex difficulties in dose avoidance to organs at risk (OAR). In either the definitive or adjuvant setting, proper RT coverage of these lesions involves unnecessary treatment of large volumes of normal brain. We propose a class solution for these lesions using proton therapy (PrT).

(P026) Limiting Radiotherapy to the Contralateral Retropharyngeal and High Level II Lymph Nodes in Head and Neck Squamous Cell Carcinoma Is Safe and Improves Quality of Life

April 15, 2014

For patients with locally advanced head and neck squamous cell carcinoma (HNSCC), eliminating coverage to the contralateral high level II (HLII) lymph nodes and contralateral retropharyngeal lymph nodes (RPLNs) in the clinically uninvolved side of the neck is associated with minimal risk of failure in these regions and significantly improves patient-reported quality of life (QOL).

(P027) Salvage of ‘Low-Risk’ Oral Tongue Failures Initially Managed With Surgery Alone-Importance of Recurrent Stage

April 15, 2014

Adjuvant therapy is not recommended after resection of oral tongue cancer in the absence of risk factors for recurrence. Having reported a 73% locoregional control rate for patients managed with surgery alone for ‘low-risk’ oral tongue cancer, this series examines our experience treating locoregional failures.

(P030) Peritumoral Lymphatic Vessel Density as a Predictor of Progression-Free Survival in Locally Advanced Laryngeal/Hypopharyngeal Cancer

April 15, 2014

The clinical significance of tumor lymphangiogenesis continues to be an area of active research. We hypothesize that high peritumoral and intratumoral lymphatic vessel density (LVD) predict for inferior oncologic outcomes, including local failure (LF), progression-free survival (PFS), and overall survival (OS).

(P031) Disease Control and Toxicity Outcomes for T4 Carcinoma of the Nasopharynx Treated With Intensity-Modulated Radiotherapy

April 15, 2014

Treatment of T4 nasopharyngeal carcinoma (NPC) is challenging due to the close proximity of the tumor to the central nervous system. We evaluated our disease control and toxicity outcomes for patients with T4 NPC treated with intensity-modulated radiation therapy (IMRT) and chemotherapy.

(P032) Clinical Outcomes for Hybrid Forward and Inverse Planned IMRT for Supine Craniospinal Irradiation

April 15, 2014

Conventional matching techniques of craniospinal irradiation (CSI) require patients to be in the prone position in order to use skin surface markers to align matched or gapped adjacent fields. Because of safety concerns regarding field overlap with a blind match, there has been reluctance to treat patients supine. Here, we present the clinical outcomes of patients treated with our supine CSI technique using a gradient match of brain and spinal fields.

(P034) Ethnic and Gender Disparities Among Limb Salvage Rates in Pediatric Sarcoma Patients

April 15, 2014

Racial and ethnic disparities in limb salvage surgery have been reported among adult sarcoma patients. The purpose of this work was to explore treatment patterns by ethnicity and gender in a cohort of pediatric sarcoma patients.

(P035) Outcomes in Patients With Hypopharyngeal Cancer Treated With Intensity-Modulated Radiation Therapy

April 15, 2014

Intensity-modulated radiation therapy (IMRT) is increasingly used in the treatment of hypopharyngeal carcinoma for functional organ-sparing. We retrospectively reviewed our single-institution experience treating stage I–IVa hypopharyngeal cancer (HPC) patients with definitive IMRT +/− chemotherapy.

(P047) Dosimetric and Toxicity Analyses of Reirradiation for Recurrent Pediatric Brain Tumors

April 15, 2014

Repeat radiation for recurrent brain tumors may be performed in the pediatric population with acceptable short- and long-term toxicity. Establishment of dose-volume guidelines will facilitate treatment planning for these challenging cases.

(P046) Use of Intensity-Modulated Radiotherapy (IMRT) With Daily Image Guidance and Reduced Treatment Margins Is the Most Significant Predictor of Reduced Late Toxicity in Patients With Human Papillomavirus–Associated (HPV+) Oropharyngeal Cancer

April 15, 2014

We hypothesize that patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with definitive chemoradiotherapy (CRT) with intensity-modulated radiotherapy (IMRT), daily image guidance, and reduced planning margins will have fewer significant late effects and improved functional outcomes than those treated with conventional techniques.

(P036) The Significance of Different Dose Fractionations in the Management of Optic Nerve Sheath Meningioma

April 15, 2014

Optic nerve sheath meningiomas (ONMs) typically present with unilateral vision loss, visual disturbance, and/or eye pain or pressure. ONMs are generally not amenable to surgery due to morbidity, visual deterioration. For this reason, radiation is often used as primary treatment.

(P037) Impact of Serial DWI and ADC Measurements in Assessment of Brain Metastases Treated With Neurosurgical Resection and Intraoperative Cesium- 131 Brachytherapy: Results of a Prospective Trial

April 15, 2014

Intraoperative Cs-131 brachytherapy has been demonstrated to be safe, well tolerated, and convenient for patients, rendering high local control and minimal toxicity for patients with brain metastases. In this study, we reviewed serial magnetic resonance imaging (MRI) images along with diffusion-weighted images (DWIs) for distinct local changes and assessed their clinical relevance and measured apparent diffusion coefficient (ADC) values.

(P038) 4π Noncoplanar Stereotactic Body Radiation Therapy for Head and Neck Cancers

April 15, 2014

Stereotactic body radiation therapy (SBRT) is an emerging treatment strategy with increasing clinical applications in patients with head and neck cancers (HNCs), including mainly those with recurrent, previously irradiated (rHNC), locally advanced unresectable primary, or metastatic HNCs who have shown radioresistance to conventional radiotherapy, amongst others. The aim of this study was to reduce treatment toxicity of SBRT for patients with HNCs using highly noncoplanar 4π RT.

(P039) Reirradiation for Recurrent Gliomas: The University of Miami Experience

April 15, 2014

Treatment options for recurrent gliomas include surgery, chemotherapy, and radiotherapy. The majority of patients receive radiotherapy as part of their primary treatment, and multiple reirradiation fractionation schedules have been used in an attempt to decrease toxicity. We sought to report our institutional experience with reirradiation in the management of recurrent gliomas.

(P040) Gastrointestinal Impact of Proton Radiation to the Spine in Pediatric Patients

April 15, 2014

Radiation to the spine may be associated with gastrointestinal (GI) toxicity, including nausea, vomiting, anorexia, and esophagitis. Proton therapy is expected to reduce this due to decreased exposure of the GI system when posterior-anterior beams are utilized.

(P041) Dosimetric Predictors of Hypothyroidism Development in Oropharynx Cancer Patients Treated With IMRT

April 15, 2014

Radiation therapy delivered to the lower neck has long been associated with an increased risk of subsequent development of hypothyroidism. The purpose of this study was to define dosimetric predictors of increased hypothyroidism risk for oropharyngeal (OPC) patients treated with intensity-modulated radiation therapy (IMRT) to be used to guide treatment planning.

(P042) Patterns of Failure in Node-Positive Thyroid Cancer

April 15, 2014

At median follow-up of 40 months, patients with node-positive thyroid cancer were most likely to recur in the neck rather than in the thyroid bed or distantly. Increasing nodal burden is associated with significantly increased risk of locoregional recurrence.

(P043) Stereotactic Radiosurgery Following Resection of Brain Metastases: Optimizing Benefit and Minimizing Risk

April 15, 2014

Postoperative radiation consolidation following resection of a symptomatic brain metastasis has traditionally been administered as whole-brain radiation therapy (WBRT). Given the increasing survival in some cancer patients, an increasing number of centers are offering postoperative cavity consolidation in the form of stereotactic radiosurgery (SRS).

(P044) Feasibility of Preoperative SBRT for Chondrosarcomas and Chordomas

April 15, 2014

The outcomes of chordomas and chondrosarcomas treated with preoperative, postoperative, and definitive CyberKnife radiosurgery are determined. The goals of preoperative radiosurgery are to improve disease-free survival (DFS) by achieving clean margins and to decrease morbidity by achieving a smaller resection volume.

(P045) Involved-Nodal Radiation Therapy Leads to Lower Doses to Critical Organs at Risk Compared With Involved-Field Radiation Therapy

April 15, 2014

Involved-field radiotherapy (IFRT) after cytotoxic chemotherapy has become the standard of care in treating pediatric patients with Hodgkin disease. However, recent interest in shrinking the treatment volume to involved-node radiotherapy (INRT) may allow lower doses to critical organ structures. We dosimetrically compared IFRT and INRT treatment approaches.

(P020) The Effect of Dose on Pain Relief and Numbness With Robotic Stereotactic Radiosurgery for Trigeminal Neuralgia

April 15, 2014

CyberKnife stereotactic radiosurgery (SRS) is a minimally invasive alternative for patients with trigeminal neuralgia (TN). The purpose of this project is to determine the effects of dose and other clinical parameters on the rate of pain relief, duration of response, and rate of adverse effects in the treatment of TN using CyberKnife SRS.

(P054) Stereotactic Body Radiation Therapy as Salvage for Intrathoracic Recurrence After Definitive Stereotactic Body Radiation Therapy for Early-Stage Non–Small-Cell Lung Cancer

April 15, 2014

Despite the success of stereotactic body radiotherapy (SBRT) as a treatment modality for early-stage non–small-cell lung cancer (NSCLC), some patients develop localized intrathoracic recurrences after treatment. Effective salvage therapy for these patients has typically been limited. We examine our institutional experience using SBRT for salvage of intrathoracic recurrence after definitive SBRT for early-stage NSCLC.

(P056) VATS With HDR Intraoperative Brachytherapy for Chest Wall Tumors

April 15, 2014

To report on the Roswell Park Cancer Institute experience with iridium-192 high-dose-rate (HDR) intraoperative brachytherapy (IOBT) in minimally invasive, video-assisted thorascopic surgery (VATS) for localized pulmonary malignancy involving the chest wall.

(P057) Acute-Phase Response Before Treatment Predicts Radiation Esophagitis in Non–Small-Cell Lung Cancer

April 15, 2014

Radiation esophagitis (RE) represents an inflammatory reaction to radiation therapy (RT). We hypothesized that aspects of the physiologic acute-phase response (APR), specifically increased platelet and decreased hemoglobin levels, predict RE.

(P058) Stereotactic Body Radiotherapy for Non–Small-Cell Lung Cancer Patients With Central Lung Tumors: An Analysis of Outcomes and Toxicity

April 15, 2014

Stereotactic body radiotherapy (SBRT) is increasingly used as the primary treatment for early-stage medically inoperable non–small-cell lung cancer (NSCLC). Although the role of SBRT is established in the treatment of peripheral lung tumors, the outcomes and toxicities of SBRT for central lung tumors are not well characterized. This study investigates our institutional experience with SBRT for central tumors in NSCLC patients.

(P059) Increased Rates of Radiation Pneumonitis in Patients Receiving Stereotactic Ablative Radiotherapy for Central Versus Peripheral Lung Tumors

April 15, 2014

Treatment of central lung tumors with stereotactic ablative radiotherapy (SABR) has been associated with higher rates of toxicities than in patients with peripheral tumors. Here, we report our institution’s experience in treating central lung tumor patients with SABR, compared with patients treated for peripheral lung tumors.

(P061) Activity Verification and Localization Using PET-CT for Patients Treated With Radioembolization

April 15, 2014

Radioembolization with yttrium-90 (Y-90) microspheres is a treatment option for primary and metastatic liver tumors. We aim to demonstrate correlation between activity measured within the patient and the administered activity and to describe the distribution within the liver.

(P062) SUVmax and Early Radiographic Changes as Prognosticators for Progression-Free Survival in Non–Small-Cell Lung Cancer Treated With Stereotactic Body Radiation Therapy

April 15, 2014

In patients with non–small-cell lung cancer (NSCLC) treated with stereotactic body radiation therapy (SBRT), there are few established predictors of outcomes. Pretreatment maximum standardized uptake value (SUVmax) has recently been debated as a prognosticator of progression-free survival (PFS). Here, we present a retrospective series with up to 86 months follow-up evaluating potential prognosticators of outcomes.

(P063) Multiple Course Stereotactic Ablative Body Radiotherapy for Non–Small-Cell Lung Cancer

April 15, 2014

Technical advances in radiotherapy (RT), especially stereotactic ablative body radiotherapy (SABR), have allowed many non–small-cell lung cancer patients once considered untreatable to be eligible for locally effective therapies. Some patients will experience recurrence or will present with multiple lung primaries. We review the success and impact of SABR in patients who have undergone multiple course therapy.

(P064) Proton Beam Therapy Is Associated With a Lower Incidence of Acute High Grade Chemoradiation-Related Esophagitis in the Treatment of Esophageal Cancer

April 15, 2014

Preoperative chemoradiation is a standard treatment for esophageal cancer. However, significant treatment-related toxicities are common in this group of patients. We wished to understand the clinical predictors for high-grade (≥ 3) acute toxicities from chemoradiation.

(P065) Metformin Use Does Not Affect Chemoradiotherapy-Associated Toxicity

April 15, 2014

Recent data suggest that metformin is a potent radiosensitizer in vitro and in vivo. Additionally, metformin use is associated with improved response to chemoradiotherapy in multiple tumor types. Based on these data, clinical trials incorporating metformin and radiotherapy are currently in development.

(P068) CTC Levels as a Preliminary Biomarker for Non–Small-Cell Lung Cancer Patients Undergoing Radiation Therapy

April 15, 2014

This study examined circulating tumor cell (CTC) counts as measured by a novel EpCAM-independent assay and compared CTC counts with multiple known patient and tumor prognostic factors to determine the utility of pretreatment CTC levels as a preliminary prognostic biomarker for patients undergoing definitive radiation therapy (RT) for NSCLC.

(P069) Stereotactic Body Radiotherapy for T1 Versus T2 Non–Small-Cell Lung Cancers

April 15, 2014

Stereotactic body radiation therapy (SBRT) has become the treatment of choice for early-stage non–small-cell lung cancers (NSCLCs) in nonoperative candidates. The purpose of this study was to examine the efficacy and toxicity of SBRT for stage T2 NSCLC.

(P070) Quantitative Analysis of Stereotactic Body Radiation Therapy (SBRT)-Induced Lung Injuries

April 15, 2014

Radiographic lung density changes are observed in most patients after stereotactic body radiotherapy (SBRT) for lung cancer. In this study, we assessed the relationship between SBRT dose and our treatment technique. Follow-up CT density changes were used as a surrogate for lung injury from SBRT.

(P071) SBRT Treatment of Central Chest Lesions: Experience at the University of California, San Francisco

April 15, 2014

Early experiences with stereotactic body radiotherapy (SBRT) for treatment of intrathoracic lesions have demonstrated excellent local control rates, upwards of 90% for primary and metastatic lesions in the lung parenchyma. We describe our institutional experience with SBRT treatment of central lung lesions and patient outcomes.

(P072) Reducing Radiation Dose to the Breast in Female Patients Undergoing Stereotactic Body Radiotherapy for Lung Cancer

April 15, 2014

Stereotactic body radiotherapy (SBRT) is gaining prominence as an effective treatment for early-stage inoperable non–small-cell lung cancer (NSCLC). To date, little attention has been paid to the radiation dose delivered to the breast tissue in female patients.

(P073) Helical Tomotherapy-Based Stereotactic Radiotherapy Is Safe and Effective in the Treatment of Peripheral Thoracic Tumors

April 15, 2014

Stereotactic body radiotherapy (SBRT) has been established as the standard of care in medically inoperable patients with peripherally located early-stage non–small-cell lung cancer (NSCLC). Our objective is to report outcomes, toxicity, and dose-volume histogram (DVH) data for patients receiving helical tomotherapy–based SBRT.

(P075) Stereotactic Body Radiotherapy With and Without Pelvic Radiotherapy for Organ-Confined High-Risk Prostate Cancer

April 15, 2014

Stereotactic body radiotherapy (SBRT) has excellent control rates for low- and intermediate-risk prostate carcinoma. The role of SBRT for high-risk disease remains less studied. We present long-term results on a cohort of patients with National Comprehensive Cancer Network (NCCN)-defined high-risk disease treated with SBRT.

(P081) An Analysis of Soft Tissue Anatomy and Tracking of the Prostate Using Transperineal Ultrasound

April 15, 2014

Transperineal ultrasound allows clinicians to both detect the anatomy of the pelvis in comparable detail with MRI and appreciate intrafraction motion of the prostate and nearby critical structures in order to deliver more precise radiotherapy.

(P084) Prostate Volume > 60 Ml Increases Risk of Urinary Retention in Prostate Cancer Patients Undergoing High-Dose-Rate Brachytherapy Monotherapy

April 15, 2014

The American Brachytherapy Society consensus guidelines state that prostate volume > 50 mL is a relative contraindication to high-dose-rate (HDR) brachytherapy. We reviewed our experience with HDR brachytherapy to determine if prostate volume affected prostate target coverage or the risk of acute urinary toxicity.

(P085) Exploiting Androgen-Induced DNA Double-Strand Breaks: Optimal Sequencing of Androgen Suppression and Radiation for Superior Tumor Control in the Treatment of Prostate Cancer

April 15, 2014

We provide evidence that irradiating tumors at a time point when formation of androgen-induced double-strand breaks is ongoing provides superior control when compared with radiation that is delivered when tumors are fully deprived of androgens. These results may have significant implications for altering current clinical management of intermediate-and high-risk prostate cancer treated with definitive radiotherapy.

(P086) The First National Experience of TraceIT™ Tissue Marker Placed Intravesically Under Local Anesthesia for Imaging Visualization of Recurrent Muscle-Invasive Transitional Cell Carcinoma for Targeted Radiotherapy

April 15, 2014

TraceIT hydrogel, injected endoscopically under local anesthesia in an office setting, can be considered a feasible option to precisely map tumor location with margins to facilitate targeted RT. The precise delineation of tumor margins on cone beam CT (CBCT) obtained with TraceIT could significantly improve an oncological outcome with minimal side effects.

(P090) Comparison of Intraoperatively Built Custom-Linked (IBCL) Seeds to Free Seeds for Permanent Prostate Brachytherapy

April 15, 2014

Our prostate brachytherapy technique at the Medical University of South Carolina evolved from implanting free seeds using a Mick Applicator (MA) (Mick Radio-Nuclear Instruments, Inc) to using intraoperatively built custom-linked (IBCL) seeds constructed with the QuickLink device (C.R. Bard, Inc). In this work, we compare dosimetric and early clinical outcomes using free seeds and IBCL seeds.

(P091) The Clinical Significance of Overlap or Underlap of the Prescription Isodose Line and Prostate Contour in Brachytherapy for Low-Risk Prostate Adenocarcinoma

April 15, 2014

While biochemical progression-free survival (BPFS) for prostate cancer treated with brachytherapy is excellent, reported outcomes differ between groups. One hypothesis that has been proposed for improved biochemical outcomes is prescribing to a planning target volume (PTV) that extends substantially beyond the prostate. We tested this hypothesis by analyzing the effect of overlap vs underlap between prescription isodose lines and prostate contours on BPFS. We also assessed whether these spatial differences are correlated with increased acute toxicity.

(P104) Trends in the Use of Neoadjuvant Radiotherapy for Rectal Cancer in the Academic Versus Community Setting

April 15, 2014

The use of neoadjuvant radiotherapy is the standard of care in the treatment of locally advanced rectal cancer. The aim of our study was to identify if patients underwent radiation first vs surgery and if the treatment patterns changed with time.

(P105) Improving Clinical Outcomes in Definitive Treatment of Esophageal Cancer Using a Novel Endoesophageal 3-Tube HDR Technique

April 15, 2014

To review our local control (LC), survival, and swallowing outcomes using an innovative endoesophageal brachytherapy technique. Further, we conducted a dose-volume comparison for clinical target volume (CTV) using the standard 1-tube vs our novel 3-tube technique.

(P107) Duodenal Sparing Stereotactic Body Radiation Therapy for Locally Advanced Pancreatic Cancer: Technique, Toxicity, and Local Response

April 15, 2014

The proximity of the pancreas to the bowel presents a unique challenge for pancreatic cancer stereotactic body radiotherapy (SBRT). This study explores the safety and effectiveness of a novel approach optimizing pancreatic tumor coverage and duodenal sparing.

(P108) A Dosimetric Comparison of Endorectal Brachytherapy, Tomotherapy, Linac-Based Stereotactic Body Radiotherapy (SBRT), and Cyberknife for the Delivery of a Rectal Tumor Boost

April 15, 2014

Neoadjuvant chemoradiation or a short course of pelvic radiation therapy followed by surgery is the standard of care for patients diagnosed with locally advanced rectal cancer. For patients who are not surgical candidates, delivery of a tumor boost is frequently considered. The present analysis compares dosimetry of endorectal brachytherapy (ERBT) with three different image-guided radiation therapy (IGRT) techniques.

(P002) Impact of Three Decades of Screening on Cervical Cancer Incidence

April 15, 2014

Effective cancer screening should detect disease at an earlier, more curable stage and thus reduce the incidence of late-stage diagnosis. In the last 3 decades, the Pap smear has become widely practiced in the US and is effective in the early diagnosis and prevention of cervical cancers.

(P003) Isolated Port-Site Metastases Following Laparoscopic Hysterectomy for Endometrial Cancer: Outcomes of Patients Treated With Radiotherapy

April 15, 2014

Laparoscopic hysterectomy is increasingly replacing total abdominal hysterectomy as the standard approach in the management of endometrial cancer. An uncommon but reported complication of this minimally invasive approach is the recurrence of disease at the surgical entry site, known as port- or trocar-site metastasis.

(P004) Definitive Radiation in Early-Stage Endometrial Carcinoma

April 15, 2014

The purpose of this study is to describe the outcomes of definitive radiation in medically inoperable early-stage endometrial carcinoma. Although early-stage disease usually results in favorable overall survival (OS) after surgery, there is a growing cohort of patients who are medically inoperable secondary to morbid obesity.

(P005) Time to Cervical Stent Placement as a Predictor of Prolonged Treatment Course in Patients Treated With Definitive Chemoradiation Therapy for Cervical Cancer

April 15, 2014

While it is known that definitive chemoradiotherapy (CRT) for cervical cancer should be completed within 56 days, many patients experience delays which prolong treatment. Our objective is to evaluate factors predictive of prolonged treatment time, including time of stent placement, in this patient population.

(P009) Early-Stage Carcinosarcoma Treated With Adjuvant Radiotherapy and Chemotherapy

April 15, 2014

Adjuvant chemotherapy coupled with intravaginal radiotherapy (RT) seems to provide a good outcome in terms of low rate of isolated pelvic recurrence. However, given the rate of distant metastasis, further intensification of systemic therapy is still needed in this group of patients.

(P010) Clinical Outcomes in Patients With Early-Stage Uterine Clear-Cell Carcinoma

April 15, 2014

There is a paucity of data on the clinical outcomes in women with uterine clear-cell carcinoma. The purpose of this study is to report single-institution clinical outcomes in patients with early-stage uterine clear-cell carcinoma.

(P012) National Trends in Surgery for Sinonasal Malignancy: The Effect of Hospital Volume on Short-Term Outcomes

April 15, 2014

Sinonasal carcinomas are rare, highly morbid neoplasms originating in the nasal cavity and paranasal sinuses. The mainstay of treatment over the past 2 decades has been a combination of surgery, radiation, and chemotherapy. We sought to characterize trends in the initial management of sinonasal malignancy with a particular focus on the impact of hospital volume on surgical care and outcomes.

(P011) Efficacy and Morbidity of Temporary Iodine-125 Brachytherapy in Pediatric Rhabdomyosarcomas

April 15, 2014

Rhabdomyosarcomas are the most common soft tissue tumors in the pediatric population, and they have a high propensity for local recurrence. Adjuvant radiation therapy is often used in their management and has a vital role in maximizing local control.

(P013) Radiotherapy at End of Life in Children

April 15, 2014

Some published reports indicate that radiation therapy (RT) may be overutilized in adult patients at end of life (EOL), defined as within 30 days of death. With regard to the pediatric population, very little data exist evaluating the use of RT at EOL.

(P015) Delayed Cerebrovasculopathy Due to Cranial Radiation Therapy for Pediatric Tumors

April 15, 2014

Radiation-induced cerebrovascular injury in the form of accelerated arteriosclerosis of blood vessels is a well-known phenomenon. Delayed cerebrovasculopathy in pediatric cancer patients as a result of cranial irradiation has been reported to present as Moyamoya disease or intracerebral hemorrhage.

(P016) Management of Pediatric Intracranial Low-Grade Gliomas: Long-Term Follow-up After Radiation Therapy

April 15, 2014

The treatment of pediatric low-grade gliomas (LGGs) generally begins with maximal safe resection. Radiation therapy (RT) and chemotherapy are typically reserved for patients with incomplete resection and/or disease progression. We report long-term treatment outcomes and toxicities in a cohort of pediatric patients with LGG after RT.

(P014) Age and Gender Patterns in the Use of Anesthesia for Children Receiving Radiotherapy

April 15, 2014

Complications in pediatric patients receiving anesthesia-assisted radiation therapy (AART) are rare, but the procedure is time-, space-, and resource-consuming. We analyzed our experience with AART for identifiable patterns regarding age and gender in children receiving daily proton radiation therapy.

(P017) Prolonged Progression-Free Survival for Surgically Managed P16-Negative Squamous Cell Carcinoma of the Oropharynx

April 15, 2014

It is well known that survival of patients with p16-negative oropharyngeal squamous cell carcinoma has a poor prognosis with standard chemoradiation. Studies have not compared the addition of surgery to chemoradiation as a method to improve survival. This study was designed to assess the benefit in progression-free survival (PFS) based on p16 status when surgery is included as part of the treatment paradigm for patients with squamous cell carcinoma of the oropharynx.