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MULTICENTRIC POOLED ANALYSIS OF STEREOTACTIC RADIOTHERAPY IN OVARIAN CANCER: (MITO-RT1 PROJECT)

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Presented at

ESGO State of the Art 2018 Conference

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Abstract

Aims: Stereotactic body radiotherapy (SBRT) represents an interesting opportunity in the treatment of ovarian cancer (OC) isolated recurrences or residual lesions after systemic treatment, as well as a valid tool to lengthen the free time of re-challenge with platinum. However, studies on this topic are sporadic and with few cases. The aim of this multicentric retrospective pooled analysis was to collect the largest unselected real-life dataset of OC patients treated with SBRT in the attempt to define the safety and efficacy. Secondary objectives were to identify the best dose/fractionation regimen in terms of local control as well as to describe acute and late toxicities. Methods: Eight Italian cancer Centers were firstly started the project giving their adhesion to this retrospective pooled analysis. A specific data-set for standardized data collection for ovarian cancer SBRT treatment was developed. Participants were required to fill a data sets including: age, histotype, site of irradiation, previous treatments, best response, toxicity as well as technical/dosimetric data about SBRT treatment. Patients’ data were obtained from the historical database of radiation oncologists who joined the study. Results: Data on 73 OC patients (median age: 63.5, range 40-83) carrying a total of 120 lesions were considered suitable for analysis. Between 2005 and 2018 all patients underwent SBRT in single or multiple fractions with a median biological equivalent dose (BEDα/β 10) of 76.8 Gy (range 7.5-262.5). Patient and treatment characteristics as well as acute toxicity are detailed in Table 1. Safety. 52 patients (71.3%) did not experience acute toxicity, the others 21 (28.7%) experienced low grade acute toxicity with no patient showing > grade 2 toxicity. With a median follow-up of 18 months (range: 1 - 120), 68 patients (93.1%) did not experienced late toxicity, the others 5 (6.9%) experienced low grade late toxicity with no patient showing > grade 2 toxicity. Efficacy. On a per-lesion basis, the 12-and 24-months actuarial local control inside SBRT field were 88.3% and 86.2%, respectively. BED10 > 50Gy was correlated with a better 12-months local control (91.7% versus 72.9%, p=0.034). Conclusions: Preliminary results on a population-level confirm that SBRT delivered in 1-10 consecutive fractions is safe and well tolerated notwithstanding several previous surgical and systemic treatments. Therefore, this treatment can be considered as a further resource in order to lengthen the free time of re-challenge with platinum.

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