International Journal of Radiation Oncology Biology Physics
S756
Scientific Abstract 3385; Table
Variable
Primary Tumor Size <5cm
Primary Tumor Size 5-10cm
Primary Tumor Size >10cm
Primary Tumor Site - Extremities
Primary Tumor Site - Trunk
Treatment - Surgery Only
Treatment - No Treatment
Treatment - Radiation Only
Treatment - Surgery + Radiation
Multivariate Analysis of Predictors for Overall Survival and Disease-specific Survival
Number (Percent)
49
61
43
134
44
81
23
24
82
Overall
Survival - HR
(22.69%)
(28.24%)
(19.91%)
(62.04%)
(20.37%)
(37.50%)
(10.65%)
(11.11%)
(37.96%)
1.00
1.96
2.76
1.00
2.06
1.00
2.10
2.90
0.67
Overall
Survival - CI
Overall
Survival - P
(0.87-4.38)
(1.16-6.58)
(1.27-3.34)
(1.13-3.90)
(1.46-5.74)
(0.40-1.12)
-
Conclusions: In conclusion, our SEER-based study has identified a subset of
216 patients with ASPS in which the 5-year OS rate is 57% (95% CI 5064%). Older age, male sex, large tumor size of >10cm, distant metastasis at
diagnosis, and trunk as primary tumor site are identified as negative predictors of survival. The use of radiation with surgery does not significantly
impact survival rates. Because SEER is limited by lack of data concerning
local control and adjuvant chemotherapy, Medicare-linked SEER datasets
and detailed cohort studies are in need to further treatment options for ASPS
and to address the role of adjuvant radiation therapy and chemotherapy.
Author Disclosure: H. Wang: None. A. Jacobson: None. D. Harmon:
None. J. Michaelson: None. T.F. DeLaney: None. Y. Chen: None.
3386
Electronic Brachytherapy for the Treatment of Nonmelanoma Skin
Cancer: Results up to 4 Years
A. Bhatnagar1,2; 1Cancer Treatment Services Arizona, Casa Grande, AZ,
2
University of Pittsburgh School of Medicine, Pittsburgh, PA
Purpose/Objective(s): The objective of this study was to assess adverse
effects, cosmesis, and recurrence rates up to four years following high dose
rate (HDR) electronic brachytherapy for the treatment of non-melanoma
skin cancer (NMSC).
Materials/Methods: From July 2009 to August 2013, 187 patients with
277 NMSC lesions were treated under an IRB approved protocol with
HDR electronic brachytherapy using surface applicator to a dose of 40 Gy
in 8 fractions, delivered twice weekly. A 10-50 mm surface applicator was
selected to allow for complete coverage of target lesion with acceptable
margin. Photographs were taken at initial consultation and follow up.
Patient care included use of petrolatum ointment during treatment and aloe
vera gel through 1 month post-treatment. At follow up, patients were
assessed for acute and late toxicities, cosmesis and local control.
Results: Treatment of 277 lesions was completed in 187 patients with a
mean age 73 years (range 49-98 years). There have been no recurrences to
date with a mean follow up of 13 months (range 1-51 months). One-month,
3-month, 6-month, 1-year, 2-year, 3-year and 4-year data were available
for 204, 145, 94, 88, 46, 28 and 6 lesions, respectively. The most frequent
acute effects were rash dermatitis in 90 (44.1%), pruritus in 9 (4.4%) and
hyperpigmentation in 4 (2.0%) of 204 lesions evaluated at 1 month after
treatment. These acute effects were present in less than 8% of lesions at 1
year after treatment. The most frequent late effects were hypopigmentation
in 17 (10.1%) and alopecia in 4 (2.4%) of 168 lesions evaluated at 1 or
more years after treatment. All adverse events were grade 1 or 2 except one
grade 3 non-healing foot ulcer that eventually required hyperbaric oxygen.
Scientific Abstract 3386; Table
.103
.022
.0035
.019
.0023
.126
Disease-specific
Survival - HR
1.00
1.96
3.13
1.00
2.50
1.00
2.58
3.36
0.73
Disease-specific
Survival - CI
Disease-specific
Survival - P
(0.84-4.59)
(1.26-7.79)
(1.52-4.12)
(1.36-4.89)
(1.62-6.97)
(0.42-1.29)
.121
.014
.00031
.0038
.0012
.282
Cosmesis at one-year was excellent for 81 (96.4%) and good for 3 (3.6%)
of 84 evaluable lesions, at two-years was excellent for 40 (88.9%) and
good for 5 (11.1%) of 45 evaluable lesions, at three-years was excellent for
25 (89.3%) and good for 3 (10.7%) of 28 evaluable lesions and at fouryears was excellent for all 6 (100%) evaluable lesions.
Conclusions: Treatment of NMSC with HDR electronic brachytherapy
using surface applicators resulted in complete response of all 277 lesions
with no recurrences and good to excellent cosmesis up to four years posttreatment. Acute toxicities resolved within one year and late toxicities
were acceptable up to four years post-treatment. HDR electronic brachytherapy provides a convenient non-surgical treatment option for NMSC
patients.
Author Disclosure: A. Bhatnagar: A. Employee; Cancer Treatment Services Arizona. E. Research Grant; Icad. G. Consultant; Icad,DermEbx,Varian. H. Speakers Bureau; Varian. K. Advisory Board; Icad,Radion. N.
Stock Options; Radion. R. Ownership Other; CTSI,DermEbx.
3387
Myxoid Liposarcomas Demonstrate a Profound Response to
Neoadjuvant Radiation Therapy: An MRI-Based Volumetric Analysis
and Pathological Correlation
T.R. Chapman,1 G. Jour,1 B.L. Hoch,1 D.J. Davidson,1,2 R.L. Jones,1,2
G.M. Kane,1 and E.Y. Kim1; 1University of Washington Medical Center,
Seattle, WA, 2Seattle Cancer Care Alliance, Seattle, WA
Purpose/Objective(s): Soft tissue sarcomas (STS) are a rare and histologically diverse group of tumors. Their treatment often involves neoadjuvant chemotherapy and/or radiation (RT). Myxoid liposarcoma (ML)
is a histologic subtype characterized by favorable response rates to
chemotherapy and RT. We aimed to quantify the volumetric response of
these tumors to neoadjuvant therapy, using measurements on serial MRIs,
and to correlate these findings with pathologic data.
Materials/Methods: After IRB approval, we performed a retrospective
analysis of patients with a pathological diagnosis of ML from 1999 to
2013. Sixty seven patients were identified, of which six received neoadjuvant RT. All patients underwent baseline MRI before initiation of
chemotherapy or RT and repeat MRI prior to surgery. Gross tumor volumes
were contoured on pre-therapy and post-therapy T1 weighted, postcontrast MRIs using MIM software. Surgical specimens were reviewed by
a STS pathologist and tumor response to therapy was quantitatively
defined as tumor hyalinization/hypocellularity or necrosis.
Results: Four men and two women were included (mean age 51 years).
There were five tumors of the limb and one of the pelvis. Four were
Treatment By Diagnosis
Diagnosis
Number of lesions (%)
Lesion size < Z 1 cm (%)
Lesion size
1-5 cm (%)
Treatment time:
mean (range)
Basal Cell Carcinoma
Squamous Cell Carcinoma
Merkle Cell Carcinoma
Cutaneous T-Cell Lymphoma
B-Cell Lymphoma
Basal-Squamous Cell Carcinoma
160 (57.8%)
110 (39.7%)
2 (0.7%)
3 (1.1%)
1 (0.4%)
1 (0.4%)
106 (66.3%)
70 (63.6%)
0
0
1
0
54 (33.8%)
40 (36.4%)
2
3
0
1
5.6
5.7
5.8
8.4
5.2
5.2
(4-11) min
(4-13) min
(5-7) min
(6-14) min
min
min