S584 I. J. Radiation Oncology d Biology d Physics Volume 69, Number 3, Supplement, 2007

Conclusions: The QOL analyses reveals differences between tx modalities in all scale scores between baseline & tx completion. Txmodality has significant influence on mean responses, impacting patients’ functioning, symptomatology & overall QOL. MS wasonly grp with resolution & improvement in 13/15 scales within 3 mo. They maintained those mean scores 2 yrs post tx.

Author Disclosure: C.J. Flynn, None; C. Mitchell, None; G. Boyea, None; F. Vicini, None; A. Martinez, None.

2690 Assessment of Quality of Life in Patients With Esophageal Cancer After Combined Modality Therapy

R. C. Miller, P. J. Atherton, B. Kabat, M. Fredericksen, C. Deschamps, A. Jatoi, Y. Romero

Mayo Clinic College of Medicine, Rochester, MN

Purpose/Objective(s): To evaluate changes in quality of life (QOL) of patients with esophageal carcinoma following treatmentwith chemotherapy and radiotherapy.

Materials/Methods: The Mayo Clinic Esophageal and Barrett’s Esophagus Registry (EABE) is a multi-institutional resource thatincludes blood, fresh-frozen and formalin-fixed tissue, linked pathologic and clinical data, and serial validated symptom and qualityof life (QOL) questionnaires obtained over time. The current investigation was performed using patients from the EABE Registrywho had have completed at least 2 QOL assessments (at baseline and 1 year later). Each QOL measurement consisted of the LinearAnalogue Self Assessment (LASA) which contained 12 questions relating to overall QOL and sub-components of QOL includingsocial, spiritual, physical, mental, emotional, social support, financial, pain (2 questions), fatigue and legal issues. 42 patients in theEABE Registry had received chemotherapy and were identified as having a QOL assessment completed pre- and post-therapy.41 of those 42 also received radiation therapy (RT). 29 (69%) underwent esophagectomies. Kruskal-Wallis tests were performedfor the difference in continuous data between groups and Chi-square (or Fischer-Exact) tests were performed for differences incategorical data between groups.

Results: Median Age was 60 (35.0–83.0 range). 35 (83%) were male and 7 (17%) were female. 37 (88%) had locally advancedtumors (T3-4NxM0 or TxN1M0 or TxNxM1a), 2 (5%) were early stage tumors (T1-2N0M0), and 3 (7%) were metastatic (TxNxM1b) atdiagnosis. 7 (17%) patients developed recurrence. Pain Frequency (p = 0.02) and Pain Severity (p = 0.01) were both statisticallysignificantly worse over time. Financial Well-being (p = 0.06) and Overall QOL (p = 0.09) were both marginally significantlyworse. There were no significant differences to report when comparing QOL scores by relapse status, however, a subset analysisof only patients without recurrent disease revealed that there was significantly worse Pain Severity (p = 0.04) and a trend towarda worse Pain Frequency (p = 0.07). Between genders, there was a marginal difference in Social Activity. (p = 0.07). Between mar-ital status, there were statistically significant differences between Mental Well-being (p = 0.01), Physical Well-being (p = 0.02),Overall QOL (p = 0.002) and Spiritual Well-being (p = 0.03) with single people having more improvement with time. When LASAQOL is evaluated by stage, comparing the locally advanced patients to the rest, the locally advanced patients did significantly worsethan the other stages in both change in Financial Well-being (p = 0.02) and change in Legal Concerns (p = 0.02) but did better whenconsidering change in Pain Frequency (p = 0.05).

Conclusions: Survivors of esophageal cancer may require ongoing attention regarding pain management, both in terms of severityand frequency, even in the absence of recurrence. Although patients receiving multi-modality therapy for locally advanced tumorsmay experience less pain frequency in comparison to similar stage patients not receiving such therapy, the increased complexityin medical treatment may impact financial and legal aspects of QOL to a greater degree.

Author Disclosure: R.C. Miller, None; P.J. Atherton, None; B. Kabat, None; M. Fredericksen, None; C. Deschamps, None;A. Jatoi, None; Y. Romero, None.

2691 Partial Volume Analysis Predicting Late Side Effects in LDR Brachytherapy of Prostate Cancer

R. Baumann, A. Warszawski, J. Wassermann, S. Machtens, J. Karstens

Medizinische Hochschule Hannover, Hannover, Germany

Purpose/Objective(s): LDR brachytherapy with permanent implants is a validated method of treatment of prostate adenocarci-nomas of favourable prognosis with low side effects. The aim is optimal tumor control while maintaining qualitiy of life for thepatient. Dose distribution in the base and apex of prostate and in the penile bulb and its influence of the probability of urinary tox-icity and erectile dysfunction was analysed.

Materials/Methods: From 2000 to 2006 in our institution 540 patients were implanted with I-125 radioactive seeds following therecommendations of the ABS and the ESTRO/EORTC for a permanent prostate brachytherapy. Base for the dosimetry was anultrasound guided intraoperative interactive real-time planning (VariSeed 6.7/7.0/7.1). Post-implant CT dosimetry was performedin all patients 6 weeks after implantation. Looking for coherences between dose distribution and side effects in addition to the de-termination of the standard dosimetric parameters recommended by the ABS a partial volume analysis was performed of the apicaland basal part of the prostate and the penile bulb in the interoperative planning as well as in the post-implant CT plan. All patientshad a systematic clinical follow-up in regular intervals. Quality of life, urinary symptoms and erectile function was analysed usingstandardized questionnaires (IPSS, IIEF, LQS) every 6 weeks for 6 to 48 months.

Results: No significant differences were seen in the volume analyses (volume of prostate, apex and base) achieved in the intra-operative ultrasound planning and post-implant CT planning. The mean D90 of apical part of the prostate was 177 Gy in the ul-trasound planning and 165 Gy in the CT plan, mean D90 of the base of the prostate was 175 Gy and 159 Gy. The D90 of the penilebulb in the CT post-plan was 40 to 78 Gy (median 56 Gy) and the D50 55 to 130 Gy (median 82 Gy). The dosimetric data of thepartial volumes were correlated to the IPPS, EF and LQI data of patients. The median follow-up was 2.6 years. A significant cor-relation of dose distribution in the partial volumes and quality of life and erectile function could be shown.

Conclusions: The interactive real time planning offers the opportunity of optimizing the dose distribution not only to the prostatebut also to partial prostate volumes and organs of risk. The dose distribution in these partial volumes seems to be relevant forerectile function and quality of life after implantation.

Author Disclosure: R. Baumann, None; A. Warszawski, None; J. Wassermann, None; S. Machtens, None; J. Karstens, None.