Purpose or ObjectiveBrain metastases (BM) occurs in 10-30 % in adult cancer patients, and it is an important factor affecting patient survival rate and quality of life.In recent years, neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) have been reported to correlate with overall survival (OS) in various cancers.However, few reports have verified the NLR and PLR in patients with BM.The purpose of this study is to evaluate whether NLR and PLR is a prognostic factor for OS, using in Japanese BM patients our hospital. Material and MethodsWe retrospectively compiled the NLR and PLR in patients who received radiotherapy in our hospital from March 2011 to December 2017.Neutrophils, platelet and lymphocytes were calculated based on absolute values and analyzed with the OS.The absolute values of neutrophils, platelet and lymphocytes were obtained at the time of diagnoses of primary cancer and BM.For the data of BM, we didn't exclude patients who underwent chemotherapy or molecular targeted drugs for primary tumor. ResultsThe number of patients is 256, and primary sites were 150 lung, 66 breast, 15 gastrointestinal, 7 urological, and 18 others.The median age of the patient cohort at diagnosis of primary cancer was 65 years (range: 20-87 years), and BM was 66 years (range: 24-87 years).The patient group contained 136 males and 120 females, median KPS of BM detection was 70 (range: 10-100).Radiation therapy was 227 patients of whole brain irradiation (20-40 Gy) and 29 patients of stereotactic radiotherapy (15-32 Gy).The median follow up period was 19 months (mo.) from cancer diagnosis (range: 1-236 mo.), and 5 mo.from BM detection (range: 1-83 mo.).The median survival time (MST) from cancer diagnosis was 33 mo.and MST from BM detection was 9 mo.Patients with NLR <4.0 at the diagnosis of primary cancer had better MST compared with patients with NLR ≥4.0 (24 mo. vs. 12 mo.;P=0.0116).Patients with PLR <150 at the diagnosis of primary cancer had better MST compared with patients with PLR ≥150 (33 mo. vs. 13 mo.;P=0.0012).Patients with NLR <4.0 at the time of BM detection had better MST compared with patients with NLR ≥4.0 (12 mo. vs. 4 mo.;P<0.001).Patients with PLR <150 at the time of BM detection had better MST compared with patients with PLR ≥150, but there was no significant difference (15 mo. vs. 7 mo.;P=0.0538).Utilizing Multivariate analysis, age ≥65 and PLR ≥150 at the diagnosis of primary cancer were significantly correlated with survival (HR2.30;P=0.0008,

PURPOSE:Based on a retrospective analysis, this study aims to develop a simple index for validity of the evaluation point for the dosimetric verification of intensity-modulated radiation therapy (IMRT). METHODS:The results for the dosimetric verifications of a total of 69 IMRT plans were analyzed in this study. A Farmer-type ion chamber was used as a dose detector, and a solid water-equivalent phantom was used. Index values were obtained by dividing the difference between the maximum and minimum dosages by the mean dosage of the 69 plans, and the values were classified into five groups with index value <4, 4-8, 8-12, 12-16, and >16. A t-test was used to assess the statistical significance of the mean differences of the absolute values of the relative errors among these groups. RESULTS:We found that there was no significant difference between the groups with index value <4 and 4-8 (p = 0.152); however, there were significant differences between the other groups (p < 0.01). In addition, when the index values were smaller than 8, the pass ratio of 3% tolerance was 96.2% and the pass ratio of 5% tolerance was 99.9%. We observed that the smaller the index value, the smaller the uncertainty of the dose measurement. CONCLUSIONS:The results obtained in this study may prove to be useful for accurate dosimetric verifications of IMRTs when ion chambers are used.

ESTRO 36 _______________________________________________________________________________________________ sepsis.Both patients had not received concomitant CTX. ConclusionOur evaluation did not reveal relevant prolongation of treatment due to RCT strategy when administering proton beam therapy in very young patients according to EU-RHAB.However, experienced, multidisciplinary teams have to carefully accompany these very young patients in order to appropriately manage treatment complications and to avoid treatment interruptions potentially jeopardizing treatment efficacy.