S280 Abstracts characteristics) was used to determine sensibility and specificity of the scores according to overall survival prognosis. Results: In multivariate analysis a triple-negative receptor status, evidence of extracranial metastases and a higher age (categorized as <60 or >60 years) were confirmed as unfavorable prognostic factors in terms of overall survival with brain metastases. HER2-positivity correlated with better survival prognosis. When evaluating the ability of the different scores to correctly stratify patients with short or long life expectancy, the breast cancer-specific Breast-GPA reached the highest prognostic value in the Kaplan–Meier- analysis (p < 0.001), as well as the highest diagnostic accuracy in the ROC analysis (AUC = 0.714; specificity: 0.98; positive predictive value (PPV): 0.875). In addition the breast cancer-specific Breast-GPA score gave the highest accuracy to identify a group of patients with very poor prognosis (survival of less than three months) (specificity: 0.98; PPV: 0.875). However, to select patients with rather good prognosis (survival 12 month) the non-specific GPA score (p = 0.005; AUC = 0.696) yielded the most convincing results. Conclusions: The results of this study show that within the cohort of patients who underwent radiotherapy for brain metastases of breast cancer, the breast cancer-specific Breast GPA seems to be the most useful score to identify women with very poor prognosis, whereas the unspecific GPA- Score was able to select patients with rather good prognosis (survival >12 months). Implementation of these scores into clinical routine should provide a tool to select breast cancer patients with BM for different treatment modalities. No conflict of interest. 1844 POSTER Preliminary treatment results of new hypoxic radiosensitizer ‘KORTUC’ (Kochi oxydol-radiation therapy for unresectable carcinomas) containing hydrogen peroxide and sodium hyaluronate for massive unresectable locally advanced breast cancer T. Hamada 1 , T. Shinbo 1 , N. Yoshikawa 1 , H. Yoshioka 1 , Y. Tanaka 1 , K. Yoshida 1 , Y. Uesugi 1 , T. Komori 1 , Y. Narumi 1 . 1 Osaka Medical College Hospital, radiology, OSAKA, Japan Background: Huge unresectable locally advanced breast cancer (HU- LABC) is often observed in patients who have exhausted chemotherapy, hormone therapy or any other treatments. In these cases, treatment options are very limited, and the patient’s QOL is significantly reduced because of the pain, bleeding and foul smell. Although radiotherapy for HULABC had been attempted, the treatment response was not favorable. The reason for the treatment resistance in such cancers is that they contain hypoxic tumor cells. Use of a hypoxic radiosensitizer named Kochi Oxydol-Radiation therapy for unresectable carcinomas (KORTUC) with radiotherapy (KORTUC- RT) was developed in Japan and has been used to treat these tumors. KORTUC contains 0.5% hydrogen peroxide and 0.83% sodium hyaluronate. This treatment is thought to rediosensitize hypoxic cells by inactivating peroxidase/catalase and also to re-oxygenize the tumor tissue by degradation of hydrogen peroxide. It has been reported that the local control rate may become higher by this treatment compared to conventional radiotherapy alone. Some researchers reported that this therapy could control different kinds of huge-advanced carcinomas. In this study, we treated HULABC with KORTUC-RT and we reported the preliminary results. Material and Methods: KORTUC was injected into the tumor tissue two times per week under ultrasonographic guidance prior to each administration of radiotherapy. Three cases of HULABC were treated (age; 53−70 years old). The T-staging was T4 and the tumor size was more than 10 cm for all the patients. KORTUC-RTs was performed at hypofractionated schedules (2.5−3.5 Gy in one fraction). The total treatment dose was 59–67.5 Gy by 21−25 fractions. Chemotherapy or hormonal therapy was continued during the KORTUC-RT for all patients. These treatments showed no response or progression of disease. Results: The median follow-up period was 18 months (5−18 months). A complete response was achieved in two patients and the tumor control is kept at present. The third patient showed near CR, however, she succumbed to lung metastasis 5 months after the KORTUC-RT. No adverse effects of the KORTUC-RT were observed. Conclusion: Though this study was conducted with a small number of patients and the follow-up time was short, new hypoxic radiosensitizer ‘KORTUC’ seemed to be very effective and safe in treating HULABC. In future, further follow-ups and a randomized clinical trial between radiotherapy with or without ‘KORTUC’ are neccessary. No conflict of interest. 1845 POSTER Latissimus dorsi flap for closure of large chest defects after excision of locally advanced fungating carcinoma breast as a formidable treatment option A.U. Qureshi 1 , M.A. Cheema 1 , S.S. Qureshi 1 . 1 King Edward Medical University, Department of Surgery, Lahore, Pakistan Introduction: Fungating breast carcinoma according to AJCC classification is termed as T4 which by no means explains the spectrum of disease and their outcome on patients. NCCN guidelines on breast carcinoma published in 2015 interestingly does not include the word “fungating” breast carcinoma in more than 150 page document. Other guidelines published by well-established breast cancer societies and authorities fail to give a standard algorithm for treatment of fungating breast carcinoma. There is a controversial debate on whether palliation or resection is a better treatment options. Most common presentation of such patients are with fungating tumours which bleed or have foul smell and patient is unable to sustain a normal social life. Resection as a palliation is one of the accepted treatment options worldwide however, toilet mastectomies in such groups leave a large skin defect. These defects are closed primarily by a number of different surgical options. Material and Methods: We are reporting a series of 23 cases of such patients who had locally advanced breast carcinoma where latissimus dorsi flap was used to close the defect primarily. Results: 23 patient (21 females, 2 males) with an mean age of 43.22 years were included in the study. Most of the cases were is stage IIIC. Indication for surgery was mainly large fungating carcinoma with either bleeding (n = 9/23) or foul smelling discharge (n = 19/23) cases. All the cases had ulcerative growth larger than 15 cm in longer diameter, where primary clo- sure was not possible without tension in the suture line. In our case series average blood loss was 265+87 ml and mean operative time for incision to final closure was 162 + 24.6 min. There was no perioperative mortality and stitches was removed on 14 postoperative day on average. Tumour recurrence (n = 2/23) Wound infection (n = 3/23) and Partial flap necrosis (n = 1/23) cases were the common complications. All patients were sub- jected to adjuvant chemotherapy. All local recurrence cases were managed successfully by local exploration and resection of recurrent lump. Disease specific mortality at 5 years in n = 4/21 as two patients have lost to follow up. Discussion: Use of LD flap to close large defects after fungating tumours is an excellent option to treat bleeding breast cancer which otherwise can kill the patient due to excessive hemorrhage. We have found the procedure very useful in improving quality of life of patient and reducing bleeding, foul smelling discharges and able to start local chemoradiation due to muscle mass available on the tumour area. Longest surviving patient with stage IIIC invasive ductal carcinoma is 8 years. No conflict of interest. 1846 POSTER Efficacy and safety of a new oral hyroxysterol (24-ethyl- cholestane-3b,5a,6a-triol) in the treatment of advanced breast cancer N. Habib 1 , H. Daaboul 1 , G. Hage 1 , A. Jabbour 1 , H. Zeitouni 1 , N. Kassem 1 , A. Yammine 1 . 1 Nabil Habib Institute, Oncology, Beirut, Lebanon Background: Oxysterols which are oxidative derivatives of cholesterol have nuclear receptors and have been shown to pass cell membranes and the blood-brain barrier at a faster rate than cholesterol itself. In addition, oxysterols have been ascribed a number of important roles in connection with cholesterol turnover, atherosclerosis, apoptosis, and necrosis. Oxysterols have been shown to have antitumor effects on experimental models. (24-ethyl-cholestane-3b,5a,6a-triol) is a new oral hydroxysterol. The introduction of additional hydroxyl groups to the cholesterol skeleton facilitates the flux of oxysterols across the blood brain barrier. Most of these derivatives have been shown to be very toxic. Our compound (24-ethyl-cholestane-3b,5a,6a-triol) is the first oxysterol to have reached the clinical level. It is also one of the rare ones to be non toxic. Material and Methods: We have treated with this new compound 16 patients suffering from advanced breast cancer. The median age was 61 years. Fifteen patients had stage IV and one stage III. All had received at least one line of chemotherapy (some received more than 4 lines of therapy) and all except 3 previous radiotherapy. Nine patients had a PS: 1, five had a PS: 2 and two had a PS: 3. Seventy-five percent were symptomatic and fifty-eight percent were taking pain killers. Patients received daily 10 mg/Kg of oral (24-ethyl-cholestane-3b,5a,6a-triol) divided in 3 equal doses, until disease progression. Results: Two patients exhibited a complete remission (CR). Six patients had a partial response (PR), Four patients had a stable disease (NC) and four patients had a disease progression (PD). The median duration of response was 15 months and 4 patients are still under treatment. One