ESTRO 38 Abstract book

S590 ESTRO 38

parameters including disease stage, length of lesion, KPS and as per grade of dysphagia at presentation. The patients received median dose of 6Gy at 1 cm off axis for 2 fractions one week apart. Fourteen patients were treated radically and 20 patients post EBRT. Multivariate analysis was used to assess the predictors for dysphagia improvement. Remissions of dysphagia and other clinical and radiological factors were assessed in the first month post-treatment, and then in the third, sixth, and twelfth months. The survival rate was compared with some chosen clinical factors using a log-rank test and the Kaplan-Meier method. Results Patients were followed up as per standard institute protocol. Median dysphagia free survival was 12 months. Stricture was seen in 3 patients and ulceration noted in another 2 patients. However, no tracheoesophageal fistula or procedure related complications were noted. Complications were seen with the post EBRT group. The overall survival in the cohort was 12 months and was better post EBRT as compared to radical ILRT (p <0.001). On multivariate analysis, stage of disease (p=0.02), size of lesion (p=0.018) and grade of dysphagia (p=0.023) were found to be predictors for improved outcomes with use of ILRT in palliation. Conclusion Brachytherapy in the form of ILRT in advanced esophageal cancer provides good palliation with minimal complications and improved survival and quality of life to patients. PO-1061 Brachytherapy For Bladder Rhabdomyosarcoma In Children: Initial Single Institutional Experience A. Slocker Escarpa 1 , E. Iraolagoitia Lasa 2 , J. Mases Rosines 3 , D. Najjari Jamal 4 , M. Vancells 5 , J. Mora 6 , F. Pino 7 , C. Gullón 7 , C. Gutierrez Miguelez 4 1 Institut Catalá d´Oncologia, Brachytherapy, Barcelona, Spain ; 2 Hospital Universitario Donostia, Radiation Oncology, Donostia - San Sebastián, Spain ; 3 Institut Català d´Oncologia, Radiation Oncology, Barcelona, Spain ; 4 Institut Català d´Oncologia, Brachytherapy, Barcelona, Spain ; 5 Sant Joan de Déu -Esplugues, Paediatric Surgery, Barcelona, Spain ; 6 Sant Joan de Déu- Esplugues, Medical Oncology, Barcelona, Spain ; 7 Institut Català d´Oncologia, Medical physics, Barcelona, Spain Purpose or Objective As total cystectomy is mutilating, evidence has been published about the possibility of bladder conservation with macroscopic complete gross tumour resection followed by immediate High Dose Rate brachytherapy (HDR-BT). The aim of this abstract is to communicate our initial experience in multimodal approach of treating non- metastatic paediatric bladder rhabdomyosarcoma (RMS) with HDR-BT at Catalan Oncology Institute (ICO). Material and Methods 3 children referred to our paediatric hospital have been treated until July 2018. In all cases, plastic tubes were placed during the surgery of tumour resection, following the HDR-BT technique described by Gustave Roussy Institute. They received 10 fractions (4Gy each, 2 times per day) with a total dose of 40Gy, completing it in the 15 days after surgery. Patient 1: a 2 year-old boy diagnosed in 2009 of bladder neck botryoidal rhabdomyosarcoma classified at intermediate risk group was treated with induction chemotherapy. Protocol evaluation evidenced tumour persistence, and total tumour resection with HDR-BRT was performed in December 2009. Afterwards, he received 6 cycles of adjuvant chemotherapy, finishing all the treatment in May 2010. Patient 2: a 12 year-old girl initially treated with radical concomitant chemoradiotherapy (50Gy, standard fractionation) had tumour persistence. She was referred

vesicles. HDR rectal dosimetry in a cohort of men with hydrogel spacer inserted as described is reported, as well as for 10 patients contemporaneously treated without a

spacer. Results

Complete 10cc hydrogel injection was successful in 6/7 patients and incomplete (<10 cc) in 1 case due to concerns of sheath placement. All men received 15 Gy HDR boost as planned. No complications have been observed. Initial results suggest separation between the prostate and anterior rectal wall was greater after the procedure compared with pre-procedure at all levels (Table 1).

On comparison to contemporously treated cohort without a hydrogel spacer, initial results suggest spacer reduces the volume of rectum receiving clinically significant moderate / high isodose levels ≥ V30 (4.5Gy) (Table 2).

Conclusion Initial experience using an adapted, novel technique of hydrogel injection at the time of HDR brachytherapy suggests that this procedure is feasible and results in greater separation between the prostate and rectum, associated with improved rectal dosimetry. Further work will be reported in a larger cohort of study participants and clinical impact of any dosimetric improvement using patient reported outcome measures.

Poster: Brachytherapy: Miscellaneous

PO-1060 Role of intraluminal brachytherapy as palliative treatment in advanced esophageal cancer V. Pareek 1 , R. Bhalavat 2 , M. Chandra 2 , C. Bakshi 3 , N. Bhambhani 4 1 Jupiter Hospital, Radiation Oncology, Mumbai, India ; 2 Jupiter Hospital, Radiation Oncology, Thane, India ; 3 Jupiter Hospital, Medical Oncology, Thane, India ; 4 Jupiter Hospital, Surgical Oncology, Thane, India Purpose or Objective This study aims to assess the improvement in dysphagia, associated complications and overall and disease free survival with intraluminal brachytherapy (ILRT) as palliative care in advanced esophageal cancer Material and Methods Thirty-four patients were treated with high dose rate ILRT with or without external radiation therapy from 2009 to 2017 at our institute. Patients were assessed for various