Abstract book - ESTRO meets Asia

S105 ESTRO meets Asia 2018

Material and Methods We conducted a retrospective observational study of patients diagnosed with urinary bladder carcinomas who received radiation therapy with definitive intent after maximal TURBT at Radiation Oncology Section, Department of Oncology, Aga Khan University Hospital between February 2006 and June 2018. All the patients with metastatic disease, who underwent cystectomy, received prior radiation therapy to pelvis or with recurrent urinary bladder cancer were excluded from the study. Statistical package for social sciences (SPSS) version 22 was used for data entry and analysis. Results Out of 27 patients identified with urinary bladder carcinomas, 19 were treated with definitive radiation to the pelvis. Mean age was 70 (46-89) years. All the patients were male. Most common histopathology was urothelial carcinoma (84.2%). 13 patients received radiation doses in excess of 60 Gy. Three-dimensional conformal radiation treatment (3D-CRT) planning was done for 13 (68.4%) patients, intensity modulated radiation therapy (IMRT) for 5 (26.3%) and 1 patient (4.8%) was treated with conventional 2-dimensional technique. Chemotherapy was administered in 17 (89.5%) patients; out of whom 10 (58.82%) patients received platinum-based doublet and 7 (41.12%) received single agent. The sequencing of chemo was concurrent in 9 (52.94%) patients, neoadjuvant in 2 (11.76%) and 1 (58.82%) with adjuvant setting. The number of patients who received chemotherapy in both neoadjuvant and concurrent setting were 5 (29.41%). Treatment was completed in 15 (78.9%) patients without any gaps while treatment gap was observed in 4 (21.1%) patients, out of which 3 were treated with 3D-CRT and 1 There is definite role of radiation therapy in selected patients with muscle invasive bladder cancers after multidisciplinary team meeting. Bladder preservation approach is well tolerated and should be discussed with patients who are unfit for surgery or who opt to retain functional urinary bladder. PO-256 Clinical outcomes of penile cancer treated in a tertiary cancer center in India D.H. Kannikanti 1 , S.H. Kombathula 1 , A. Menon 1 , V. Parthasarathy 1 , J. Pandjatcharam 1 1 JIPMER, Radiation Oncology, Puducherry, India Purpose or Objective Penile cancer is one of the common genitourinary cancers in India. We studied the clinical outcomes of penile cancer patients retrospectively from the treatment records. The primary objectives are assessment of 1-year and 2-year disease free survival (DFS) and over-all survival (OS). Material and Methods The treatment records of patients of penile cancer registered in our outpatient department from January 2015- January 2018 were analysed. DFS was calculated from the date of surgery or biopsy until the patient develops a local, regional or distant relapse. OS was calculated as the interval between the surgery or biopsy till the time of death due to any cause. Patients with incomplete information in the records were telephoned and enquired about their disease and vital status. Those who were unavailable on telephone were contacted through post. Results We identified treatment records of 54 patients afflicted with penile cancer. 48 patient records were analysed since 6 had incomplete information. The median age was 50 years (Range: 32-81 years). The histology was squamous cell carcinoma in all patients, 30 of them with well differentiated and 14 with moderately differentiated variants. Clinical nodal involvement at diagnosis was seen with IMRT. Conclusion

comprehensive reports on definitive radiation therapy for ureteral cancer have been published. We therefore conducted a retrospective study to determine the role of radiation therapy in ureteral cancer. Material and Methods The study cohort comprised seven patients with ureteral cancer who had undergone radiation therapy with curative intent from November 2011 to April 2017. Urothelial carcinoma was histologically confirmed in six of them, the remaining patient’s diagnosis being based on findings of MR and CT imaging studies. Five of the patients had newly diagnosed ureteral cancer with contraindications to surgery and one of them had a pelvic lymph node metastasis. Two patients had local recurrence after nephroureterectomy. None had distant metastases. For radiation therapy, the patient was placed in a supine position and immobilized using Blue BAG for BodyFIX. Patients with lower ureteral tumors were treated with a full bladder. All patients underwent intensity-modulated radiation therapy (IMRT) using helical TomoTherapy. A total dose of 56–66 Gy (median, 60 Gy) was delivered to the gross tumor volume with an adequate margin in 28–33 fractions (median, 30 fractions). The patient with lymph node metastasis was given prophylactic irradiation to the ipsilateral pelvic lymph node region. Results Duration of follow-up was 2–76 months (median, 24 months). Six of the seven patients had survived without clinical or radiological evidence of disease progression. The 2-year overall survival and local control rates were 86% and 100%, respectively. One patient died of multiple lymph node and distant metastases soon after treatment. He was initially diagnosed as having N0 disease, however lymph node metastasis was suspected on subsequent review of his imaging studies. According to post-treatment imaging studies, tumors decreased in size and ureteral dilation upstream of the tumor improved in all patients. No acute or late adverse events were noted. Two patients were found to have bladder cancer both before and after treatment of their ureteral cancers. The renal function of two of the five patients with initially diagnosed ureteral cancer improved after treatment; the remaining three had prior chronic renal disease. Conclusion IMRT is a safe and effective treatment modality for patients with ureteral cancer, the major advantage being avoidance of nephroureterectomy. Because lymph node metastasis is a poor prognostic factor, pretreatment evaluation should be meticulous. Additionally, because ureteral cancer tends to be complicated by bladder cancer, careful follow-up is necessary. PO-255 Definitive radiation therapy for muscle invasive urinary bladder cancer: a tertiary care experience M.A. Mansha 1 , A.M.H. Khan 1 , B.M. Qureshi 1 , A.N. Abbasi 1 , N. Ali 1 , A. Hafiz 1 , B. Mirkhan 1 1 Aga Khan University, Oncology, Karachi, Pakistan Purpose or Objective Neoadjuvant chemotherapy followed by radical cystectomy is the standard of care in non-metastatic muscle invasive urinary bladder cancers. Surgery is associated with significant sexual and urinary dysfunction and psychosocial stress which eventually affects patient’s quality of life. There are no head to head randomized comparisons between cystectomy and bladder preservation techniques for muscle invasive bladder cancers. Contemporary bladder sparing approaches combine transurethral resection of bladder tumor (TURBT) followed by concomitant radiation therapy and chemotherapy. We share the experience of definitive radiation therapy for muscle invasive bladder cancer at a tertiary care university hospital.