Abstract book - ESTRO meets Asia

S90 ESTRO meets Asia 2018

2 Rajiv Gandhi Cancer Institute and Research Centre- Delh i, Radiotherapy, Delhi, India 3 Rajiv Gandhi Cancer Institute and Research Centre- Delh i, Research, Delhi, India Purpose or Objective Gastric cancer is the fourth most common malignancy and the second leading cause of cancer related death worldwide. Surgery remains the mainstay of curative treatment albeit only twenty percent of all patients are amenable for a curative resection, with overall survival ranging 20 – 30 %. Thus adjuvant chemoradaiation after a D2 gastrectomy is evolving as a preferred regimen with a modest survival advantage and an acceptable toxicity profile. This study was conceived with the aim of reviewing gastric cancer data from our institute, in terms of clinical outcomes and patterns of failure. Material and Methods This was a single institute retrospective study of all gastric cancer patients who underwent D2 gastrectomy followed by adjuvant chemoradiation between January 2010 and December 2017. Clinical outcomes in terms of response and failure patterns including time and site of recurrence were recorded. Results A total of 122 patients met the inclusion criteria. The median age at diagnosis was 55.6 yrs with a definite male preponderance accounting for 65% of all patients. Poorly differentiated adenocarcinoma was the commonest histology seen in 54% cases. More than half of the patients had pathological stage III tumours with 95% having node positive status. All patients received adjuvant chemoradiation. Post adjuvant chemoradiation ascites was noted in 10.6% (13/122) patients. Median follow up was – months. Recurrence was seen in 20% (24/122) patients, out of which 10% (12/122) failing distally, lung being the most common site of distal metastasis and 6% (7/122) had isolated local recurrence, with the anastomotic site and peritoneum being the earliest sites to get involved. 14% (17/122) patients had a combines local and distal failure. Conclusion Adjuvant chemoradiation after D2 gastrectomy has become an integral part of management of locally advanced carcinoma stomach with modest survival benefit and a favourable toxicity profile. Results from our institute are encouraging and comparable to world standards PO-220 clinical outcome and patterns of failure after D2resection and adjuvant chemoradiation in Ca stomach R. Khurana 1 , S. Mitra 2 , A. Dewan 2 , I. Kaur 2 , S. Dutta 2 , V. Muthagi 2 , V. Antony 2 1 Rajiv gandhi cancer institute and research centre, Radiation Oncology, Delhi, India 2 Rajiv Gandhi Cancer Institute and Research Centre, Radiotherapy, Delhi, India Purpose or Objective Gastric cancer is the fourth most common malignancy and the second leading cause of cancer related death worldwide. Surgery remains the mainstay of curative treatment albeit only twenty percent of all patients are amenable for a curative resection, with overall survival ranging 20 – 30 %. Thus adjuvant chemoradaiation after a D2 gastrectomy is evolving as a preferred regimen with a modest survival advantage and an acceptable toxicity profile. This study was conceived with the aim of reviewing gastric cancer data from our institute, in terms of clinical outcomes and patterns of failure Material and Methods This was a single institute retrospective study of all gastric cancer patients who underwent D2 gastrectomy followed

by adjuvant chemoradiation between January 2010 and December 2017. Clinical outcomes in terms of response and failure patterns including time and site of recurrence were analysed. Results A total of 122 patients met the inclusion criteria. The median age at diagnosis was 55.6 yrs with a definite male preponderance accounting for 65% of all patients. Poorly differentiated adenocarcinoma was the commonest histology seen in 54% cases. More than half of the patients had pathological stage III tumours with 95% having node positive status. All patients received adjuvant chemoradiation. Post adjuvant chemoradiation ascites was noted in 10.6% (13/122) patients. Median follow up was 36 months. Recurrence was seen in 20% (24/122) patients, out of which 10% (12/122) failing distally, lung being the most common site of distal metastasis and 6% (7/122) had isolated local recurrence, with the anastomotic site and peritoneum being the earliest sites to get involved. 14% (17/122) patients ahd a combines local and distal failure. Conclusion Adjuvant chemoradiation after D2 gastrectomy has become an integral part of management of locally advanced carcinoma stomach with modest survival benefit and a favourable toxicity profile. Results from our institute are encouraging and comparable to world standards PO-221 Initial experiences of SBRT treatment for Hepatocellular carcinoma in Bangladesh M.A. Sumon 1 , A.K. Uddin 2 , S. Chaudhuri 2 , K.R. Mani 2 1 Kurmitola General Hospital, Oncology, Dhaka, Bangladesh 2 United Hospital Ltd, Department of Radiation Oncology, Dhaka, Bangladesh Purpose or Objective Stereotactic Body Radiation Therapy (SBRT) has established its role in Hepatocellular carcinoma (HCC). Purpose of the study was to evaluate the efficacy and tolerability of SBRT in HCC in Bangladesh. Material and Methods Total ten patients with HCC were treated with SBRT from February 2014 to March 2017 were retrospectively analyzed. All the patients underwent 4DCT simulation with rigid and reproducible immobilization devices. Maximum Intensity Projection (MIP) were used to delineate the ITV and cross checked with the 10 phases of 4DCT data. Average Intensity Projection (AvIP) data were used for the dose calculation purpose. SBRT treatments were performed with 6MV Flattening Filter Free beam with a dose rate of 1400MU/min using volumetric modulated arc therapy if the target was irregular and multiple static beams were used in case of regular target shape. The tumour volume (maximum dimension) varies from 116.8 cc (6.1cm) to 1459.9cc (14cm) with median 623.59cc (8.9cm). Dose prescription varied from 30 to 50 gray in 5 to 6 fractions. Target localization and patient setup were verified before and after every treatment fraction by cone beam CT. Overall survival, progression free survival and toxicities were recorded and analyzed. All patients underwent pre-RT-imaging (baseline) and post –RT follow- up imaging with the interval of 3 to 6 months for first two years to monitor the disease progression and control. Results The median age of the patients were 48.31years (range 34 to 64 years) with a base line kernofsky performance status of 90%. Median follow up was 21.3 months, range from 13 to 36 months and mean progression free survival was 15.5 months. With this small group of patients, we found 6 months survival was 90% and 1 year survival was 80%. Out of ten patients, 3 patients died (1 cardiac arrest after 3 years & 2 patients with disease progression), 1 patient lost