ESTRO 36 Abstract Book

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S669 ESTRO 36
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Results
61 patients were treated with a short course of palliative
radiotherapy at the Academic Medical Center. A majority
had stage four disease (69%) and a minority had local
recurrence after surgery (10%). Median age was 62 years,
51% of the patients were male and mean Karnofsky
performance score (KPS) was 79%. Median pain score
before treatment was 8 on an 11-point numeric pain rating
scale. Eighty-five percent of the patients used strong
opioids with a mean equivalent oral morphine dose of 147
mg a day. Four radiotherapy dose schedules were given: 3
x 8 Gy (46%), 2 x 8 Gy (39%), both once per week, 1 x 8 Gy
(13%) and 1 x 6 Gy (2%). Pain relief after radiotherapy was
experienced by 66% of patients. Median time to reduction
in pain was 1 week after end of radiotherapy, although
this time interval could only be assessed in 25 patients.
Information on use of pain medication after treatment was
not clearly documented. Four patients had complete pain
relief and in 4 patients pain medication was reduced or
even stopped. Nausea was a common reported side effect
in 51% and vomiting was reported in 21%. Median overall
survival was 3.5 months. Patients who had pain relief after
treatment had a better overall survival (p<0,0001)
compared to non responders.
Conclusion
A short course of palliative radiotherapy was effective in
66% of the patients with the most frequent given
radiotherapy dose schedule of 3 x 8 Gy. Radiotherapy was
fairly well tolerated. These results were the basis for a
prospective phase-2 study at our institute named
PAINPANC (NTR5143). Thirty patients with painful
unresectable pancreatic cancer will receive 3 x 8 Gy, one
fraction a week, and are prospectively followed with
EORTC-QLQ-C15-PAL and Brief Pain inventory
questionnaires during and after treatment.
EP-1242 Palliative EBRT for incurable esophageal
cancer and symptomatic dysphagia-single center
results
K. Yordanov1, A. Richetti 1, S. Cima1, G. Pesce1, C.
Azinwi 1, F. Martucci1, B. Muoio1, P. Fanti1, M.C. Valli1
1 Oncology Institute of Southern Switzerland,
Radiotherapy, Bellinzona, Switzerland
Purpose or Objective
Purpose: to assess the effectiveness and safety of external
beam radiation therapy (EBRT ) to palliate dysphagia in
advanced esophageal cancer patients treated with total
dose of 40 Gy/2.5Gy.
Material and Methods
we retrospectively reviewed the records of 19 patients
diagnosed with locally advanced or metastatic esophageal
cancer, treated in our institution from 2012 to 2015 with
palliative EBRT. All patients had histologically confirmed
diagnosis of squamous cell or adenocarcinoma of the
esophagus and were symptomatic for dysphagia. Before
the start of EBRT the dysphagia was scored according to
scale 0-4 (0- no dysphagia , 1 -dysphagia with certain solid
foods , 2 -able to swallow semi-solid soft foods , 3-able to
swallow liquids only and 4 - unable to swallow saliva ).
The prescribed total dose to all patients was 40Gy with
daily dose of 2.5Gy, 5 fractions per week in sixteen
fractions using Volumetric Modulated Arc technique . We
evaluated the dysphagia score one months after the end
of the EBRT.
Results
Grade 1 dysphagia was detected before RT treatment in 3
patients ( 15.8%), grade 2 in 8 patients (42.2%), grade 3 in
6 patients (31.5%) and grade 4 in 2 patients (10.5%).No
patient discontinued RT due to acute toxicity.
One month after the end of the EBRT 4 patients(21%)
experienced complete dysphagia relief.
Fourteen patients (73.7%) experienced improvement of
symptomatic dysphagia.
Four patients(21%) had no positive effect and one patient
died 3 weeks after the end of treatment.Conclusion
EBRT with mild hypofractionation is an effective
treatment for esophageal cancer patients with
symptomatic dysphagia. It is well tolerated and can
provide symptom relief and quality of life improvement.
EP-1243 A Study on predictive value of 18F-FDG PET-
CT to Chemoradiation of Esophageal Cancer
J. Li1, W. Sun2
1Fujian Cancer Hospital, radiation oncology, Fuzhou-
Fujian, China
2Fujian medical university, Provincial Clinical College,
Fuzhou, China
Purpose or Objective
To evaluate whether the SUVmax and MTV predict short-
term clinical curative effect of radiotherapy or
chemoradiotherapy in nonoperative esophageal squamous
cell cancer.
Material and Methods
A retrospective analysis was made on 98 cases patients
with esophageal cancer from January 2014 to January
2016 in Fujian Provincial Cancer Hospital. All of them had
an examination by FDG PET/CT before treatment.
Respectively analysis was conducted on SUVmax, MTV's
relationship with clinical factors and short-term clinical
curative effect.
Results
There is no difference on SUVmax and MTV of different
group of age, gender, morbid position and histology
differentiated degree (P > 0.05). Significant difference
was found on SUVmax and MTV of different group of lesion
length, T grade, stage pathologic N stage and clinical (P <
0.05). And positive correlation was noticed between the
SUVmax, MTV and lesion length, T grade, stage pathologic
N stage and clinical stage (P < 0.05). Low MTV group and
low SUVmax group were higher than high MTV group and
high SUVmax group on the percentage of lesion length
reduction(P < 0.05). And it was negative correlation
between SUVmax , MTV and the percentage of lesion
length reduction, but the correlation of MTV was stronger
than SUVmax.
Conclusion
there was no significant effect on SUVmax and MTV for
age, gender, morbid position and histology differentiated
degree (P > 0.05), but lesion length, T grade, pathologic N
stage and clinical stage were significantly positive
correlated with SUVmax and MTV. The SUVmax and MTV
can predict short-term clinical curative effect of
radiotherapy or chemoradiotherapy in nonoperative
esophageal squamous cell cancer, but MTV was more
valuable than SUVmax .
EP-1244 Neoadjuvant Chemo Radiation followed by
Surgery in Ca Esophagus – Retrospective Review from
India
V. Goel1, A.K. Anand1, H.K. Chaturvedi2, A. Verma1, P.
Agarwal1, T. Saxena1, R. Shukla1, D. Arora 3, A.K. Bansal 3,
A. Gulia1, C. Garg1, U. Mukherjee4
1Max superspecality hospital, Radiation Oncology, Delhi,
India
2Max superspecality hospital, Surgical Oncology, Delhi,
India
3Max superspecality hospital, Medical Physics, Delhi,
India
4Max superspecality hospital, Pathology, Delhi, India
Purpose or Objective
Neo-adjuvant Concurrent Chemoradiation (NACCRT)
followed by Surgery is now the standard of care for middle