ESTRO 36 Abstract Book

S670

ESTRO 36

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& lower third esophageal carcinoma. However this is an

intensive treatment regimen. Often there are concerns

and doubts about its feasibility in Indian population, who

do not have as good nutritional status as western patients.

At our institute we have been following this treatment

approach since 2009 and have analysed our own outcomes

in terms of feasibility, toxicity, mortality and survivals.

Material and Methods

We treated 62 patients with NACCRT followed by surgery

from October 2009 to December 2015 at Max Hospital,

Delhi, India. All patients underwent esophageal

endoscopy, biopsy and PETCT scan for diagnosis and

staging purpose. Inclusion criteria for NACCRT followed by

surgery were, patients with bulky primary tumour,

enlarged lymph nodes (LN) on imaging, adherence to

surrounding organs and clinical suitability for trimodality

therapy. All patients received radiation therapy (RT) with

IMRT technique with single/double agent concurrent

chemotherapy. PET CT was used in target volume

delineation for IMRT in all patients. RT doses were 41.4

Gy/23 fractions and 45 Gy/25 fractions with double &

single agent chemotherapy respectively. Patients

underwent open transthoracic esophagectomy with 2-

Field lymph node dissection; 6-8 weeks after completion

of NACCRT.

Results

Squamous cell carcinoma was present in 82% patients

while only 18% patients had adeno carcinoma. Tumour was

located in Middle, Lower and Lower and GE junction in

50%, 23% and 27% patients respectively.

Total 60/62 (96.8%) patients completed NACCRT. Of these

46 (76.6%) were taken up for surgery. Three patients (5%)

were considered unsuitable for surgery, 13.3% defaulted

for surgery and 5% were lost to follow up after NACCRT.

Resectability rate for patients taken up for surgery was

93.4%. Perioperative death occurred in 3 patients (6.6%).

Pathological complete response was seen in 37.2%

patients. At median follow up of 17.6 months, 3(7%)

patients had a mediastinal nodal recurrence and 12%

developed distant metastases. In all three patients with

nodal recurrence, LN was located in superior

mediastinum. Median disease free survival (DFS) and

overall survival (OS) is not yet reached. The OS in our study

at 1 and 2 year respectively was 76% and 62.8% for all

patients.

Conclusion

NACTRT followed by surgery is feasible in middle and

lower third carcinoma esophagus patients in Indian

population and yields high DFS and OS. Most common

locoregional pattern of failure was in superior mediastinal

nodal station, which needs to be further addressed in

terms of RT planning volumes and surgical dissection.

EP-1245 A retrospective study for Helical

Tomotherapy for Radiotherapy in Esophageal Cancer:

is it feasible?

Z. Jastaniah

, J.B. Clavier

, D. ANTONI

, M. Ben

Abdelghani

, C. Schumacher

centre paul strauss, radiotherapy, Strasbourg, France

Purpose or Objective

despite many advances in the treatment of esophageal

cancer, local and regional control is a major issue. IMRT

showed to be beneficial in terms of reducing the late

complication in head & neck cancer. A retrospective

analysis to assess the feasibility and the safety of

esophageal cancer patients definitively treated with IMRT

using Tomotherapy.

Material and Methods

Between October 2009 and December 2015, 56 patients

with squamous cell carcinoma and adenocarcinoma of the

esophagus were retrospectively reviewed.

Results

Median age was 67.5 years (47–86). Median radiation dose

was 50 Gy (42–66) with 1.8–2 Gy fractions. Median follow-

up was 12 months (0–31). The median overall survival and

the median progression free survival were 20 months, and

16.8 months, respectively. The 1- and 2-year overall

survival is 59% and 41.9% respectively. Patients with

elective nodal irradiation have significantly better overall

survival and progression free survival. In a univariate

analysis, we did not find any significant correlation

between incidences of symptomatic respiratory

pneumonitis with any clinical or dosimetric parameters.

Conclusion

Radiotherapy using IMRT technique is a feasible and secure

treatment esophageal cancer. We demonstrated

encouraging results in terms of local control and survival

with low acute and late side effects.

EP-1246 Definitive chemoradiotherapy for esophageal

cancer: the impact of histological subtypes on survival

F.E.M. Voncken

, R.T. Van der Kaaij

, K. Sikorska

, J.M.

Van Dieren

, C. Grootscholten

, P. Snaebjornsson

, J.W.

Van Sandick

, B.M.P. Aleman