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ESTRO 36
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2015 at 2 academic centres with concurrent chemo-
radiation employing either SIB-IMRT or CRT was analysed.
The SIB-IMRT group consisted of 87 patients, treated with
2 cycles of Mitomycin and 5-Fluorouracil using a SIB-IMRT
based schedule of 42-45 Gy/28-30 fractions to the elective
pelvic lymph nodes and 50.4-54 Gy/28-30 fractions to the
primary tumor and involved nodes, based on pre-
treatment staging.
The CRT group comprised 103 patients, treated with
Mitomycin or Cisplatin and 5-Fluorouracil or Capecitabine
concurrent to CRT with 36 Gy/20 fractions to a single
volume including gross tumor, clinical nodes and elective
nodal volumes, and a sequential boost to primary tumor
and involved nodes of 23.4 Gy/13 fractions.
We determined colostomy-free survival (CFS) and overall
survival (OS), loco-regional recurrence and distant
metastases rates for each radiation modality. Cox
proportional-hazards model addressed factors influencing
OS and CFS. Propensity score-matched analyses were
performed to compare SIB-IMRT and CRT.
Results
Median follow-up for the entire patient group was 32
months. Average overall treatment time was 42 days in
the SIB-IMRT group and 59 days in the CRT group. Patients
treated with CRT had significantly higher stage and lower
grading. The overall survival at the time of analysis was
74%, similarly for the two groups. Three-year colostomy-
free survival was 66% for all patients, with no significant
difference between the two groups (61% for SIB-IMRT and
74% for CRT, Log-Rank 0.85). The cumulative incidence of
colostomies showed that the majority of events occurred
within 18 months in both groups. We found no significant
difference in terms of outcomes by univariate analysis and
a propensity score analysis adjusted for disparities
between the groups.
NA:Not
Available
Tab. 1 Patient and treatment characteristics and pattern
of failure
Fig. 1 Colostomy-free survival
Conclusion
Results of this analysis indicate that 3-year clinical
outcomes of SIB-IMRT are similar to CRT. Even if
highlighting the retrospective observational nature of the
study, these data support the routinely use of SIB-IMRT in
clinical practice for anal cancer patients submitted to
concurrent
chemo-radiation.
EP-1259 Modern Intensity Modulated Radiotherapy
with Daily Image Guidance for Anal Cancer Patients
B. De Bari
1
, L. Lestrade
2
, A. Franzetti-Pellanda
3
, M.
Biggiogero
3
, M. Kountouri
2
, O. Matziinger
4
, R. Miralbell
2
,
J. Bourhis
5
, M. Ozsahin
5
, T. Zilli
2
1
Hôpital Univ. Jean Minjoz, Radiation Oncology,
Besançon, France
2
Hopitaux Universitaires de Genève, Radiation Oncology,
Genève, Switzerland
3
Clinica Luganese, Radiation Oncology, Lugano,
Switzerland
4
Hôpital Riviera-Chablais, Radiation Oncology, Vevey,
Switzerland
5
Centre Hospitalier Universitaire Vaudois, Radiation
Oncology, Lausanne, Switzerland
Purpose or Objective
We report the outcomes of the largest populations of anal
cancer (AC) patients treated with modern intensity-
modulated radiotherapy (IMRT) techniques and daily
image guidance.
Material and Methods
AC patients treated with IMRT +/- chemot herapy in 3
radiotherapy departments were retrospectivel y analysed.
They received 36 Gy (1.8 Gy/fraction) on the pelvic and
inguinal nodes and on the anal canal, using IMRT (n = 39),
volumetric modulated arc therapy (VMAT; n = 15), or
helical Tomotherapy (HT; n = 97), and a sequential boost
up to a total dose of 59.4 Gy (1.8 Gy/fraction) on the anal
and on the nodal gross tumor volumes, delivered with
either IMRT (n = 16, until 2011), VMAT (n = 17), HT (n =
61), or 3D-conformal EBRT (CRT, n = 61).
Results
A total of 151 patients were treated (09/2007 - 03/2015).
Of them, 122 presented a stage II - IIIA disease.
Chemotherapy was delivered in 138 patients, mainly using
mitomycin C and 5-fluorouracil (n = 81). Median follow-up
was 38 months (interquartile range, 12-52). Four-year