696 / 1096
S680
ESTRO 36
_______________________________________________________________________________________________
multivariate analysis, post-CRT SUV
max
(≤6.5 vs. >6.5) was
a significant factor for LRFS and DFS. Post-op CEA (≤2.0 vs.
>2.0) was a significant factor for LRFS and OS.
Conclusion
This study showed the post-CRT SUV
max
was a significant
parameter for predicting tumor recurrence. Meanwhile,
post-op CEA was the only prognostic factor affecting OS
among these parameters.
EP-1265 Image-guided SIB-IMRT for the treatment of
anal cancer patients
F. Arcadipane
1
, P. Franco
1
, S. Martini
1
, G. Furfaro
1
, M.
Ceccarelli
2
, M. Mistrangelo
3
, N. Rondi
4
, P. Cassoni
5
, P.
Racca
6
, U. Ricardi
1
1
University of Turin- A.O.U. Citta' della Salute e della
Scienza, Department of Oncology- Radiation Oncology,
Torino, Italy
2
Cancer Epidemiology and CPO Piemonte - A.O.U. Citta'
della Salute e della Scienza, Department of Oncology-
Radiation Oncology, Torino, Italy
3
University of Turin- A.O.U. Citta' della Salute e della
Scienza, Department of Surgical Sciences, Torino, Italy
4
A.O.U. Citta' della Salute e della Scienza, Department
of Oncology- Radiation Oncology, Torino, Italy
5
University of Turin- A.O.U. Citta' della Salute e della
Scienza, Department of Medical Sciences- Pahtology,
Torino, Italy
6
A.O.U. Citta' della Salute e della Scienza, Department
of Oncology- Centre for Gastrointestinal Cancers-
Medical Oncology 1 Unit, Torino, Italy
Purpose or Objective
Concurrent chemoradiation (CT-RT) has been established
as the standard of care for anal cancer patients. We
explored intensity-modulated and image-guided
radiotherapy (IMRT–IGRT) with a simultaneous integrated
boost (SIB) approach reporting on clinical outcomes within
a mono-istitutional observational study.
Material and Methods
Between April 2007 and April 2015, 87 patients with biopsy
proven squamous cell anal cancer were treated with SIB-
IMRT. Radiotherapy was delivery using a schedule of
50.4/54 Gy to the primary tumor and involved lymphnodes
and 42/45 Gy to the elective volumes. Dose prescription
varied according to clinical stage, following Radiation
Therapy Oncology Group (RTOG) 0529 indications.
Concurrent 5-Fluorouracil and Mitomycin-C were given.
Clinical data and toxicity are herein reported.
Results
A total of 87 patients (stage I 6%; II 56%; III 38%) were
treated and observed for median time of 34 months
(range: 9-102). CT-RT with MMC and 5-FU was
administered in 90.8% of patients. One patient received
MMC only, two patients 5-FU only and five patients
underwent exclusive RT, after consderation of age,
comorbidities and performance status. The 3-year rates
of colostomy-free survival, local control, disease free and
overall survival were 71% (95% CI 0.59-0.80), 69% (95% CI
0.57-0.79), 64% (95% CI 0.52-0.75), and 79% (95% CI 0.66-
0.87) respectively (Figure 1). At the time of analysis 20/87
(23%) patients were dead and 14 death were related to
cancer. Up to 23 patients recurred; ten failed locally, 7
failed both locally and distantly and 6 developed systemic
failure only. Seventy-seven patients reached a clinical
complete response six months after treatment (88.5%).
Major acute toxicity events (>G3) were recorded for
gastrointestinal (6.9%), genitourinary (1.2%) and
hematologic (neutropenia: 19.6%) aspects. Borderline
significance as prognostic factors with respect to CFS
were found for gender and stage (Table 1).
Conclusion
Image-guided IMRT with a SIB approach concomitant to 5-
FU/MMC based chemotherapy is a safe and well tolerated
treatment strategy in an unselected anal cancer patient
population.
EP-1266 In silico evaluation of subcutaneous skin dose
associated to use of MRIdian MRI- 60Co System
G.C. Mattiucci
1
, L. Boldrini
2
, D. Cusumano
3
, L. Azario
4
, M.
Ferro
2
, S. Chiesa
2
, G. Chiloiro
2
, N. Dinapoli
2
, M.A.
Gambacorta
1
, C. Masciocchi
5
, E. Placidi
6
, D. Piccari
7
,
M.V. Antonelli
7
, M. Rapisarda
7
, S. Teodoli
6
, M. Balducci
1
,
A. Piermattei
4
, F. Cellini
2
, V. Valentini
1
1
Università Cattolica del Sacro Cuore, Gemelli ART -
Radiation Oncology, Rome, Italy
2
Fondazione Policlinico A. Gemelli, Gemelli ART -
Radiation Oncology, Rome, Italy
3
Fondazione Policlinico A. Gemelli, UOC di Fisica
Sanitaria - Gemelli ART - Radiation Oncology, Rome,
Italy
4
Università Cattolica del Sacro Cuore, Rome, Italy
5
Fondazione Policlinico A. Gemelli, KBO Labs - Gemelli
ART - Radiation Oncology, Rome, Italy
6
Fondazione Policlinico A. Gemelli, UOC Fisica Sanitaria -
Gemelli ART - Radiation Oncology, Rome, Italy
7
Fondazione Policlinico A. Gemelli, TSRM - Gemelli ART -
Radiation Oncology, Rome, Italy
Purpose or Objective
The MRIdian MRI-
60
Co radiotherapy system (ViewRay,
Oakwood, Ohio) combines an open split-solenoid MRI
scanner equipped for parallel imaging and three
60
Co
gamma-ray sources.
The dose delivered to the subcutaneous tissues of skin by
such system should be evaluated: the lower mean beam