ESTRO 36 Abstract Book

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S683 ESTRO 36
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52.2%, and 10-year RFS 62.1% versus. 52.2%, p = 0.048,
respectively). Also, patients with extremely high CEA (>
50ng/ml) had trend to lower distant metastasis-free
survival rate (DMFS) (5-year DMFS 72.0% versus. 55.9%, and
10-year DMFS 67.4% versus. 55.9%, p = 0.087,
respectively), and there were no differences in
locoregional recurrence-free survival rate (LRRFS) (5-year
LRRFS 89.3% versus. 81.8%, 10-year LRRFS 82.8% versus.
81.8%, p = 0.355).
Conclusion
This study showed that non-metastatic rectal cancer
patients with extremely high pretreatment serum CEA
level (> 50 ng/ml) had higher risk of relapse with trend of
increasing distant metastasis.
EP-1271 Is 3D-CRT still a valid option in radical
radiochemotherapy of anal carcinoma in the era of
IMRT?
S. Shakir1, A. Garant 2, S. Alshehri2, D. Slobodan3, T.
Alcindor4 , T. Vuong1
1 Jewish General Hospital, Radiation Oncology, Montreal,
Canada
2 McGIll University Health Center, Radiation Oncology,
Montreal, Canada
3 Jewish General Hospital, Medical physics, Montreal,
Canada
4 McGIll University Health Center, Medical oncology,
Montreal, Canada
Purpose or Objective
Intensity Modulated Radiation Therapy (IMRT) is well
accepted in our institution as standard radiation technique
for patients with anal canal cancer. We are reporting
treatment related toxicity profiles recorded during
treatment with 3D conformal radiation (3D-CRT) versus
IMRT with radical concomitant radiochemotherapy at
McGill University Health Center.
Material and Methods
This is a retrospective study of all patients’ charts
diagnosed with squamous cell carcinoma of anal cancer
from January 2002 to May 2009. The standard treatment
was radical radiation with 2 cycles of chemotherapy using
5-Fluorouracil (1000mg/ m 2 daily for 4 days in a 24 hours
continuous perfusion) and Mitomycin-C (at 10 mg / m 2).
Radiation doses were 50.4 Gy, 54 Gy and 60 Gy in 28, 30,
33 fractions to macroscopic disease for T1, T2/T3, and T4
tumors respectively and 30 Gy in 15 fractions to
microscopic nodal disease at risks. Demographic data,
treatment modality, different acute toxicities and
tolerance as well as outcomes were compared between
patients treated with 3D-CRT using conformal diamond
diagonal opposing fields [1], and those treated with IMRT.
Results
From January 2002 to May 2009, 90 patients (3D-CRT: 40,
IMRT: 50) treated with radical intent were included in this
study. The median age for the entire cohort was 57 years.
Male to female ratio was 0.61. Fifty-four percent (n=41)
of patients had greater than stage II disease (table 1-A).
Acute toxicities were collected prospectively with weekly
blood tests, intra treatment weekly evaluation for bowel
frequency, skin-reaction and hospital admission for
treatment related toxicity. Toxicity grading was based on
the national cancer Institute common toxicity criteria
version 2.0. The rates of ≥ grade 2 skin, hematological and
gastrointestinal toxicities for 3D-CRT group were 65%, 45%
and 25% respectively; whereas for IMRT group; 58%, 48%
and 20% respectively with corresponding p values of 0.522,
0.834 and 0.617 respectively. Treatment interruption rate
was significantly higher (p value: 0.018) with 5% vs 24%
rate among patients treated by 3D-CRT vs IMRT, despite a
non-significant difference for higher grade 3
hematological rate of 20% versus 28% for 3D-CRT and IMRT
groups, respectively, (p = 0.46), (table 1-B).
Conclusion
Acute toxicity profiles did not differ significantly between
the two radiotherapy techniques, but treatment
interruption was significantly higher in IMRT group with a
trend of higher grade 3 hematotoxicity. Thus, 3D-CRT
diamond fields remain a valid option for patients with anal
canal cancer. Since May 2009, IMRT has become our
standard treatment and we are now looking at its impact
on local control in our patient population.
REFERENCES:
1. Vuong et al. Contribution of conformal therapy in the
treatment of anal canal carcinoma with combined
chemotherapy and radiotherapy: Results of a phase II
study. Int J Radiat Oncol Biol Phys 2003; 56(3): 823-31.
EP-1272 Impact of Ki67 on pathological complete
response rate after neoadjuvant CRT in cT3N0M0 rectal
cancer
D. Adua 1, L. Giaccherini2, A. Guido 2, D. Cuicchi3, F. Di
Fabio1, F.L. Rojas Llimpe 1, G. Macchia 4, S. Cammelli2, L.
Fuccio 3, A. Ardizzoni1, A.G. Morganti2
1S.Orsola-Malpighi Hospital, Department of Medical
Oncology, Bologna, Italy
2University of Bologna, Radiation Oncology Unit-
Department of Experimental- Diagnostic and Specialty
Medicine - DIMES- Sant'Orsola-Malpighi Hospital,
Bologna, Italy
3University of Bologna, Department of Medical and
Surgical Sciences - DIMEC, Bologna, Italy
4Fondazione di Ricerca e Cura Giovanni Paolo II-
Università Cattolica del Sacro Cuore, Radiotherapy Unit,
Campobasso, Italy
Purpose or Objective
Multimodal therapeutic approach with pre-operative
chemoradiation (CRT), conservative surgery +/- adjuvant
chemotherapy (CT) is currently the standard treatment in
patients with locally advanced rectal ca. The possibility to
predict tumor response before chemoradiation could be
useful to tailor neoadjuvant treatment. Therefore, aim of
this analysis was to correlate the expression of Ki67 with
pathological complete response (pCR) rate after CRT in an
homogeneous population of patients with cT3N0M0 rectal
carcinoma.
Material and Methods
We retrospectively analysed the pre-treatment biopsies of
a subgroup of patients (pts) witch cT3N 0 rectal ca.
The expression of Ki-67 was evaluated. Radiotherapy was
delivered with 3-D conformal technique (total dose: 50.4
Gy, 1.8 Gy/fraction) concurrently with CT (Capecitabine:
31%, 5-Fluorouracil: 17%, 5-Fluorouracil plus Oxaliplatin:
52%). All pts underwent surgery 6-8 weeks after CRT.
Adjuvant CT was performed in 37 (76%) pts. DFS and OS
were estimated by Kaplan-Meier method. Using as cut-off
value the median value of ki-67 expression (91.3%, range