ESTRO 36 Abstract Book

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S689 ESTRO 36
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Conclusion
The SIB/VMAT schedule is well tolerate in LARC. The
toxicity was well manageable and the prescribed dose is
delivered. Despite the few numbers of patients the rate of
pCR is promising. Longer follow-up is required for survival
outcomes.
EP-1282 Clinical and pathological prognostic factors in
locally advanced rectal cancer (larc)
S. Montrone1, A. Sainato1, R. Morganti2, C. Vivaldi3, C.
Laliscia1, B. Manfredi1, G. Coraggio1, M. Cantarella1, G.
Musettini 3, D. Delishaj1, E. Lombardo1, A. Cristaudo1, F.
Orlandi1, G. Masi3, P. Buccianti 4, A. Falcone3, F.
Pasqualetti1, F. Paiar1
1 OSPEDALE SANTA CHIARA, Radiotherapy, PISA, Italy
2 OSPEDALE SANTA CHIARA, Oncology- Biostatistical
Consulting, PISA, Italy
3 OSPEDALE SANTA CHIARA, Oncology, PISA, Italy
4 OSPEDALE CISANELLO, Colon-rectal Surgery, PISA, Italy
Purpose or Objective
Colorectal cancer is the most common gastrointestinal
malignancy. More than half of rectal cancer patients (pts)
have a LARC at diagnosis and preoperative RT-CT followed
by total mesorectal excision (TME) is the standard of cure
in these pts. Many studies have analyzed clinical and
pathological parameters that could be considered as
prognostic factors in pts with rectal cancer. This study aim
to identify prognostic factors related to OS and DFS in pts
affected by LARC and treated in Pisa University Hospital
between January 2008 and April 2014.
Material and Methods
We analyzed retrospectively the data of 119 pts affected
by LARC treated with neoadjuvant RT-CT (50.4 Gy in 28 FF
+ capecitabine 1650 mg/mq/day) followed by TME-
surgery. In order to identify prognostic factors, we
analyzed T and N characteristics at diagnosis and at
restaging (before surgery) and their variations (based on
MR-images). We also analyzed age, sex and pathological
characteristics (surgical approach, ypT, ypN, number of
nodes removed, nodal ratio considered as N+/Nresected,
histological mucinous aspect, grading, margins, Quirke
grade andDworak’s tumor regression).
Results
All pts completed planned RT-CT. The OS at 2 and 5 years
was 97,3% and 88,5%, respectively; 2 and 5 years DFS was
91,5% and 77,5%, respectively. In the multivariate
analysis the statistically significant prognostic factors
related to DFS were: T-volume (p= 0,046), number of
involved quadrants (p= 0,011), distance between T and
mesorectal fascia (p= 0,015), pT (p= 0,001), pN (p<0,001),
nodal ratio (p<0,0001) and TRG (p= 0,001). Regard to OS,
the statistically significant prognostic factors were:
number of involved quadrants (p= 0,011), pN (p= 0,009),
number of resected nodes (p= 0,042) and nodal ratio (p=
0,002).
Conclusion
Analyzing our data, we could conclude that clinical T-
parameters, pathological T stage and pathological N-
parameters are strongly related to an higher incidence of
local and distant relapses (DFS). Regard to OS, clinical T-
parameters and pathological N-parameters are
singnificantly correlated, while pathological T stage does
not seem to have a role as prognostic factor. A better
knowledge of these factors related to local and distant
relapses will be necessary to decide whether intensify
local or systemic treatments.
EP-1283 Short Course Radiation Therapy For Locally
Advanced Rectal Cancer
J. Casalta Lopes1, A. Ponte 1, I. Nobre-Góis 1, T. Teixeira 1,
M.R. Silva2, M. Borrego1
1Centro Hospitalar e Universitário de Coimbra, Radiation
Oncology, Coimbra, Portugal
2Centro Hospitalar e Universitário de Coimbra,
Pathology, Coimbra, Portugal
Purpose or Objective v
Locally advanced rectal carcinoma (LARC)v is usually
treated with radiotherapy (RT) followed by svurgery. One
of the schemes is short course RT (SC: 25Gy / v5 fractions
/ 1 week) historically followed by immedviate surgery.
Studies show that a longer interval between SC-RT and
surgery may increase downstaging, with the acceptance of
this approach in published international guidelines.
Intervals from 1 to 4 weeks are associated with higher
rates of postoperative complications.
In this study we aim to evaluate toxicity, response to
treatment and survival in patients with LARC treated with
SC-RT in the neoadjuvant setting.
Material and Methods
Prospective inclusion of patients with LARC treated by SC-
RT between 2002 and 2015. Response was assessed by
pathological stage and Ryan modified tumor regression
grade (TRG); toxicity was evaluated using CTCAE 4.0 scale.
Survival curves were estimated using Kaplan-Meier’s
method. A type I error of 0.05 was considered.
Results
73 patients included, 63.0% male. Median age was 80
years, 31.5% with Karnofsky index lesser or equal to 80%.
Tumor stage was cT3 in 80.9% and cT4 in 15% of patients;
58.9% were cN+. Perineal acute toxicity grade 2 was
described in 2.7%, with no other toxicities. 68 patients
underwent surgery with a median RT-surgery interval of 7
weeks (1-22 weeks). Conservative surgery was performed
in 79.4% and postoperative complications observed in
33.8%. Complete pathological response (cPR) achieved in
7.4% of patients with TRG 0-1 in 8.9%. Lymphovascular