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ESTRO 36 2017
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Conclusion
A real-time 3D tumor motion monitoring method was
established and validated in experiments and simulations
using known Calypso-recorded liver tumor motion. The
method is fully automatic and can be used for arbitrarily
shaped fiducial markers in the thorax or abdomen on a
conventional linac without additional time or hardware.
The internal position estimation can also be performed for
non-coplanar fields where there is no room to deploy the
kV imaging system.
OC-0465 Organ preservation for rectal cancer: the
GRECCAR 2 randomized phase III trial
V. Vendrely
1
, P. Rouanet
2
, J.J. Tuech
3
, H. Mosnier
4
, B.
Lelong
5
, M. Rivoire
6
, J.L. Faucheron
7
, M. Jafari
8
, G.
Portier
9
, B. Meunier
10
, B. Sastre
11
, M. Prudhomme
12
, F.
Marchal
13
, M. Pocard
14
, D. Pezet
15
, A. Rullier
16
, J.
Asselineau
17
, A. Doussau
17
, E. Rullier
1
1
CHU de Bordeaux, Gironde, Pessac, France
2
Institut Regional du Cancer Montpellier, Herault,
Montpellier, France
3
CHU Charles Nicolle, Seine-Maritime, Rouen, France
4
Groupe Hospitalier Diaconesses Croix Saint-Simon,
Paris, Paris, France
5
Département de Chirurgie Oncologique- Institut Paoli
Calmette, Bouches-du-Rhone, Marseille, France
6
Département de Chirurgie Oncologique- Centre Léon
Bérard, Rhone, Lyon, France
7
Service de Chirurgie Digestive- Hôpital A. Michallon,
Isere, Grenoble, France
8
Centre Oscar Lambret, Nord, Lille, France
9
Hopital Purpan - Pavillon Dieulafoy, Haute-Garonne,
Toulouse, France
10
CHU Pontchaillou, Ille-et-Vilaine, Rennes, France
11
CHU Timone, Bouches-du-Rhone, Marseille, France
12
Hôpital Universitaire Carémeau, Gard, Nimes, France
13
Centre Alexis Vautrin, Meurthe-et-Moselle, Nancy,
France
14
Hopital Lariboisiere, Paris, Paris, France
15
CHU Hotel-Dieu, Puy-de-Dome, Clermont-Ferrand,
France
16
CHU de Bordeaux- Hopital Pellegrin, Gironde,
Bordeaux, France
17
CHU de Bordeaux- USMR, Gironde, Bordeaux, France
Purpose or Objective
The objective was to compare local excision (LE) and total
mesorectal excision (TME) in patients with a good response
after radiochemotherapy for low rectal cancer.
Material and Methods
Patients with T2-T3 low rectal carcinoma, maximum size
4 cm, received neoadjuvant radiochemotherapy. Good
clinical responders (residual tumor ≤ 2 cm) were
randomized between LE and TME. In the LE group, a
completion TME was required if ypT2-3. The primary end
point was a composite outcome including death,
recurrence, morbidity and after-effects at 2 years.
Secondary outcomes were pathologic response, 3-year
local recurrence and survival.
Results
A hundred forty eight good clinical responders to
radiochemotherapy were randomized, 3 were excluded
and 145 were analyzed: 74 in the LE group and 71 in the
TME group. In the LE group, 26 patients had a completion
TME. At 2 years, significant events occurred in 56% in the
LE group and 48% in the TME group (p=0.320). In intention-
to-treat analysis, there was no difference between LE and
TME in all components of the composite outcome. Per
protocol analysis showed a lower morbidity
(11%/21%/48%,p=0.001)
and
fewer
after-effects
(17%/29%/62%,p<0.001) according to type of surgery LE,
TME and completion TME. Pathologic results showed a low
rate of positive lymph nodes in ypT0-1 (0%) and ypTx/cN0
(2%). 3-year local recurrence (5%) and overall survival
(92%) were similar between LE and TME groups.
Conclusion
LE is oncologically safe as compared to TME. Globally it is
not superior to TME, due to a high rate of completion TME
that increases morbidity and after-effects. A better
patient selection removing unnecessary completion TME
(ypT2/cN0) will improve the strategy.
OC-0466 Brachytherapy for conservative treatment of
penile carcinoma: prognostic factors and outcome
A. Escande
1
, C. Haie-Meder
1
, R. Mazeron
1
, P. Castelnau-
Marchand
1
, P. Maroun
1
, A. Cavalcanti
2
, F. Marsolat
1
, K.
Doyeux
1
, R. De Crevoisier
3
, F. Martinetti
1
, I. Dumas
1
, E.
Deutsch
1
, C. Chargary
1
1
Gustave Roussy Cancer Campus, Brachytherapy Unit-
Radiation Oncology, Villejuif, France
2
Gustave Roussy Cancer Campus, Department of Surgery,
Villejuif, France
3
Eugene Marquis Cancer Center, Radiation Oncology,
Rennes, France
THIS ABSTRACT FORMS PART OF THE MEDIA PROGRAMME
AND WILL BE AVAILABLE ON THE DAY OF ITS
PRESENTATION TO THE CONFERENCE.
OC-0467 Investigating reporting-and-learning systems
of Irish radiation therapy: Can standards be improved?
K. Dowling
1
, C. Poole
1
, L. Mullaney
1
, S. Barrett
1
1
Trinity College Dublin, Discipline of Radiation Therapy,
Dublin, Ireland
Purpose or Objective
Wide variation exists between event (incidents and near-
misses) reporting-and-learning systems utilised in the field
of radiation oncology. Due to the high potential for error