ESTRO 36 Abstract Book

S261

ESTRO 36 2017

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with recent decades showing a trend for induction

regimens followed by surgery. The latter have included

induction CHT followed by surgery, and, in more recent

years, induction RT-CHT followed by surgery. When tested

in prospective randomized phase III studies, preoperative

RT-CHT (with or without preceding CHT) followed by

surgery brought no improvement in overall survival or local

control compared to definitive concurrent RT-CHT, and

was associated also with an increase in treatment-related

mortality. In the second part of this presentation we will

discuss and clarify the role of radiotherapy according to

the latest literature and international guidelines. We

invite all to join the final discussion.

SP-0498 Cervical cancer: literature overview and

discussion of clinical case

L. Bolm

Lübeck, Germany,

Cervical cancer is the leading cause of death from

gynecological cancer worldwide and the majority of

patients are diagnosed with locally advanced tumours.

Therapeutic concepts are based on clinical FIGO staging.

Standard treatment in FIGO IB1 to IVA cervical cancer

remains a multi-modality therapy involving external-beam

radiotherapy, platinum-based chemotherapy and a local

brachytherapy boost. Regarding the literature to date

several aspects in the treatment of cervical cancer are an

issue of debate. We will discuss internationally varying

treatment guidelines as to outline current controversies.

Pre-therapeutic staging accuracy and the role of imaging

techniques such as MRI are emerging in the treatment of

locally advanced cervical cancer (LACC). Image-guided

therapy may not only serve to optimize treatment

planning of external beam radiotherapy, but to constantly

check motions of target volume and organs at risk also in

brachytherapy. We will present the process of treatment

planning, target definition as well as delineation

guidelines involving the e-learning programmes "Falcon"

and "Dove". A case of LACC with nodal involvement will be

presented at the symposium to demonstrate therapeutic

challenges, side effects and the process of follow-up. We

invite everyone to join the final discussion.

SP-0499 "Cervical cancer: literature overview and

discussion of clinical case"

L. Motisi

University of Lübeck, Radiation Oncology, Lübeck,

Germany

For the treatment of cervical cancer a multi-modality

approach plays a crucial role from the point of diagnosis

to treatment until follow up. The gynecological

examination is still the most important investigation for

the staging of cervical cancer, but on the other hand the

introduction of new imaging techniques such as MRI are

emerging, not only as a support for the planning treatment

of external beam radiotherapy (EBRT,) but also for

brachytherapy. Furthermore these new techniques are

helping to detect the “target” and also the organs at risk

as to spare them from high doses. Moreover the use of new

techniques of EBRT, such as Cone Beam CT, are helpful to

constantly check the motions of organs at risk especially

rectum and bladder in daily routine, and to adapt the

treatment plan. We will focus our attention also on the

contouring of lymph nodes according to the new criteria

of classification in low-, intermediate- and high-risk

patients. Even if the lymphadenectomy and images like

PET-CT are important for the staging of lymph nodes, we

have to take into account many other factors predictive of

local recurrence and that will guide the radiotherapist to

define the best treatment plan for the patient.

SP-0500 Rectal cancer: literature overview and

discussion of clinical case

I.S. Barua

1,2

Akershus University Hospital - Norway, Department of

Oncology, Oslo, Norway

University of Oslo, Faculty of Medicine, Oslo, Norway

The first part of the talk will cover epidemiology, staging

and management of rectal cancer in Europe. This includes

last decades’ development and differences in prevalence

and treatment in Europe. TNM classification will be

presented and radiology images shown to illustrate

different stages. The management of rectal cancer,

including the most common treatment modalities, will be

covered and followed by a presentation of the European

guidelines for radiotherapy of rectal cancer. In the second

part a rectal cancer case from Akershus University

Hospital in Norway will be presented. The focus will be on

the views from biology, physics and RTT perspectives as

well as the clinical aspect. At the end there will be a

discussion with the senior expert regarding typical

challenges related to choice of treatment, before the

senior expert will end the session with summarizing the

clinical case and the preferred treatment option at her

clinic.

SP-0501 Rectal cancer: literature overview

K. Haustermans

UZ KU Leuven, Department of Radiation Oncology,

Leuven, Belgium

The treatment of rectal cancer is risk-adapted and

depends on the initial staging. If a patient has a low risk

of local recurrence, no preoperative treatment is needed

and the patient can go straight to surgery. For superficial

lesions a Transanal Endoscopic Microsurgery (TEM)

procedure can be considered. For more advanced cases

Total Mesorectal Excision (TME) is preferred. The addition

of preoperative radiotherapy has further reduced the risk

of local recurrence. Patients with an intermediate risk of

relapse are currently treated by a short course of

radiotherapy (5 times 5 Gy) followed by immediate

surgery. Patients with a high risk of local recurrence e.g.

threatened mesorectal fascia by the primary tumor, are

treated with a long course of chemoradiation followed by

TME surgery 8 to 12 weeks after the end of the

chemoradiation. In case of threatened sphincter, a long

course of chemoradiation followed by a long interval is

currently the treatment of choice. Currently, many

studies are ongoing looking into the possibility of organ

preservation or in intensifying the preoperative

chemotherapy with the aim of reducing the risk of distant

metastasis. Omitting radiotherapy in patients responding

well to preoperative chemotherapy aims at reducing

radiation induced toxicity. Lengthening the interval after

short course radiotherapy is being compared with

preoperative chemoradiotherapy followed after 8 to 12

weeks by TME. Until the results of these studies become

available none of these approaches can be regarded as

standard.

Poster Viewing : Session 11: Head and neck and CNS

PV-0502 Post-operative radiation therapy in atypical

meningiomas: analysis of prognostic factors

S. Shakir

, L. Souhami

, K. Petrecca

, J. Mansure

, V.

Panet-Raymond

, G. Shenouda

, K. Singh

, A. Alodaini

B. Abdulkarim

, M. Guiot

McGIll University Health Center, Radiation Oncology,

Montreal, Canada

McGill University Health Centre, Radiation Oncology,

Montreal, Canada

McGill University Health Centre, Neurosurgery,