ESTRO 36 Abstract Book

381 / 1082

S366 ESTRO 36 2017
_______________________________________________________________________________________________
Of the 156 eligible patients, 133 (85.3%) responded to at
least one of the questionnaires. Non-response included
patients who didn’t return the questionnaires (8.3%) or
had missing values in the WAI questionnaire (6.4%). Of the
responders, 107 patients (80.5%) had paid employment.
These patients had a mean age of 56.2 years and 73.8%
were male. All patients underwent neoadjuvant therapy
of which 64.5% chemoradiation, 30.8% short-course
radiation and 4.7% other regimes. Surgery was performed
in 89.7% of the patients, mostly by low anterior (50.5%) or
abdominoperineal resection (33.6%). At baseline, the
mean WAI score was 32.3, which was substantially lower
than the reference population score of 40.9. Workability
was poor in 27.5% of the patients, and moderate, good and
excellent in resp. 34.1%, 34.1% and 4.4% (Figure 1).
Corresponding scores of the Dutch reference population
were 2.8%, 14.2%, 47.2% and 35,8% resp. Workability was
limited by illness in 82.4% of the patients, and 23.1%
completely stopped working. At 3 months, the mean WAI
score decreased significantly to 27.1 (p<.001) and was
poor in 54.7% of the patients. Here after, at 6 and 12
months, the mean WAI score increased to resp. 29.1 and
34.6. At 12 months, 55.3% of the patients reported
absenteeism of 100-365 days as result of health problems
in the past year compared to 2.3% in the reference
population. Only 14.9% of the patients reported no
absenteeism. Stratification by neoadjuvant regimen and
surgical procedure did not modify the results.
Conclusion
Workability in patients with rectal cancer is negatively
affected by treatment but seems to recover towards
baseline levels at 12 months after diagnosis. Compared to
the Dutch population, rectal cancer patients report a
much lower workability and a higher level of absenteeism.
PO-0706 Assessing the impact of sentinel lymph-node
and inguinal irradiation in patients with anal cancer
C. Gumina1, N. Slim1 , G.M. Cattaneo2, P. De Nardi 3, C.
Canevari4, M. Ronzoni5, A. Fasolo5, C. Fiorino2, L. Perna2,
A.M. Tamburini 3, R. Rosati3, P. Passoni1, N. Di Muzio 1
1 San Raffaele Scientific Institute, Radiotherapy, Milan,
Italy
2 San Raffaele Scientific Institute, Medical Physics, Milan,
Italy
3 San Raffaele Scientific Institute, Surgery, Milan, Italy
4 San Raffaele Scientific Institute, Nuclear Medicine,
Milan, Italy
5 San Raffaele Scientific Institute, Medical Oncology,
Milan, Italy
Purpose or Objective
To evaluate the role of sentinel lymph-node biopsy (SLNB)
in staging and the impact of inguinal irradiation.
Material and Methods
Patients with anal squamous cell carcinoma and without
gross inguinal lymph-nodes metastases were considered
for SLNB after staging with standard imaging procedures
and FDG-PET. The Clinical Target Volume (CTV) included
the Gross Tumor Volume (GTV: primary tumour and
positive lymph-nodes) and pelvic ± inguinal lymph-nodes.
Planning Target Volume (PTV)1 and PTV2 corresponded to
GTV and CTV, respectively, with a margin of 0.5-1.0 cm.
Prescribed dose was 50.4 Gy in 28 fractions to the PTV2
and 64.8 Gy in 36 fractions to the PTV1, delivered with
IMRT or VMAT. Concomitant chemotherapy consisted of
Mito-C 10 mg/m 2 and continuous infusion 5-FU 1000 mg/m2
for 4 consecutive days.
Results
From 03/2008 to 02/2014, 48 consecutive patients were
treated. FDG-PET was performed in 42 out of 48 patients.
Pathologic inguinal uptake was shown in 15/42 (36%) and
9 of them underwent lymphoscintigraphy: SLNB confirmed
inguinal metastases only in 3/8 (37.5 %) (SLN not found in
1 patient). FDG-PET did not show inguinal uptake in 27/42
(64%) patients and 17 of them underwent
lymphoscintigraphy: SLNB found metastases in 2/17 (12%).
Thirty-one patients received prophylactic or curative
radiotherapy to the groins (Inguinal RT group) and 17
patients did not (No inguinal RT group). Sixteen/17
patients of the No inguinal RT group had a negative SLNB.
At a median follow-up of 41 months no relapse was
observed in the “No inguinal RT”. No significant
differences in terms of toxicities, apart from inguinal
dermatitis, were observed between the two groups.
Conclusion
SLNB improves the PET-based staging and is highly
accurate in identifying the true negative patients for
which the inguinal irradiation could be avoided. The use
of advanced radiotherapy techniques, sparing inguinal
lymph-nodes reduces dramatically the inguinal skin
toxicity while no differences were found for other side
effects.
PO-0707 Magnetic Resonance Imaging Texture Analysis
Parameters for predicting risk of Anal Cancer
recurrence
K. Owczarczyk 1, D. Prezzi1, M. Siddique 1, J. Stirling1, G.
Cook1, R. Glynne-Jones2, A. Gaya 1, M. Leslie1, V. Goh1
1Guy's and St.Thomas' Hospital NHS Foundation Trust,
Department of Cancer Imaging, LONDON, United Kingdom
2Mount Vernon Cancer Center, Department of Oncology,
London, United Kingdom
Purpose or Objective
Despite advances in the management of anal squamous
cell carcinoma (ASCC), roughly 25% of patients undergoing
standard chemoradiotherapy (CRT) will experience
disease recurrence. Currently, there is no established way
of predicting disease outcome. Quantitative magnetic
resonance (MR) imaging texture analysis (TA) parameters
have shown promise in assessing the risk of recurrence in
other cancer types. This study was carried out to assess
their role in evaluating recurrence risk in patients with
ASCC undergoing CRT.
Material and Methods
We used baseline high-resolution T2-weighted MR images
from 42 patients with ASCC undergoing CRT to identify TA
parameters with the best ability to predict disease
recurrence. Multi-slice regions of interest (ROI) were
drawn around the tumours, generating a whole tumour
volume. 3D volume statistical and fractal heterogeneity
parameters were derived using in-house
calculated False Discovery Rate (FDR) p-value for all TA
parameters using the Benjamini-Hochberg correction to
adjust for multiple tests and used a FDR p-value cut-off of
0.15 to identify candidate then analysed
baseline T2-W MR images from further 33 patients to
independently cross-validate performance of the
identified TA parameters. We calculated replication FDR
p-values for the validation cohort as well as p values for
the pooled cohort.
Results
Two patients in the test cohort and three patients in the
replication cohort had to be excluded based on lack of
visible tumour (n=2) and palliative treatment intent (n=3).
40 patients in the test cohort and 30 patients in the
replication cohort were included in the final analysis. All