ESTRO 36 Abstract Book

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S664 ESTRO 36 2017
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terms of RT planning volumes and surgical dissection.
EP-1245 A retrospective study for Helical
Tomotherapy for Radiotherapy in Esophageal Cancer:
is it feasible?
Z. Jastaniah1, J.B. Clavier1, D. ANTONI1, M. Ben
Abdelghani1, C. Schumacher1
1 centre paul strauss, radiotherapy, Strasbourg, France
Purpose or Objective
despite many advances in the treatment of esophageal
cancer, local and regional control is a major issue. IMRT
showed to be beneficial in terms of reducing the late
complication in head & neck cancer. A retrospective
analysis to assess the feasibility and the safety of
esophageal cancer patients definitively treated with IMRT
using Tomotherapy.
Material and Methods
Between October 2009 and December 2015, 56 patients
with squamous cell carcinoma and adenocarcinoma of the
esophagus were retrospectively reviewed.
Results
Median age was 67.5 years (47–86). Median radiation dose
was 50 Gy (42–66) with 1.8–2 Gy fractions. Median follow-
up was 12 months (0–31). The median overall survival and
the median progression free survival were 20 months, and
16.8 months, respectively. The 1- and 2-year overall
survival is 59% and 41.9% respectively. Patients with
elective nodal irradiation have significantly better overall
survival and progression free survival. In a univariate
analysis, we did not find any significant correlation
between incidences of symptomatic respiratory
pneumonitis with any clinical or dosimetric parameters.
Conclusion
Radiotherapy using IMRT technique is a feasible and secure
treatment esophageal cancer. We demonstrated
encouraging results in terms of local control and survival
with low acute and late side effects.
EP-1246 Definitive chemoradiotherapy for esophageal
cancer: the impact of histological subtypes on survival
F.E.M. Voncken1, R.T. Van der Kaaij 2, K. Sikorska3, J.M.
Van Dieren4, C. Grootscholten4, P. Snaebjornsson5, J.W.
Van Sandick2, B.M.P. Aleman1
1 The Netherlands Cancer Institute- Antoni van
Leeuwenhoek Hospital, Radiation Oncology, Amsterdam,
The Netherlands
2 The Netherlands Cancer Institute- Antoni van
Leeuwenhoek Hospital, Surgical Oncology, Amsterdam,
The Netherlands
3 The Netherlands Cancer Institute- Antoni van
Leeuwenhoek Hospital, Biometrics, Amsterdam, The
Netherlands
4 The Netherlands Cancer Institute- Antoni van
Leeuwenhoek Hospital, Gastrointestinal Oncology,
Amsterdam, The Netherlands
5 The Netherlands Cancer Institute- Antoni van
Leeuwenhoek Hospital, Pathology, Amsterdam, The
Netherlands
Purpose or Objective
Definitive chemoradiotherapy (dCRT) is an established
treatment option for irresectable or inoperable squamous
cell cancer of the esophagus (SCC). For esophageal
adenocarcinomas, the role of dCRT is debated. The
adenocarcinoma subtypes (according to the Lauren
classification) have shown different pathological response
rates after neoadjuvant chemoradiotherapy. Aim of this
study was to investigate long-term outcomes of
esophageal cancer patients after treatment with dCRT
according to the histological subtype.
Material and Methods
Esophageal cancer patients treated in the Netherlands
Cancer Institute with dCRT between 1999 and 2016 were
retrospectively analysed. Treatment consisted of 50Gy/25
fractions with concurrent fluorouracil/cisplatin, or
50.4Gy/28 fractions with concurrent
carboplatin/paclitaxel. Patients who refused surgery after
completion of neoadjuvant CRT, i.e. 41.4Gy-50.4Gy/23-28
fractions, were also included in the analysis. Patients were
grouped by the histological subtype found in the
endoscopic biopsy at diagnosis. Biopsies were classified as
squamous cell carcinoma (SCC), adenocarcinomas of the
intestinal subtype (AC-I) or of the diffuse/ mixed subtypes
(AC-D+M). Overall survival (OS), disease-free survival
(DFS) and isolated locoregional recurrence (LRR) free
interval were compared between patient groups with
different histological subtypes. The impact of the
histological subtype on OS was evaluated using a Cox
regression model.
Results
The cohort consisted of 117 patients, including 9 patients
who refused surgery after neoadjuvant CRT. Five patients
did not complete dCRT because of comorbidity or toxicity.
Median follow up was 56 months. Median OS was 21 months
and not significantly different between patients with SCC
(20 [95% CI 15-25] months; n=73), AC-I (24 [95% CI 21-27]
months; n=34) or AC-D+M (15 [95% CI 7-23] months; n=10).
Median DFS was 19 months and, for SCC, AC-I and AC-D+M,
DFS was 18 (95% CI 10-30), 21 (95% CI 21-27) and 15 (95%
CI 7-23) months, respectively (p=0.29). Median time to
isolated LRR was 64 months; for SCC, AC-I and AC-D+M,
this was 64 (95% CI 0-129), 47 (95% CI 1-93) and 18 (95% CI
5-31) months, respectively (p=0.61). Multivariable analysis
was adjusted for gender, age, completion of radiotherapy
(all significantly associated with prognosis in univariable
analysis), chemotherapy regimen and Charlson
comorbidity score (both p=0.1 in univariable
analysis). Age and failure to complete radiotherapy were
significant predictors for overall survival. As compared to
SCC, overall survival was similar for AC-I; HR 1.22 (95% CI
0.72-2.1) and AC-D+M; HR 1.93 (95% CI 0.9-4.0).
Conclusion
In our cohort no significant relationship was found
between the histological subtype and long-term outcomes
following dCRT for esophageal cancer, although, AC-D+M
showed a trend towards poorer outcomes. Not only for
SCC, but also for intestinal type adenocarcinomas of the
esophagus, dCRT can be considered.
EP-1247 Exclusive chemoradiation with Carboplatin-
Taxol vs Folfox-4 in locally advanced esophageal
cancer.
G. Crehange1, A. Bertaut2, J.F. Bosset3, J. Boustani3, M.
Rouffiac1, F. Ghiringhelli4, C. Borg5, B. De Bari3, J. Buffet
Miny3
1Centre Georges-François Leclerc, Radiotherapy, Dijon,
France
2Centre Georges-François Leclerc, Biostatistics, Dijon,
France
3University Hospital Jean Minjoz, Radiation Oncology,
Besançon, France
4Centre Georges-François Leclerc, Medical oncology,
Dijon, France
5University Hospital Jean Minjoz, Medical Oncology,
Besançon, France
Purpose or Objective
Exclusive chemoradiation delivering 50Gy of external
beam radiotherapy (EBRT) combined with Cisplatinum and
5-FU remains the standard of care for locally advanced
disease since a quarter century. The French PRODIGE 5
phase III trial has demonstrated the safety and the efficacy
of FOLFOX-4 combined with exclusive 50Gy EBRT while the
Dutch CROSS phase III trial showed an improvement in
overall survival with Carboplatin and Taxol when
combined with 41.4Gy in the preoperative setting. We
sought to determine the feasibility and efficacy of