ESTRO 36 Abstract Book

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S671 ESTRO 36 2017
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Fig. 1 Colostomy-free survival
Conclusion
Results of this analysis indicate that 3-year clinical
outcomes of SIB-IMRT are similar to CRT. Even if
highlighting the retrospective observational nature of the
study, these data support the routinely use of SIB-IMRT in
clinical practice for anal cancer patients submitted to
concurrent chemo-radiation.
EP-1259 Modern Intensity Modulated Radiotherapy
with Daily Image Guidance for Anal Cancer Patients
B. De Bari1, L. Lestrade2, A. Franzetti-Pellanda3, M.
Biggiogero3, M. Kountouri2, O. Matziinger4, R. Miralbell2,
J. Bourhis5, M. Ozsahin 5, T. Zilli2
1 Hôpital Univ. Jean Minjoz, Radiation Oncology,
Besançon, France
2 Hopitaux Universitaires de Genève, Radiation Oncology,
Genève, Switzerland
3 Clinica Luganese, Radiation Oncology, Lugano,
Switzerland
4 Hôpital Riviera-Chablais, Radiation Oncology, Vevey,
Switzerland
5 Centre Hospitalier Universitaire Vaudois, Radiation
Oncology, Lausanne, Switzerland
Purpose or Objective
We report the outcomes of the largest populations of anal
cancer (AC) patients treated with modern intensity-
modulated radiotherapy (IMRT) techniques and daily
image guidance.
Material and Methods
AC patients treated with IMRT +/- chemot herapy in 3
radiotherapy departments were retrospectivel y analysed.
They received 36 Gy (1.8 Gy/fraction) on the pelvic and
inguinal nodes and on the anal canal, using IMRT (n = 39),
volumetric modulated arc therapy (VMAT; n = 15), or
helical Tomotherapy (HT; n = 97), and a sequential boost
up to a total dose of 59.4 Gy (1.8 Gy/fraction) on the anal
and on the nodal gross tumor volumes, delivered with
either IMRT (n = 16, until 2011), VMAT (n = 17), HT (n =
61), or 3D-conformal EBRT (CRT, n = 61).
Results
A total of 151 patients were treated (09/2007 - 03/2015).
Of them, 122 presented a stage II - IIIA disease.
Chemotherapy was delivered in 138 patients, mainly using
mitomycin C and 5-fluorouracil (n = 81). Median follow-up
was 38 months (interquartile range, 12-52). Four-year
local control rate was 82% (95% CI: 76-91%). Complete
toxicity data were available for 143 patients: 22% of them
presented a G3+ acute toxicity, mainly as moist
desquamation (n = 25) or diarrhoea (n = 10). Three
patients presented a late grade 3 gastrointestinal toxicity
(anal incontinence). No grade 4 acute or late toxicity was
recorded. Patients treated with standard dynamic IMRT
presented a significantly higher risk of acute grade 3 or
more toxicity compared to those treated with VMAT or HT
(38.5% vs 15.3%, p = 0.049).
Conclusion
Modern IMRT (VMAT or HT) with daily IGRT are effective
and safe in treating AC patients, and should be considered
the standard of care in this clinical setting.
EP-1260 Helical Tomotherapy with Daily Image
Guidance for Rectal Cancer patients
B. De Bari1, A. Franzetti-Pellanda2, A. Saidi 3, M.
Biggiogero2, D. Hahnloser4, D. Wagner5, M. Montemurro5,
J. Bourhis3, O. Ozsahin3
1Hôpital Univ. Jean Minjoz, Radiation Oncology,
Besançon, France
2Clinica Luganese, Radiation Oncology, Lugano,
Switzerland
3Centre Hospitalier Universitaire Vaudois, Radiation
Oncology, Lausanne, Switzerland
4Centre Hospitalier Universitaire Vaudois, Surgery,
Lausanne, Switzerland
5Centre Hospitalier Universitaire Vaudois, Medical
Oncology, Lausanne, Switzerland
Purpose or Objective
Helical Tomotherapy (HT) has only been recently
introduced in the neoadjuvant treatment of locally
advanced rectal cancer (LARC) patients (pts). Aim of this
retrospective study is to report the results in terms of
toxicity and local control of the largest population treated
with neoadjuvant HT and chemotherapy (CRT) with daily
image guidance (IGRT) followed by surgery.
Material and Methods
Data of 117 patients LARC pts treated in 2 Swiss
Radiotherapy departments were collected and analyzed.
Radiotherapy (RT) consisted of 45 Gy (1.8 Gy/fraction, 5
days/week for 5 weeks) to the regional lymph nodes.
Seventy pts also received a simultaneous-integrated boost
(SIB) up to a total dose of 50 Gy to the tumor (2
Gy/fraction, 5 days/week for 5 weeks). Chemotherapy
consisted of capecitabine 850 mg/m2, twice daily, during
the RT days. Following a mean interval after completion
of CRT of 53 days (range, 13-142), all pts underwent
surgery. Ninety-four patients (80.3%) received a low
anterior resection (LAR), while 23 pts (19.7%) received an
abdomino-perineal resection (APR). The resection status
was classified as R0 in 107 patients, and R1 in 3 patients
(not reported in 7 patients).
Results
The overall rate of G2 or more toxicity was 22% (22/117
patients). Only 3 patients (2.5%) presented a G3 toxicity,
as dermatitis (n = 1) or diarrhoea (n =2). None of the
patients presented a G3 (or more) hematologic toxicity
and/or G4 non-hematologic toxicity. After a median
follow-up time of 23.3 months (range, 4.8 – 66.8), only 2
pts (1.7%) presented a G3-4 late toxicity. The 3-year local
control rate was 96.9% (95% confidence interval: 96.4 -
97.3%).
Conclusion
CRT delivered with HT and daily IGRT shows excellent
rates of local control with few acute toxicity. Longer
follow-up is needed to confirm these encouraging results.
EP-1261 Hypofractionated radiotherapy for inoperable
rectal cancer: A retrospective analysis 2007 to 2015
N. Abdul Satar1, A. Sibtain1, C. Cottrill 1, T.M. Richards 2
1Barts and the London NHS Trust, Radiotherapy Dept,
London, United Kingdom
2Barts and the London NHS Trust- University College