ESTRO 36 Abstract Book

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S969 ESTRO 36 2017
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tumours without violating the OAR dose. For smaller
tumours the OAR dose was reduced without compromising
the target coverage.
Electronic Poster: Brachytherapy: Anorectal
EP-1790 A balloon applicator with adjustable
catheters for image-guided endoluminal rectal
brachytherapy
M. Heilmann1, D. Berger1 , R. Schmid1, J. Bör1, B.
Wisgrill1, R. Pötter1 , C. Kirisits1, M.P. Schmid1
1 Medizinische Universität Wien Medical University of
Vienna, Universitätsklinik für Strahlentherapie, Vienna,
Austria
Purpose or Objective
To investigate the dosimetric results and first clinical
experience with an in-house made balloon-based
applicator for endoluminal brachytherapy for patients
with locally advanced rectal cancer not undergoing
surgery.
Material and Methods
The applicator consists of an inflatable rectal balloon with
six attached foley catheters used as guidance for
brachytherapy plastic needles. The construction of the
applicator and the dosimetric profile in terms of
representative dose points in 0, 2, 5, 10 mm ipsilaterally
and in 0mm contralaterally are described. Feasibility and
treatment response in three patients are reported.
Results
For all three patients the application was well tolerated
and could be performed in an ambulant setting. A
reproducible dose gradient was achieved in all patients.
The surface dose on the target side was 204±19% of the
normalized dose in 5 mm (100%) tissue depth and 143±8%
in 2 mm and 64±3% in 10 mm. The surface dose on the
contra-lateral side was 20±8%. After radiochemotherapy
with 50 Gy external beam radiotherapy and concomitant
chemotherapy with capecitabine, a HDR brachytherapy
boost in 2-3 fractions of 7-10 Gy each was delivered. All
patients achieved a clinical complete response at 3
months and no major toxicity was observed.
Conclusion
The use of our balloon based applicator was clinically
feasible and resulted in a stable and reproducible dose
distribution. The dose gradient is similar to 50 kV contact
x-rays. First clinical results are promising.
Electronic Poster: Brachytherapy: Head and neck
EP-1791 HDR Interstitial Brachytherapy for Head and
Neck Malignancies and use of Iridium – 192 implants
V. Pareek1, R. Bhalavat2, M. Chandra2
1 Jupiter Hospital- Thane, Radiation Oncology, Mumbai,
India
2 Jupiter Hospital, Radiation Oncology, Thane, India
Purpose or Objective
To evaluate the treatment outcomes with HDR Interstitial
Brachytherapy in Head and Neck Cancers at our Institute
with use of Angiocatheters as carrier source of Iridium –
192 wire implants.
Material and Methods
58 Patients with Head and Neck malignancies of varying
TNM staging as per AJCC staging criteria were analyzed
retrospectively between 2008 and 2015. 42 patients
(72.41%) received EBRT with HDR – BRT and 26 patients
(27.59%) received BRT alone. 23 patients (39.65%)
received concurrent Chemotherapy. The age group ranged
from 27 to 81 years (Median age 56 years) with 41 patients
(70.69%) males and 17 patients (29.31%) females. HDR –
BRT was delivered with Iridium – 192 wire implants using
plastic bead techniques with varying dose rates. The
Biological equivalent doses (BED) were calculated for both
BRT and EBRT keeping α/β =10 for tumor and α/β =3 for
normal tissue and subsequently median BED doses were
calculated and similarly 2 Gy equivalent dose (EQD2) were
calculated and loco-regional control and disease free
survival was assessed.
Results
After completion of HDR – BRT, Patients for followed up
one month later and subsequently every 3 months for first
2 years and thereafter every 6 months with median follow
up period of 25 months (Range 2-84 months). The DFS
probability at year 1 was 82.76% and 68.05% at year 7. The
overall survival probability was 91.37% at year 1 and
85.89% at year 5. The local control rate was 67.27% and
the control rates according to the stage of disease and T
size classification are mentioned in Table 1. The rate of
local recurrence was 8.62%, Regional Recurrence was
1.72%, Loco-Regional Failure was 3.44% and Distant
metastases following local or regional failure was 17.23%.
The Median BED for α/β =10 was 86.775Gy and DFS was
74.07% in patients receiving more than 86.775Gy and DFS
was 64.82% in patients receiving less than 86.775Gy and
Median BED for α/β =3 was 128.76Gy and DFS was 74.07 in
patients receiving more than 128.76Gy as compared to
64.82% in patients receiving less than 128.76Gy. The
median EQD2 for α/β =10 was 71.6Gy and for α/β =3 was
75.85Gy. The DFS was 75.86% in patients receiving more
than median dose of 71.6Gy compared to 61.53% in those
receiving less than the median dose. The DFS was 78.57%
in patients receiving median dose of 75.85Gy as compared
to 59.26% in those receiving less than the median dose.
Conclusion
The overall outcome in the Patients with oral cavity and
oropharyngeal malignancies was good with implementing
of HDR – Interstitial Brachytherapy and use of
Angiocatheters as carriers of Iridium – 192 wire. The BED10
value of 86.775Gy and BED3 of 128.76Gy showed that the
dose received more than the median showed better
outcomes in the form of DFS. The EQD2 calculated values
suggested the dose received more than 71.6Gy (α/β =10)
and 75.85Gy (α/β =3) showed better outcomes .The role
of HDR Interstitial Brachytherapy in Head and Neck
cancers is a proven, effective and safe treatment method
with excellent long term outcome.
EP-1792 Nasal function after exclusive brachytherapy
for primary SCCs of the nasal vestibulum
F. Bussu1, L. Tagliaferri2, G. Mattiucci2, G. Di Cintio1, N.
Dinapoli2, J. Galli1, G. Almadori1, E. De Corso1, G.
Passali 1, G. Paludetti1, V. Valentini2
1Universita' Cattolica del Sacro Cuore Policlinico
Agostino Gemelli, Head and Neck Surgical Sciences,
Rome, Italy
2Universita' Cattolica del Sacro Cuore Policlinico
Agostino Gemelli, Radiation Oncology, Rome, Italy
Purpose or Objective
Squamous cell carcinoma arising from the nasal vestibule
is a rare condition accounting for about 1% of head and
neck malignancies with several peculiarities concerning
both staging and treatment. Exclusive brachytherapy has
been proven to be a treatment as effective as surgery
under an oncological point of view, with the advantage of
much better preserving the complex cartilaginous
framework of the nose. The aim of this study is to
evaluate, through specific tests, the functionality of the
nose after an oncologically effective brachytherapy for
SCCs of the nasal vestibulum.
Material and Methods
15 consecutive patients diagnosed with primary squamous
cell carcinomas of the nasal vestibulum, treated with
exclusive brachytherapy between 2010 and 2016, and free
of disease since at least 9 months were enrolled. 15