Abstract Book

S822

ESTRO 37

Purpose or Objective To evaluate the safety and efficacy of nimotuzumab plus concurrent IMRT and chemotherapy of unresectable cervical cancer. Material and Methods From December 2013 to February 2017, 34 patients with cervical cancer on stage (FIGO) IB2-IVB were received concurrent chemoradiotherapy plus nimotuzumab. The prescription dose of radiation was 50.4 Gy/28f on pelvic field with or with not extended field radiation. An additional 30-36 Gy to Point A were delivered with high- dose-rate techniques. Cisplatin of 40 mg/m 2 and nimotuzumab of 200mg were infused intravenously once weekly during RT for 6 weeks. The main outcome measure was toxicity evaluated by CTCAE 4.0. Secondary outcome measure was short-term outcome evaluated by RESIST1.1. Results The median of followed up time was 23.4 months (8.3- 45.5 months). Almost all patients were local advantaged cancer except 2 patients with distant metastases. All patients received external radiotherapy. 2 patients were not treated with brachytherapy. 6 patients failed to finish radiotherapy within 56 days. All of 34 patients received concurrent treatment with nimotuzumab for 6 times. 2 patients refused chemotherapy. There was no life-threatening toxicity. Grade 1/2 of nausea, vomiting and diarrhea were 70.6% (24/34), 32.4% (11/34) and 52.9%(18/34), respectively. Grade 3 of leucopenia, granulopenia, thrombocytopenia and anemia were 52.9% (18/34), 17.6% (6/34), 14.7% (5/34), 11.8% (4/34), respectively. Grade 3 of nausea and vomiting were 8.8% (3/34) and 2.9% (1/34), respectively. No grade 3 of anorectal inflammation. Rrectovaginal fistula was observed in one case 6 months after radiotherapy, and operation was performed. Surgical treatment of intestinal obstruction was performed in one case. 2 cases got vaginal stenosis. The objective response rate was 100%. Complete response was achieved in 29 cases (85.3%) and partial response in 5 cases (14.7%). Conclusion Nimotuzumab plus concurrent IMRT and chemotherapy may represent an effective and well-tolerated treatment in patients with unresectable cervical cancer. EP-1517 Outcome of Radiation therapy for locally advanced vulvar carcinoma: Analysis of inguinal lymph node. Y. Mukai 1 , M. Hata 1 , I. Koike 1 , E. Miyagi 2 , T. Inoue 1 1 Yokohama City University Graduate School of Medicine, Radiology, Yokohama, Japan 2 Yokohama City University Graduate School of Medicine, Gynecology, Yokohama, Japan Purpose or Objective The aim of this study was to report the outcome of radiation therapy for vulvar carcinoma, and especially to investigate the effectiveness of inguinal lymph node (ILN) irradiation as well as the effect of diameter, effective dose, and number of ILN treatments on its efficacy. Material and Methods From May 1993 and December 2016, 30 consecutive vulva carcinoma patients were treated using external beam radiation therapy (EBRT) for definitive disease (n=25) or postoperatively (n=5). All patients had histopathologically diagnoses of vulva carcinoma; 24 (80%) had squamous cell carcinoma (SCC). Tumor stages were distributed as follows: 0: n=1, IB: n=1, II: n=6, IIIA: n=2, IIIB: n=5, IVA: n=12, and IVB: n=3. Three patients (12%) received

simultaneous chemotherapy; there were cisplatin (n=2, 40 mg/m 2 of the body surface area), and carboplatin (n=1). Results In individual ILN with diameter were over 30 mm, the complete response + partial response (CR + PR) was 25%. In contrast, when the ILN diameter was under 20mm, the CR + PR rate was 60%. The outcome was significantly different between 30 mm or more and less than 30mm ILNs （ p=0.005). There was no significant difference in the number of positive ILNs; 1-2 vs. 3-4, p=0.91 and 1-3 vs. 4, p=0.517. In SCC patients, the outcome was significant different in the prescribed doses over 60 Gy (p=0.002). Prophylactic irradiation of the ILN area (median prescribed doses were 45 Gy) was administered to 11 patients, none of whom developed any ILNs metastasis. Median total prescribed doses for primary tumor was 64.8 Gy (range14-79.2 Gy). Twenty-eight patients (93.3%) completed radiation therapy without interruption. The median follow-up time was 11 months (range, 2 -179 months). Thirteen patients (43.3%) achieved CR and 15 patients (50 %) were considered PR; the CR + PR rate was 93.3 %. The 2-year overall survival rates (OS) were 25.3%. One patient had Grade 3 radiation-induced intermittent diarrhea, and one patient had Grade 3 myelosuppression. However, the symptoms were manageable and most of the pain diminished with 1-2 months after the treatment. No other severe late toxicities (> Grade 3) associated with treatment were observed. Conclusion Irradiation provided good primary tumor control as initial treatment, and ILN irradiation was effective, however there was a high rate of primary recurrence. Diameter over 30 mm and the prescribed doses over 60 Gy were associated with ILN control in patients with vulvar carcinoma. To our knowledge, this is the first report to analyze the outcomes of ILN irradiation s in vulvar carcinoma with respect to diameter, number of positive node, and prescribed irradiation doses. EP-1518 Monitoring brachytherapy radiation therapy by thermal image T. Rabin 1 , O. Hoffer 2 , M. Ben-David 1 , I. Gannot 3 1 Sheba Medical Center, Radiatiom Oncology, Ramat-Gan, Israel 2 Tel Aviv University, Department of Biomedical Engineering- Faculty of Engineering, Tel Aviv, Israel 3 John Hopkins University, Department of Electrical and Computer Engineering- Whiting School of Engineering-, Baltimore- MD, USA Purpose or Objective Cervical cancer is the third-most common cancer among women worldwide, with an annual incidence of 530,000 cases and 250,000 deaths. Cervical cancer can be detected and monitored by any of several modalities, the most common method is PAP smear that can detect potentially pre-cancerous and cancerous processes in the cervix. Previous studies found different thermographic profiles between the normal cervix and cervical lesions as endocervical polyp, erosion (PAP II), CIN and invasive cancer. Material and Methods Following IRB approval and signing informed consent, seven patients receiving brachytherapy for advanced cervical carcinoma were monitored in each brachytherapy session (total of 5 sessions) by thermal imaging of the cervix prior to insertion of the instruments