Abstract Book

S872

ESTRO 37

EP-1621 Retrospective study - Outcome of radiotherapy for invasive bladder cancer in older patients E.D. Rodrigues Pinto 1 , S. Garcia 1 , R. Lago 1 , L. Vendeira 1 , G. Pinto 1 1 Hospital de São João, Radioterapia, Porto, Portugal Purpose or Objective To assess the role of radiotherapy (RT) in bladder cancer (BC) in patients who refused cystectomy or for whom it was contraindicated. To evaluate the impact of RT in number of BC related events. Material and Methods A retrospective analysis of patients with BC treated with RT, with or without chemotherapy was carried out at our institution during the period March 2005 to March 2017, excluding patients who performed cystectomy. Events were defined as haematuria episodes requiring intravesical irrigations or transurethral resection or admission in Urology Department caused by haematuria or others symptoms related with BC. Data was statistically analyzed using IBM® SPSS® v.24. Results A total of 111 patients with BC were admitted in our institution although 53 were excluded due to pos- cystectomy status or incomplete course of RT. Fifty eight patients were included (44 men, 14 women, whose median age at diagnosis was 77 years from a range 67 - 92 years). Fifty three patients had transitional carcinoma, 1 squamous cell carcinoma, 1 adenocarcinoma, 1 sarcomatoid carcinoma, 1 lymphoepithelioma-like carcinoma and 1 neuroendocrine tumour. Eight patients received chemotherapy, 3 of them due to trimodal therapy. Nine patients were treated with RT dose below 50 Gy (20-45Gy, dose per fraction 2.5-4Gy), in relation with non-resectable disease, nodal involvement, presence of metastasis or poor performance status. Fourty nine patients were treated with RT dose above 50Gy (maximum 60.4Gy, dose per fraction 1.8/2Gy). Pathologic or clinical stage were pT1: 7 (13%), pT2: 29 (51%), pT3/cT3: 9 (17%), cT4: 11 (19%), N+: 15 (26%) and M1: 3 (5,2%). The median follow-up time was 24 months (range 4 – 176 months) and at the date of data collection 10 patients were alive without BC, 5 alive with BC, 34 died in relation with BC and 9 died from other causes not related with BC. In the group treated with RT dose below 50 Gy the overall survival at 1, 2 and 3 years was 67%, 40% and 20%, respectively. The BC-specific survival at 1, 2 and 3 years was 75%, 45% and 23%, correspondingly. A Wilcoxon Signed-Ranks Test indicated that number of events after RT were statistically significantly lower than number of events before RT (Z= -2.232, p= 0.026, r= -0.526).In the group treated with RT dose above 50 Gy the overall survival at 1, 2 and 3 years was 81%, 58% and 43%, respectively. The BC-specific survival at 1, 2 and 3 years was 83%, 65% and 51%, correspondingly. A Wilcoxon Signed-Ranks Test indicated that number of events after RT were statistically significantly lower than number of events before RT (Z= -2.536, p= 0.011, r= -0.256). Conclusion This therapeutic approach can have an important role in older patients with bladder cancer, in terms of reducing disease related events. Symptom control was significantly achieved in both therapeutic groups.

3D-CRT and the others were treated by IMRT. Only 2 treatment plans’ dose distribution violated tolerance dose of QUANTEC report (V6Gy<30%), but neither of them induced renal graft failure. There were four renal graft failure found in study group, which resulted from different reason, including recurrent infection, tumor recurrence, chronic allograft nephropathy and chemotherapy related. Although most radiation dose was distributed to gastrointestinal (GI) tract to protect graft, the GI toxicities were all tolerable. No patients had their radiotherapy course shortened or terminated because of toxicities. Conclusion Based on our results, we assumed that current irradiation technique is quite safe for kidney allograft when treating UC and can comply nearly all the constrains suggested by QUENTEC report. Radiotherapy for patients with kidney transplant is safe and feasible. EP-1620 Muscle-Invasive Bladder Cancer Bladder- Preservation by Combined-Modality Therapy: Long- Term Outcomes A. Soler 1 , M. López 1 , D. Martínez 1 , A. Benedicto 2 , A. Navarro 1 , J.L. Monroy 1 , M. Albert 1 , C. Domingo 1 , M. Soler 1 1 Hospital Universitario de la Ribera, Radiation Oncology, Alzira, Spain 2 Hospital Universitario de la Ribera, Urology, Alzira, Spain Purpose or Objective Muscle-Invasive Bladder Cancer is an aggressive entity and a major health problem. Radical cystectomy is elective treatment, but the best of them is nonetheless mutilating. We present the results of our Institution's Long-Term Combined-Modality treatment. Material and Methods From January 2002 to December 2015, 128 bladder cancer patients have been treated with radical intention, but only 101 accomplished the criteria for study. The median age at diagnosis was 72 years (range: 41-85 years). All with confirmed transitional cancer histology. All of them were subjected to maximum TURBT and CT- Scan staging. 96% had G3. Initial stages were: 76% T2, 16% T3, 5% T4, and 3% T1; 85% N0, 15% N1-N2. RT was delivered over first and second nodal station at 45- 50.4Gy, followed dose 59.4-66Gy over bladder; the first 15 cases had split course with re-staging TURBT between phases. Chemotherapy (CT) platinum based were, neo- adjuvant-concurrent 72%, neoadjuvant 3%, concurrent 11%, and none 14%. Results After a mean follow-up of 118 months (17-182), Overall Survival was 39%, and Cancer-Specific survival was 72%. After local relapse, radical cystectomy was performed in 6 patients, meanwhile TURBT in 3 cases. Death at the end of study was: 25% cancer, 3% iatrogenic events, and 32% other diseases. Bladder preservation was feasible in 79% patients; 21% had local relapse with median time 12 months. Conclusion Bladder preservation protocol results are encouraging in terms of cancer-survival and organ preservation. Furthermore, the low incidence of late recurrences becomes Combined Modality Treatment a good alternative to radical cystectomy, particularly in non- suitable for surgery patients.