ESTRO 2020 Abstract Book

S578 ESTRO 2020

PO-1091 Quality of life and sexual function of men who have sex with other men treated for anal cancer G.P. Mauro 1 , K.G.M.D.C. Vasconcelos 2 , H.D.A. Carvalho 1 1 University of Sao Paulo, Radiology and Oncology, Sao Paulo, Brazil ; 2 Instituto do Cancer do Estado de Sao Paulo - ICESP, Radiotherapy, Sao Paulo, Brazil Purpose or Objective To assess quality of life (QoL) and sexual function (SxF) among men who have sex with other men (MSM) treated with radical chemorradiation for anal cancer. Material and Methods Prospective cohort of MSM who were treated for anal cancer in a single institution. For inclusion, patients had to be treated with concurrent chemoradiation (IMRT technique) with curative intent as by the ACTII randomized trial guideline. QoL and SxF were assessed by the questionnaires QLQ-C30, IIEF, and SF-36. The questionnaires were applied at diagnosis, after the end of the treatment, and 3, 6 and 12 months later on. Local control, systemic progression, colostomy-free, and overall survivals were measured from the date of diagnosis. Informed consent was obtained for inclusion. Results Patients were accrued between November 2015 and May 2019. Forty men were selected and 19, that accepted to participate in the study, were included. The most frequent causes of exclusion from the study were patient not MSM (11) and patients who were submitted to surgery or were not going to receive chemotherapy (5). Median age of the included patients was 59.3 years. The majority had advanced disease (14/73.7%) with a mean tumor size of 5.4 cm. Fifteen (78.9%) were HIV positive. The sexual inventory showed that most were homosexual cis-males (17/89.4%), single (11/57.9%), and monogamous (14/73.7%). No sexual intercourse over the month prior to treatment was stated by 12 patients (63.2%), and no pain during intercourse in the previous six months was reported by 13 (68.4%). Median follow-up was 19.8 months. Mean overall survival, systemic progression free survival, survival free of local relapse and colostomy-free survival were, respectively, 20.8, 19.8, 17.2 and 17.4 months. No median value was reached. Results of QLQ-C30 and SF-36 showed that QoL significantly worsened by the end of treatment and raised to maximum value by three months after treatment, followed by a continuous fall until the levels pre-treatment were reached again by 12 months after treatment. IIEF questionnaire showed that patients started treatment with moderate erectile dysfunction and reached normal level at 3 months after treatment, only to reach pre-treatment levels again by the end of first year after treatment. Intercourse frequency followed QoL measures, reaching a peak at 3 months and returning to pre-treatment levels by the end of first year of follow-up. Conclusion In a MSM population with anal canal cancer, QoL and SxF followed the same pattern up to one year after treatment. Most patients had their SxF compromised as shown by IIEF levels and intercourse frequency. Anal cancer and its’ treatment represent a burden to MSM regarding QoL and SxF. PO-1092 Clinical results of particle therapy in patients with postoperative recurrence of rectal cancer T. Waki 1 , T. Okimoto 2 , K. Terashima 2 , Y. Niwa 1 , D. Jin 1 , Y. Demizu 2 , K. Katsui 3 , S. Tokumaru 2 , S. Kanazawa 3 1 Tsuyama Chuo Hosptal, Radiology, Tsuyama-shi, Japan ; 2 Hyogo Ion Beam Medical Center, Radiology, Tatsuno-shi, Japan ; 3 Okayama University Hospital, Radiology, Okayama-shi, Japan Purpose or Objective To evaluate the outcome of particle therapy in patients with postoperative locoregional recurrence of rectal cancer at Hyogo Ion Beam Medical Center.

Material and Methods Retrospective analysis of 59 patients who received 74 Gy (RBE) / 37 fr between March 2004 to March 2014 was performed. There were 42 males and 17 females, with a median age of 63 years (range, 37-79). Proton and carbon ion therapy were used for 48 and 11 patients, respectively. Seven patients had the history of distant metastasis prior to particle therapy, and all metastasis were under control by local therapies. Median serum CEA and CA19-9 level at the end of irradiation were 5.7 ng/ml (range, 0.8-465.0) and 16.9 U/ml (range, 0.2-334.3), respectively. Results The median follow-up period was 26.7 months (range, 4.6- 104.7 months). The 2-year overall survival (OS), progression-free survival (PFS), and local control (LC) rates were 83.0%, 35.2%, and 64.4%, respectively. In multivariate analysis using the Cox proportional hazards model, lower serum CEA and CA19-9 level at the end of irradiation and no history of distant metastasis were significantly favorable factors for OS and PFS. Lower serum CA19-9 level at end of irradiation was a significantly favorable factor for LC. There were no differences between carbon ions and protons on OS, PFS, LC. The late adverse effects of ≥Grade 3 were observed in 9 patients. Conclusion Particle therapy using protons or carbon ion has shown to achieve survival benefit not inferior to surgery. PO-1093 Defecography for sphincter evaluation in rectal cancer patients irradiated with dose intensification C. Rosa 1 , M. Di Tommaso 1 , B. Seccia 2 , A. Delli Pizzi 2 , R. Cianci 2 , R. Basilico 2 , A. Di Pilla 1 , M. Taraborrelli 1 , L. Caravatta 1 , D. Genovesi 1 1 Ospedale Clinicizzato S.S. Annunziata, Radiotherapy Oncology- Chieti, Chieti, Italy ; 2 Ospedale Clinicizzato S.S. Annunziata, Department of Radiology, Chieti, Italy Purpose or Objective Sphincter disorders and dysfunctions could be possible in patients with locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (CRT) and sphincter saving surgery, followed by recanalization. Defecography (DRE) evaluates the transport of a semi-solid barium column to the outside during a simulated defecation, investigating the two components of this process, both anatomically and functionally. We performed this study with the aim to evaluate the sphincter functionality by DRE. Material and Methods Twenty-nine LARC patients (M:W=18:11) underwent neoadjuvant CRT with dose intensification treatment up to 5500 cGy (220 cGy/die) and sphincter saving surgery. DRE was performed evaluating the characteristics of contraction or inhibition of the pubo-rectal muscle and the type of incontinence (at rest/during Valsalva). The number of evacuations per day, including incontinence, was evaluated using the Memorial Sloan Kettering Cancer Center (MSKCC) Score. Furthermore, we performed a comparison of both methods. Results All patients completed the prescribed treatment. The median patients age was 66 years (range, 44-79 years). The mean length tumor was 45 mm, sited at a distance from the anorectal ring shorter than 30 mm, between 31 and 50 mm, and longer than 50 mm in 10 (34.5%), 11 (37.9%), and 8 (27.6%) patients, respectively. The majority of patients (22 patients, 75.9%) had cT3 tumors. All patients underwent anterior rectal resection with complete pathological response rate of 51%. With a median follow- up of 3.4 years, all patients had a local control, with distant metastases reported in 6 (21%). Twenty-nine patients underwent DRE: 11 patients within 2 years, 18 after 2 years from the end of CRT. Mostly women reported an anterior rectocele (9 women vs 6 men, in a total of 15