ESTRO 2020 Abstract Book

S600 ESTRO 2020

Material and Methods In this prospective, randomized, 3 arms, cross-over, comparative trial, 30 patients (ASA grade I-II patients aged 18-75 years with BMI <30 Kg/m2) of cervical cancer scheduled for Intracavitary brachytherapy/ Intracavitary radiation therapy under spinal anaesthesia were randomly allocated to three groups, either receiving 9mg hyperbaric bupivacaine, or 9mg hyperbaric bupivacaine plus 10µg dexmedetomidine, or 9mg hyperbaric bupivacaine plus 25 µg fentanyl. Results The results of the study revealed that the duration of perioperative pain relief with intrathecal dexmedetomidine was much more (322.67 ± 41.25 minutes) than intrathecal fentanyl (202.33 ± 21.04 minutes) or plain bupivacaine (133.33 ± 19.31 minutes). The mean onset time of sensory block (T10 level) for the dexmedetomidine group (4.2 ± 1.10 minutes) was much less than the fentanyl group (5.6 ± 1.43 minutes). It was also found that hemodynamically patients remained stable with minimum side effects in the dexmedetomidine group. Dexmedetomidine also provided better sedation resulting in better patient satisfaction for the peri-operative period. Conclusion The present study suggests that 10 µg dexmedetomidine with bupivacaine by intrathecal route is better analgesic adjuvant than 25 µg fentanyl with bupivacaine in patients undergoing intracavitary brachytherapy under spinal anaesthesia. It provides hemodynamically stable conditions, minimal side effects, significantly prolong the duration of sensory block and good quality and duration of peri-operative analgesia. PO-1140 Role of Functional Imaging in evaluation of Radiation Colitis A. Jajodia 1 , A. Chaturvedi 1 , N. Gupta 2 , A. Rao 1 , M. Gairola 3 , S. Mitra 3 , V. Mahawar 1 , P. Ahlawat 3 , S. Goyal 4 , V.P.B. Koyyala 4 , S. Aggarwal 3 , S. Tandon 3 , R. Tripathi 5 , S. Pasricha 6 , A. Mehta 7 1 Rajiv Gandhi Cancer Institute And Research Centre, Radiology, New Delhi, India ; 2 Rajiv Gandhi Cancer Institute and Research Centre, Gastroenterology, New delhi, India ; 3 Rajiv Gandhi Cancer Institute and Research Centre, Radiation Oncology, New Delhi, India ; 4 Rajiv Gandhi Cancer Institute and Research Centre, Medical Oncology, New Delhi, India ; 5 Rajiv Gandhi Cancer Institute and Research Centre, Research, New delhi, India ; 6 Rajiv Gandhi Cancer Institute and Research Centre, Oncopathology, New delhi, India ; 7 Rajiv Gandhi Cancer Institute and Research Centre, Molecular Diagnosis, New delhi, India Purpose or Objective Despite major revisions in conventional radiotherapy techniques , Radiation induced colitis (RIC) is encountered as a pestering problem .The purpose of our study was to compare quantitative MRI and histopathological (HPE) features in patients with genitourinary and anal canal cancer. Material and Methods MR study was retrospectively analyzed in patients presenting ( n= 62) to Gastroenterology department of our institute with symptoms attributed to RIC. Sigmoidoscopy findings suggestive of RIC were taken into account and MRI quantitative analysis was done in finally 48 patients . Evaluated parameters included T1 ratio ( T1 post contrast/T1 pre-contrast), T2 M-S ratio (T2 mural wall/ striated muscle) ; T2 M-M (T2 mural wall/mesentery ) , T2 M-CSF (T2 mural wall/CSF ) and apparent diffusion coefficient (ADC). The MR examination was within 2 weeks prior to Sigmoidoscopy . Hematological assessment of total leukocyte count and polymorphs was done. These were compared with final HPE using Chi-squared tests. HPE confirmation of RIC was available in 18 patients.

Velasco 1 1 Hospital Universitario Puerta de Hierro, Oncology Radiotherapy, Majadahonda - Madrid, Spain ; 2 Hospital Universitario Clinico San Carlos, Oncology Radiotherapy, Madrid, Spain Purpose or Objective To evaluate clinical outcomes and quality of life (QoL) of patients receiving adjuvant vaginal brachytherapy (VB) for stage I endometrial carcinoma (EC-I) in the elderly. Material and Methods Between 2011-2016, 32p with pathological EC-I were treated by VB in our department. Mean age: 79y(74- 91). Stage/grade: IA/G1-2:7p; IA/G3:4p; IB/G1-2:16p; IBG3:5p. Twenty patients were treated with 3D-VB to a total dose of 21Gy at 5mm depth from applicator surface, in 3 weekly fractions (3x7Gy), and 11p were treated with external radiotherapy and 3D-VB (2x5.5Gy). The effects of pathologic stage and grading on loco-regional relapse (LRR), metastases, and tumor-related death were investigated. EORTC QLQ-C30 and QLQ-EN24 questionnaires were used to evaluate vaginal toxicity and QoL. Statistical analysis: Kaplan-Meier method, Logrank test and Chi-square test. Results After median follow-up of 49 months (7-93), 5-year disease-free survival (DFS), local relapse-free survival (LRFS) and pelvic relapse-free survival (PRFS) 80%, 100% and 91.2%, respectively. PRFS was lower in grade 3 tumors compared to grade 1-2 (83% vs 95%, p=NS). No patients had G3-4 toxicity. Vaginal chronic toxicity (Grade 1-2) was seen in 44% of patients. Patients reported excellent QoL in the C30 questionnaire which showed functional scores above 70% and symptoms scores below 30%. The global health status and QoL scale was 75%, which should be considered as “good” or “very good”. In the EN24 questionnaire the worse scores were sexual enjoyment and pain problems (MS 0% and 40%, respectively). Conclusion In this series 3D adyuvant VB in EC-I achieved good local control rates with good results in QoL. PO-1139 Intrathecal dexmedetomidine vs fentanyl for intracavitary brachytherapy analgesia in cancer cervix. M. Gupta 1 , R. Chawla 1 , S. Mitra 2 1 rajiv gandhi cancer institute and research centre, department of anaesthesiology, delhi, India ; 2 rajiv gandhi cancer institute and research centre, department of radiation oncology, delhi, India Purpose or Objective Intracavitary brachytherapy for cancer cervix is a day care procedure of 6-8 hours. Most patients experience discomfort and pain during brachytherapy resulting in improper applicator placement, inadequate dose distribution, adverse effects on local control, and/or an increased risk of morbidities. Anaesthesia (general or regional) reduces pain during brachytherapy and provides the ideal condition for the procedure. The present study compared the efficacy of perioperative pain relief of intrathecal dexmedetomidine (selective α-2 adrenoreceptor agonist) and intrathecal fentanyl (synthetic opioid agonist) when used as adjuvants to bupivacaine in the spinal anaesthesia in patients of cervical cancer for intracavitary brachytherapy. The primary objective was to compare the perioperative analgesia and duration of pain relief [time interval between the time of subarachnoid block and first rescue analgesia (VAS for pain > 3)]. Secondary objectives were the onset of sensory block, maximum sensory. block achieved, Time to reach maximum sensory block, haemodynamic variability, regression characteristics, sedation characteristics, and side effects.