ESTRO 2022 - Abstract Book

S1095

Abstract book

ESTRO 2022

PO-1297 Neoadjuvant chemoradiotherapy for esophageal cancer – a single institution experience

A. Secerov Ermenc 1 , F. Anderluh 1 , A. Jeromen Peressutti 1 , V. Velenik 1 , I. Oblak 1 , P. Korosec 1 , J. But Hadzic 1 , N. Pulko 2

1 Institute of Oncology, Division of Radiotherapy, Ljubljana, Slovenia; 2 University Medical Centre Maribor, Department of Oncology, Maribor, Slovenia Purpose or Objective Neoadjuvant chemoradiotherapy (nCRT) followed by surgery is the standard care for locally advanced esophageal carcinoma of the lower two thirds of esophagus. The purpose of the study was to evaluate treatment outcome regarding the concomitant chemotherapy regimen and stent placement in a single institution. Materials and Methods We retrospectively analyzed the data from patients with esophageal cancer who were treated with IMRT at our institution from July 2013 to May 2021. We included patients with locally advanced esophageal cancer. They received IMRT with the dose of 45 Gy in 25 fractions. From July 2013 to May 2019 the standard regimen of concomitant chemotherapy was 5- FU/cisplatin, after May 2019 it was paclitaxel/carboplatin. Results One-hundred-two patients were available for analysis. Median age at diagnosis was 63 years, 81% patients were men and 59% had squamous cell carcinoma. Paclitaxel/carboplatin (PC) as concomitant chemotherapy was administered to 33 patients (32.4%) and 5-FU/cisplatin (FC) to 69 patients (67.6%). Surgical resection was achieved in 28 patients (84.8%) in the PC group and in 45 (69.2%) patients in the FC group, (p=0.09). Complete pathological response was observed in 11 patients (39.3%) in the PC group and in 9 patients (21.4%) FC group, (p=0.10). There was no difference in two-year OS, for both groups it was 35%, (p=0.05). Hospitalisation due to complication of nCRT treatment was observed in 33% in the PC and 42% in the FC group, (p=0.45). Stents were placed in 13 (11%) patients in order to relieve dysphagia prior nCRT. Surgical resection was achieved in just 3 (23%) patients with stent placement in comparison to 70 (84%) patients without stent placement, (p=0.00). Median OS for patients with stent was 7 months and for patients without stent 30 months, (p=0.00). Conclusion We did not observe differences in treatment outcome between two groups of concomitant chemotherapy, only a trend in favour of patients that were treated with nCRT with concomitant paclitaxel and carboplatin. Patients with stents placed prior nCRT had worse overall survival. 1 All India Institute of Medical Sciences, New Delhi, National Cancer Institute, Radiation Oncology, New Delhi, India; 2 Institute of Liver & Biliary Sciences, New Delhi, Radiation Oncology, New Delhi, India; 3 Institute of Liver & Biliary Sciences, New Delhi, Hepatology, New Delhi, India; 4 All India Institute of Medical Sciences, New Delhi, Radiation Oncology, New Delhi, India; 5 Institute of Liver & Biliary Sciences , Radaition Oncology, New Delhi, India; 6 Institute of Liver & Biliary Sciences , Radiation Oncology, New Delhi, India Purpose or Objective To study the hematological and biochemical parameters over the course of SBRT treatment. And to establish its clinical and dosimetric correlations. Materials and Methods A total of 27 patients with unresectable and nonmetastatic HCC were treated with stereotactic body radiotherapy (SBRT). Triple phase 4DCT was done for simulation and contouring was done with the generation of internal target volume. Complete blood counts, liver functions and tumor markers, namely Alpha feto protein (AFP) & Protein induced by vitamin K absence-II (PIVKAII) were collected at baselines, during 1 st and 2 nd week of SBRT, at 1 month and at 3 months of treatment. The dose-volume effect of Spleen was correlated with thrombocytopenia and leukopenia. Students T test and the bivariate correlation analysis was used for the statistical analysis. Confidence interval was set to 95% and p value was set to be significant at <0.05. Results A total of 14 and 13 patients had child pugh A and B, respectively. The mean dose per fraction delivered was 7.6Gy (3- 10Gy) over an average period of 2 weeks. Majority of the patients belonged to staged IV (BCLC –C). There was significant decrease in the lymphocyte count during SBRT at 1 st and 2 nd week as compared to baseline(p=0.001). The thrombocytopenia and packed cell volume at 2 weeks was correlated with the volume of spleen receiving more than 10 Gy of dose(V10). The mortality rate was correlated with higher mean dose to the spleen. Significant rise of neutrophil to lymphocyte ratio was seen during both the weeks of treatment. AFP and PIVKA II were collected and compared. There was an initial rising trend of AFP during 1 st week of treatment which started to fall after 1 month. Levels of PIVKA II were found to fall rapidly from baseline till 2 nd week of radiation. No significant changes were observed in liver functions during the radiation course. None of the patients developed radiation induced liver disease. PO-1298 Hematological & Biochemical Changes During And Post SBRT For Hcc : An Institutional Study S. Gupta 1 , H. Yadav 2 , S. Sarin 3 , A. Gupta 4 , R. Sahansi 4 , R. Kamal 5 , D. Thaper 6