ESTRO 2025 - Abstract Book

S1188

Clinical – Lower GI

ESTRO 2025

Keywords: Neoadjuvant Therapy, Rectal cancer, Radiomics

References: 1. Sujit SJ, Aminu M, Karpinets TV, et al. Enhancing NSCLC recurrence prediction with PET/CT habitat imaging, ctDNA, and integrative radiogenomics-blood insights. Nat Commun. 2024; 15(1): 3152. 2. Wu J, Cao G, Sun X, et al. Intratumoral Spatial Heterogeneity at Perfusion MR Imaging Predicts Recurrence-free Survival in Locally Advanced Breast Cancer Treated with Neoadjuvant Chemotherapy. Radiology. 2018; 288(1): 26-35.

2008

Digital Poster The management of anal squamous cell carcinoma in frail and elderly patients – is 30Gy enough?

Christakis Agathokleous 1 , Clare Jacobs 1 , Alexandra Gilbert 2 , Rebecca Muirhead 1 1 Radiotherapy, Oxford University NHS Foundation Trust, Oxford, United Kingdom. 2 Leeds Institute for Medical Research, University of Leeds, Leeds, United Kingdom Purpose/Objective: Frail and comorbid patients with anal squamous cell carcinoma (ASCC) are often not fit for standard chemoradiotherapy and, as such, excluded from clinical trials such as the PLATO platform study (ISRCTN88455282). We aim to quantify outcomes after 30Gy with or without chemotherapy in frail and elderly patients to inform future clinical trials for this population within the PLATO umbrella. Material/Methods: In this single centre retrospective cohort design study, all patients receiving 30Gy in 10 or 15 fractions between 11/3/2019 and 2/10/2023 were identified. Data on patient and tumour demographics, chemotherapy and radiotherapy delivered, and outcomes were documented. Outcomes were divided into 6 categories detailed in Figure 1. The categories encompassed whether the patient was alive, whether they died of ASCC or non-ASCC causes, if patients were disease-free at death or last FU and clinician derived quality of life with active ASCC. Co morbidity and frailty were scored using the Rockwood Frailty Score and the Adult Comorbidity Evaluation (ACE)-27 Score. Median follow-up (FU) was calculated from the last day of radiotherapy to the date of data collection (01/10/2024). Median overall survival was calculated from the last day of radiotherapy to date of death or last FU. Results: Twenty-nine patients were identified. Median FU was 32 months (16 to 66). Median age was 73 (42 To 90). Male to female ratio was 12:17. Median frailty score was 5 (range 2 to 6). The median worst comorbidity score was 2s (range 0 to 3). Sixteen patients had early Stage (T1/2N0) (58.6%), 13 patients with locally advanced (T3/4 N+) (41.4%). All patients completed planned radiotherapy. Median days to complete 14 (range 11 to 24). Concurrent chemotherapy was delivered in 18 patients (62.1%). Median OS 17 months (range 3 to 54). Following initial treatment, two patients received reirradiation, one patient went on to have APR at recurrence. Figure 1 illustrates the different outcomes, with the authors impression of whether 30Gy is sufficient for each outcome. One additional outcome was added following analysis.