ESTRO 36 Abstract Book

S261 ESTRO 36 2017 _______________________________________________________________________________________________

SP-0500 Rectal cancer: literature overview and discussion of clinical case I.S. Barua 1,2 1 Akershus University Hospital - Norway, Department of Oncology, Oslo, Norway 2 University of Oslo, Faculty of Medicine, Oslo, Norway The first part of the talk will cover epidemiology, staging and management of rectal cancer in Europe. This includes last decades’ development and differences in prevalence and treatment in Europe. TNM classification will be presented and radiology images shown to illustrate different stages. The management of rectal cancer, including the most common treatment modalities, will be covered and followed by a presentation of the European guidelines for radiotherapy of rectal cancer. In the second part a rectal cancer case from Akershus University Hospital in Norway will be presented. The focus will be on the views from biology, physics and RTT perspectives as well as the clinical aspect. At the end there will be a discussion with the senior expert regarding typical challenges related to choice of treatment, before the senior expert will end the session with summarizing the clinical case and the preferred treatment option at her clinic. SP-0501 Rectal cancer: literature overview K. Haustermans 1 1 UZ KU Leuven, Department of Radiation Oncology, Leuven, Belgium The treatment of rectal cancer is risk-adapted and depends on the initial staging. If a patient has a low risk of local recurrence, no preoperative treatment is needed and the patient can go straight to surgery. For superficial lesions a Transanal Endoscopic Microsurgery (TEM) procedure can be considered. For more advanced cases Total Mesorectal Excision (TME) is preferred. The addition of preoperative radiotherapy has further reduced the risk of local recurrence. Patients with an intermediate risk of relapse are currently treated by a short course of radiotherapy (5 times 5 Gy) followed by immediate surgery. Patients with a high risk of local recurrence e.g. threatened mesorectal fascia by the primary tumor, are treated with a long course of chemoradiation followed by TME surgery 8 to 12 weeks after the end of the chemoradiation. In case of threatened sphincter, a long course of chemoradiation followed by a long interval is currently the treatment of choice. Currently, many studies are ongoing looking into the possibility of organ preservation or in intensifying the preoperative chemotherapy with the aim of reducing the risk of distant metastasis. Omitting radiotherapy in patients responding well to preoperative chemotherapy aims at reducing radiation induced toxicity. Lengthening the interval after short course radiotherapy is being compared with preoperative chemoradiotherapy followed after 8 to 12 weeks by TME. Until the results of these studies become available none of these approaches can be regarded as standard. PV-0502 Post-operative radiation therapy in atypical meningiomas: analysis of prognostic factors S. Shakir 1 , L. Souhami 2 , K. Petrecca 3 , J. Mansure 4 , V. Panet-Raymond 1 , G. Shenouda 1 , K. Singh 5 , A. Alodaini 6 , B. Abdulkarim 1 , M. Guiot 6 1 McGIll University Health Center, Radiation Oncology, Montreal, Canada 2 McGill University Health Centre, Radiation Oncology, Montreal, Canada 3 McGill University Health Centre, Neurosurgery, Poster Viewing : Session 11: Head and neck and CNS

with recent decades showing a trend for induction regimens followed by surgery. The latter have included induction CHT followed by surgery, and, in more recent years, induction RT-CHT followed by surgery. When tested in prospective randomized phase III studies, preoperative RT-CHT (with or without preceding CHT) followed by surgery brought no improvement in overall survival or local control compared to definitive concurrent RT-CHT, and was associated also with an increase in treatment-related mortality. In the second part of this presentation we will discuss and clarify the role of radiotherapy according to the latest literature and international guidelines. We invite all to join the final discussion. SP-0498 Cervical cancer: literature overview and discussion of clinical case L. Bolm 1 1 Lübeck, Germany, Cervical cancer is the leading cause of death from gynecological cancer worldwide and the majority of patients are diagnosed with locally advanced tumours. Therapeutic concepts are based on clinical FIGO staging. Standard treatment in FIGO IB1 to IVA cervical cancer remains a multi-modality therapy involving external-beam radiotherapy, platinum-based chemotherapy and a local brachytherapy boost. Regarding the literature to date several aspects in the treatment of cervical cancer are an issue of debate. We will discuss internationally varying treatment guidelines as to outline current controversies. Pre-therapeutic staging accuracy and the role of imaging techniques such as MRI are emerging in the treatment of locally advanced cervical cancer (LACC). Image-guided therapy may not only serve to optimize treatment planning of external beam radiotherapy, but to constantly check motions of target volume and organs at risk also in brachytherapy. We will present the process of treatment planning, target definition as well as delineation guidelines involving the e-learning programmes "Falcon" and "Dove". A case of LACC with nodal involvement will be presented at the symposium to demonstrate therapeutic challenges, side effects and the process of follow-up. We invite everyone to join the final discussion. SP-0499 "Cervical cancer: literature overview and discussion of clinical case" L. Motisi 1 1 University of Lübeck, Radiation Oncology, Lübeck, Germany For the treatment of cervical cancer a multi-modality approach plays a crucial role from the point of diagnosis to treatment until follow up. The gynecological examination is still the most important investigation for the staging of cervical cancer, but on the other hand the introduction of new imaging techniques such as MRI are emerging, not only as a support for the planning treatment of external beam radiotherapy (EBRT,) but also for brachytherapy. Furthermore these new techniques are helping to detect the “target” and also the organs at risk as to spare them from high doses. Moreover the use of new techniques of EBRT, such as Cone Beam CT, are helpful to constantly check the motions of organs at risk especially rectum and bladder in daily routine, and to adapt the treatment plan. We will focus our attention also on the contouring of lymph nodes according to the new criteria of classification in low-, intermediate- and high-risk patients. Even if the lymphadenectomy and images like PET-CT are important for the staging of lymph nodes, we have to take into account many other factors predictive of local recurrence and that will guide the radiotherapist to define the best treatment plan for the patient.