ESTRO 36 Abstract Book

S671 ESTRO 36 2017 _______________________________________________________________________________________________

presented a G3+ acute toxicity, mainly as moist desquamation (n = 25) or diarrhoea (n = 10). Three patients presented a late grade 3 gastrointestinal toxicity (anal incontinence). No grade 4 acute or late toxicity was recorded. Patients treated with standard dynamic IMRT presented a significantly higher risk of acute grade 3 or more toxicity compared to those treated with VMAT or HT (38.5% vs 15.3%, p = 0.049). Conclusion Modern IMRT (VMAT or HT) with daily IGRT are effective and safe in treating AC patients, and should be considered the standard of care in this clinical setting. EP-1260 Helical Tomotherapy with Daily Image Guidance for Rectal Cancer patients B. De Bari 1 , A. Franzetti-Pellanda 2 , A. Saidi 3 , M. Biggiogero 2 , D. Hahnloser 4 , D. Wagner 5 , M. Montemurro 5 , J. Bourhis 3 , O. Ozsahin 3 1 Hôpital Univ. Jean Minjoz, Radiation Oncology, Besançon, France 2 Clinica Luganese, Radiation Oncology, Lugano, Switzerland 3 Centre Hospitalier Universitaire Vaudois, Radiation Oncology, Lausanne, Switzerland 4 Centre Hospitalier Universitaire Vaudois, Surgery, Lausanne, Switzerland 5 Centre Hospitalier Universitaire Vaudois, Medical Oncology, Lausanne, Switzerland Purpose or Objective Helical Tomotherapy (HT) has only been recently introduced in the neoadjuvant treatment of locally advanced rectal cancer (LARC) patients (pts). Aim of this retrospective study is to report the results in terms of toxicity and local control of the largest population treated with neoadjuvant HT and chemotherapy (CRT) with daily image guidance (IGRT) followed by surgery. Material and Methods Data of 117 patients LARC pts treated in 2 Swiss Radiotherapy departments were collected and analyzed. Radiotherapy (RT) consisted of 45 Gy (1.8 Gy/fraction, 5 days/week for 5 weeks) to the regional lymph nodes. Seventy pts also received a simultaneous-integrated boost (SIB) up to a total dose of 50 Gy to the tumor (2 Gy/fraction, 5 days/week for 5 weeks). Chemotherapy consisted of capecitabine 850 mg/m2, twice daily, during the RT days. Following a mean interval after completion of CRT of 53 days (range, 13-142), all pts underwent surgery. Ninety-four patients (80.3%) received a low anterior resection (LAR), while 23 pts (19.7%) received an abdomino-perineal resection (APR). The resection status was classified as R0 in 107 patients, and R1 in 3 patients (not reported in 7 patients). Results The overall rate of G2 or more toxicity was 22% (22/117 patients). Only 3 patients (2.5%) presented a G3 toxicity, as dermatitis (n = 1) or diarrhoea (n =2). None of the patients presented a G3 (or more) hematologic toxicity and/or G4 non-hematologic toxicity. After a median follow-up time of 23.3 months (range, 4.8 – 66.8), only 2 pts (1.7%) presented a G3-4 late toxicity. The 3-year local control rate was 96.9% (95% confidence interval: 96.4 - 97.3%). Conclusion CRT delivered with HT and daily IGRT shows excellent rates of local control with few acute toxicity. Longer follow-up is needed to confirm these encouraging results. EP-1261 Hypofractionated radiotherapy for inoperable rectal cancer: A retrospective analysis 2007 to 2015 N. Abdul Satar 1 , A. Sibtain 1 , C. Cottrill 1 , T.M. Richards 2 1 Barts and the London NHS Trust, Radiotherapy Dept, London, United Kingdom 2 Barts and the London NHS Trust- University College

Fig. 1 Colostomy-free survival Conclusion

Results of this analysis indicate that 3-year clinical outcomes of SIB-IMRT are similar to CRT. Even if highlighting the retrospective observational nature of the study, these data support the routinely use of SIB-IMRT in clinical practice for anal cancer patients submitted to concurrent chemo-radiation. EP-1259 Modern Intensity Modulated Radiotherapy with Daily Image Guidance for Anal Cancer Patients B. De Bari 1 , L. Lestrade 2 , A. Franzetti-Pellanda 3 , M. Biggiogero 3 , M. Kountouri 2 , O. Matziinger 4 , R. Miralbell 2 , J. Bourhis 5 , M. Ozsahin 5 , T. Zilli 2 1 Hôpital Univ. Jean Minjoz, Radiation Oncology, Besançon, France 2 Hopitaux Universitaires de Genève, Radiation Oncology, Genève, Switzerland 3 Clinica Luganese, Radiation Oncology, Lugano, Switzerland 4 Hôpital Riviera-Chablais, Radiation Oncology, Vevey, Switzerland 5 Centre Hospitalier Universitaire Vaudois, Radiation Oncology, Lausanne, Switzerland Purpose or Objective We report the outcomes of the largest populations of anal cancer (AC) patients treated with modern intensity- modulated radiotherapy (IMRT) techniques and daily image guidance. Material and Methods AC patients treated with IMRT +/- chemot herapy in 3 radiotherapy departments were retrospectivel y analysed. They received 36 Gy (1.8 Gy/fraction) on the pelvic and inguinal nodes and on the anal canal, using IMRT (n = 39), volumetric modulated arc therapy (VMAT; n = 15), or helical Tomotherapy (HT; n = 97), and a sequential boost up to a total dose of 59.4 Gy (1.8 Gy/fraction) on the anal and on the nodal gross tumor volumes, delivered with either IMRT (n = 16, until 2011), VMAT (n = 17), HT (n = 61), or 3D-conformal EBRT (CRT, n = 61). Results A total of 151 patients were treated (09/2007 - 03/2015). Of them, 122 presented a stage II - IIIA disease. Chemotherapy was delivered in 138 patients, mainly using mitomycin C and 5-fluorouracil (n = 81). Median follow-up was 38 months (interquartile range, 12-52). Four-year local control rate was 82% (95% CI: 76-91%). Complete toxicity data were available for 143 patients: 22% of them