ESTRO 36 Abstract Book

S669 ESTRO 36 _______________________________________________________________________________________________

Results 61 patients were treated with a short course of palliative radiotherapy at the Academic Medical Center. A majority had stage four disease (69%) and a minority had local recurrence after surgery (10%). Median age was 62 years, 51% of the patients were male and mean Karnofsky performance score (KPS) was 79%. Median pain score before treatment was 8 on an 11-point numeric pain rating scale. Eighty-five percent of the patients used strong opioids with a mean equivalent oral morphine dose of 147 mg a day. Four radiotherapy dose schedules were given: 3 x 8 Gy (46%), 2 x 8 Gy (39%), both once per week, 1 x 8 Gy (13%) and 1 x 6 Gy (2%). Pain relief after radiotherapy was experienced by 66% of patients. Median time to reduction in pain was 1 week after end of radiotherapy, although this time interval could only be assessed in 25 patients. Information on use of pain medication after treatment was not clearly documented. Four patients had complete pain relief and in 4 patients pain medication was reduced or even stopped. Nausea was a common reported side effect in 51% and vomiting was reported in 21%. Median overall survival was 3.5 months. Patients who had pain relief after treatment had a better overall survival (p<0,0001) compared to non responders. Conclusion A short course of palliative radiotherapy was effective in 66% of the patients with the most frequent given radiotherapy dose schedule of 3 x 8 Gy. Radiotherapy was fairly well tolerated. These results were the basis for a prospective phase-2 study at our institute named PAINPANC ( NTR5143) . Thirty patients with pain ful unresectable panc reatic cancer will receive 3 x 8 Gy, one fraction a week, and are prospectively followed with EORTC-QLQ-C15-PAL and Brief Pain inventory questionnaires during and after treatment. EP-1242 Palliative EBRT for incurable esophageal cancer and symptomatic dysphagia-single center results K. Yordanov 1 , A. Richetti 1 , S. Cima 1 , G. Pesce 1 , C. Azinwi 1 , F. Martucci 1 , B. Muoio 1 , P. Fanti 1 , M.C. Valli 1 1 Oncology Institute of Southern Switzerland, Radiotherapy, Bellinzona, Switzerland Purpose or Objective Purpose: to assess the effectiveness and safety of external beam radiation therapy (EBRT ) to palliate dysphagia in advanced esophageal cancer patients treated with total dose of 40 Gy/2.5Gy. Material and Methods we retrospectively reviewed the records of 19 patients diagnosed with locally advanced or metastatic esophageal cancer, treated in our institution from 2012 to 2015 with palliative EBRT. All patients had histologically confirmed diagnosis of squamous cell or adenocarcinoma of the esophagus and were symptomatic for dysphagia. Before the start of EBRT the dysphagia was scored according to scale 0-4 (0- no dysphagia , 1 -dysphagia with certain solid foods , 2 -able to swallow semi-solid soft foods , 3-able to swallow liquids only and 4 - unable to swallow saliva ). The prescribed total dose to all patients was 40Gy with daily dose of 2.5Gy, 5 fractions per week in sixteen fractions using Volumetric Modulated Arc technique . We evaluated the dysphagia score one months after the end of the EBRT. Results Grade 1 dysphagia was detected before RT treatment in 3 patients ( 15.8%), grade 2 in 8 patients (42.2%), grade 3 in 6 patients (31.5%) and grade 4 in 2 patients (10.5%).No patient discontinued RT due to acute toxicity. One month after the end of the EBRT 4 patients(21%) experienced complete dysphagia relief.

Fourteen patients (73.7%) experienced improvement of symptomatic dysphagia. Four patients(21%) had no positive effect and one patient died 3 weeks after the end of treatment. Conclusion EBRT with mild hypofractionation is an effective treatment for esophageal cancer patients with symptomatic dysphagia. It is well tolerated and can provide symptom relief and quality of life improvement. EP-1243 A Study on predictive value of 18F-FDG PET- CT to Chemoradiation of Esophageal Cancer J. Li 1 , W. Sun 2 1 Fujian Cancer Hospital, radiation oncology, Fuzhou- Fujian, China 2 Fujian medical university, Provincial Clinical College, Fuzhou, China Purpose or Objective To evaluate whether the SUVmax and MTV predict short- term clinical curative effect of radiotherapy or chemoradiotherapy in nonoperative esophageal squamous cell cancer. Material and Methods A retrospective analysis was made on 98 cases patients with esophageal cancer from January 2014 to January 2016 in Fujian Provincial Cancer Hospital. All of them had an examination by FDG PET/CT before treatment. Respectively analysis was conducted on SUVmax, MTV's relationship with clinical factors and short-term clinical curative effect. Results There is no difference on SUVmax and MTV of different group of age, gender, morbid position and histology differentiated degree (P > 0.05). Significant difference was found on SUVmax and MTV of different group of lesion length, T grade, stage pathologic N stage and clinical (P < 0.05). And positive correlation was noticed between the SUVmax, MTV and lesion length, T grade, stage pathologic N stage and clinical stage (P < 0.05). Low MTV group and low SUVmax group were higher than high MTV group and high SUVmax group on the percentage of lesion length reduction(P < 0.05). And it was negative correlation between SUVmax , MTV and the percentage of lesion length reduction, but the correlation of MTV was stronger than SUVmax. Conclusion there was no significant effect on SUVmax and MTV for age, gender, morbid position and histology differentiated degree (P > 0.05), but lesion length, T grade, pathologic N stage and clinical stage were significantly positive correlated with SUVmax and MTV. The SUVmax and MTV can predict short-term clinical curative effect of radiotherapy or chemoradiotherapy in nonoperative esophageal squamous cell cancer, but MTV was more valuable than SUVmax . EP-1244 Neoadjuvant Chemo Radiation followed by Surgery in Ca Esophagus – Retrospective Review from India V. Goel 1 , A.K. Anand 1 , H.K. Chaturvedi 2 , A. Verma 1 , P. Agarwal 1 , T. Saxena 1 , R. Shukla 1 , D. Arora 3 , A.K. Bansal 3 , A. Gulia 1 , C. Garg 1 , U. Mukherjee 4 1 Max superspecality hospital, Radiation Oncology, Delhi, India 2 Max superspecality hospital, Surgical Oncology, Delhi, India 3 Max superspecality hospital, Medical Physics, Delhi, India 4 Max superspecality hospital, Pathology, Delhi, India Purpose or Objective Neo-adjuvant Concurrent Chemoradiation (NACCRT) followed by Surgery is now the standard of care for middle