ESTRO 38 Abstract book

S227 ESTRO 38

Purpose or Objective Need for the Study:

Over 75% of people with cancer worldwide have no access to safe surgery. Access is worse in low income countries where 95% of people with cancer do not receive basic cancer surgery. Patients in remote areas in Rural India, South Asia, Africa and Poorer EU Member States do not have access to surgical infrastructure or qualified personnel to deliver high quality surgery in locally advanced esophageal carcinoma. Further, Esophageal Cancer has an abysmal response despite multimodality treatment. Endoluminal Brachytherapy is an under-utilized modality in the curative setting and an elegant tool to escalate the dose to improve the clinical response and clinical symptoms. This study examines if Dose Escalation with Endoluminal Brachytherapy after Induction Chemotherapy and Definitive Chemoradiation is feasible in the background of the above scenarios in underserved populations. Objective: To evaluate Dysphagia Free Interval (DFI), Disease Free Survival (DFS), Overall Survival (OS) and Toxicity Profile in Endoluminal Brachytherapy in Ca.Esophagus with Induction Chemotherapy and Definitive Chemoradiation. Material and Methods

Results

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Median Age of Recruitment was 62.5 years. All 31 Patients completed treatment and were clinically stable at discharge. 83.97% Completed Chemotherapy, 96.77% completed Radiation Therapy according to protocol. 35.48% patients were alive on last follow up. Median OS was 21 months. OS at 2 years was 53.6% . Median DFI was 10.7 months. Those with a Cumulative EQD2 >60 Gy had a significant 5 year OS of 59.1% vs. 33.3% for those who received EQD2<60 Gy (p=0.061, CI=76.3-91.4). 5 year DFS for EQD2 >60 Gy was 56.1% vs. 16.7% for those who received Cumulative EQD2 <60Gy (p=0.079, CI=74.2-93.8). There were no Grade III/IV acute toxicities. There were no Fistulas on follow up. 2 patients required stenting within 1 year of treatment and died within 2 months thereafter. 2 Patients developed CHF at 4 years.1 Patient Developed Left Breast Fibrosis at 4.5 years.

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31 patients with biopsy proven Esophageal Carcinoma Stage IIA-IVA with Node (-) Status were enrolled at our Institute from June 2007 to July 2018. ILRT 10Gy/2# was delivered following Definitive CTRT 50.4Gy/28# with 3-weekly CDDP/5-FU after 6-10 cycles of Pacli/Carbo. Proximal and Distal borders were marked from the Prechemotherapy tumor volume on OGD. Patients were simulated in a GE Multislice CT scanner to confirm accurate coverage of the pre-chemotherapy disease. Positions were marked and secured to prevent any shift in placement before and during treatment. ILRT Dose was prescribed to 1 cm from the center of the source. Swallowing Status was established on follow up. OS and DFS was censored at death or last follow up. Statistical Analysis was performed using SPSS.

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Conclusion Endoluminal Brachytherapy with Induction Chemotherapy and Definitive Chemoradiation is a feasible option in the absence of conventional alternatives. OC-0433 Feasibility and early clinical response of interstitial BT for hepatocellular carcinoma S. Corradini 1 , F. Walter 1 , C. Maihöfer 1 , M. Rottler 1 , J. Well 1 , L. Nierer 1 , M. Seidensticker 2 , R. Seidensticker 2 , T. Streitparth 2 , F. Streitparth 2 , J. Ricke 2 , C. Belka 1 1 Radiation Oncology, Department of Radiation Oncology LMU, Munich, Germany; 2 Radiology, Department of Radiology LMU, Munich, Germany