ESTRO 38 Abstract book

S228 ESTRO 38

Sphincter function was self-evaluated by the Wexner questionnaire, that assess different types of incontinence (solids, liquids, gases) and their impact on the quality of life, leading to a score from 0 to 20. Interpretation of Wexner’s score was defined as follows: None (0), Minimal (1 to 4), Moderate (5 to 9), Important (10 to 16) and Severe (17 to 20). Threshold of 9 has also been used, associated in the literature to a poorer quality of life. Additional items issued from the questionnaire developed by Vaizey (impact on sexuality, faecal urgency and self- medication) were also assessed. Results Patients who responded to the questionnaire had similar characteristics to those of the whole cohort, except for average follow-up (43 vs 23 months, p<0.001). Average Wexner score was 4.1 (25%IQ: 0 - 75%IQ: 7). 19% had a score > 9. 41.8% of this cohort did not report any symptoms (score 0). Only 2.5% had severe symptoms. Regarding sexual symptoms, 56.5% of our patients have expressed no discomfort. Faecal urgency was present in 45.6% of our cohort. Only 11.4% of patients have used drugs for a constipation purpose. No pre-therapeutic or therapeutic factors have been identified as associated with the occurrence of anal incontinence. The occurrence of a late gastrointestinal or cutaneous toxicity (> grade 2) does not have a significant influence on the occurrence of these symptoms (HR: 1.693 [95%CI: 0.573 – 5.008], p=0.357). We observed a non-significant (p=0.185) decrease of the average score with the delay between the BT and the evaluation: 6.3, 3.8 and 3.5 respectively when the questionnaire was applied less than 2; 2 to 5; or more than 5 years after BT. Incontinence for solid stools was statistically reducing with time (average score: 1.3, 0.4 and 0.3 respectively, p=0.011) as well as the proportion of patients without symptoms (13.3%, 40% and 55.9% respectively, p=0.019). Conclusion Anal incontinence after conservative treatment of the sphincter system remains a poorly explored pathology, with multiple scores available in the literature. Our homogeneous retrospective cohort reports a low incidence of incontinence, but faecal urgency remains important with a definite impact on the quality of life of these patients. With reservation of confounding factors (modifications of the indications and treatments’ modalities during the period of observation), the function of the sphincter may improve over time. OC-0435 Contact X-Ray Brachytherapy (CXB) after local excision (LE) for early rectal adenocarcinoma. J. Gérard 1 , S.M. Arthur 2 , F. Antoine 3 , D. Amandeep 4 1 Centre Antoine Lacassagne, Radiotherapy - University Côte d'Azur, Nice, France ; 2 Clatterbridge Cancer Centre, Radiotherapy Papillon Suite, Liverpool - Clatterbridge, United Kingdom; 3 Centre Antoine Lacassagne, Biostatistiques - University Côte d'Azur, Nice, France ; 4 East Yorkshire Hospitals, Radiotherapy Oncology, Hull, United Kingdom Purpose or Objective Early rectal cancers, increasingly diagnosed through screening programmes, are often treated using local excision (LE). In case of pathological pejorative features a radical surgery (TME) is the standard recommendation. The risks and sequelae of TME have stimulated alternative option using radiotherapy to preserve the rectum. We present the results of adjuvant CXB with or without external beam radiotherapy (EBRT) after LE in a multicenter cohort. Material and Methods Between 2009-2017 CXB was given after LE in three centers to 197 patients (Clatterbrige :120, Hull: 35, Nice:34). All patients were M0. Negative pathological features were: lymphovacular invasion (LVI), sm2-3

Purpose or Objective Several local approaches for hepatocellular carcinoma have been evaluated in clinical practice. Interstitial CT- guided brachytherapy (BT) has been shown to be a safe and effective treatment option in various sites, but remains under investigation in the setting of hepatocellular carcinoma. Material and Methods Between 07/2017-07/2018 patients treated with CT- guided high-dose interstitial brachytherapy for hepatocellular carcinoma were evaluated. All patients with a minimum follow-up of 2 months were included in the present Analysis. Results Between 07/2017-07/2018 patients treated with CT- guided high-dose interstitial brachytherapy for hepatocellular carcinoma were evaluated. All patients with a minimum follow-up of 2 months were included in the present analysis. Results Overall, 82 hepatocellular carcinoma lesions were treated with BT in 36 patients. Median age was 66 years (range 46- 85 years). 29 patients presented with a liver cirrhosis Child-Pugh A and 11 patients with Child-Pugh B cirrhosis at the time of brachytherapy. Prior treatments were: transaterial chemotherapy embolization (TACE), radiofrequency ablation (RFA), surgical resection, selective internal radiotherapy (SIRT), SBRT. In 22 patients more than one lesion was treated per fraction (mean 1.6, range 1-5 per fraction). Mean liver volume was 1654cc (range 800-2488cc). Brachytherapy was performed in a single fraction with an aimed prescription dose of 15Gy, taking into account constraints of organs at risk. A mean dose of D100: 14.4 Gy was reached, D95: 18.9 Gy, D90: 21.0 Gy. Mean CTV volume of single lesions was 14cc (range 0.2-103cc) and cumulative CTV volume per fraction of 36cc (range 1.4-282cc). Mean liver volume receiving > 5Gy was 326cc (range 21-1330cc). After a mean follow-up of 6 months (2-12months), 3 patients who received brachytherapy as a bridging treatment, had undergone liver transplantation after 2- 5month. Regarding overall local control of treated lesions, 26 complete responses, 24 partial responses and 1 progression were recorded. 15 patients developed new HCC lesions within the liver and 5 patients developed distant metastases. 4 patients died during the follow-up period, resulting in a 6- and 12-months overall survival of 96% and 74%, respectively. Conclusion Interstitial CT-guided BT showed to be an effective treatment option due to its good rate of local control. However, longer follow-up is needed to definitively assess its role in this Setting. OC-0434 Sphincter function after EBRT and Pulsed Dose Rate Brachytherapy (PDR-BT) in anal cancer patients T. Brahmi 1 , A.A. Serre 1 , F. Gassa 1 , M. Sandt 1 , F. Lafay 1 , P. Pommier 1 1 Centre Léon Bérard, Radiation Therapy, Lyon, France Purpose or Objective One of the objectives of the anal canal cancer treatment is the preservation of the pelvic sphincter system to avoid a definitive stoma. However, the sphincter function is poorly evaluated, especially regarding patients' perspective. Material and Methods Between 2005 and 2017, 179 consecutives patients with anal canal cancer (all histological types) received PDR-BT as a boost after EBRT (+/- concomitant chemotherapy) in our institution. 79 out of 131 of them eligible for the study (alive with a minimum 7 months follow-up; no recurrence) were included.