ESTRO 38 Abstract book

S359 ESTRO 38

the selection of good responding patients by histological or radiological response assesment. SP-0692 Against the motion This House believes that patients with Squamous Cell Carcinoma (SCC) of Oesophagus no longer need surgery W. Allum 1 1 Royal Marsden Hospital Trust and Institute of Cancer Research, Surgery, London, United Kingdom Abstract text The management of oesophageal SCC is a fully multidisciplinary process. There are options for treatment and the selection for an individual patient requires careful discussion in the context of each individual’s health, stage of disease and personal wishes. The availability of options stimulates significant differences in opinion amongst all oncology disciplines, not only reflecting available evidence but also the pattern of disease epidemiologically. Across Europe there are significant variations with surgery, usually with neoadjuvant treatments, in some centres and definitive chemoradiotherapy in others. In the UK there is an apparent 50:50 split between surgery and chemoradiotherapy. National audit data show similar results stage for stage. Furthermore many UK patients have significant co-morbidity precluding radical surgery. Despite the sensitivity of oesophageal SCC to combination chemoradiotherapy, the rates of recurrence vary. This can occur as residual disease at the end of treatment or recurrent disease some time after treatment. Past series have indicated that salvage surgery was hazardous with limited survival. However more recent series have shown that although complication rates are greater than primary surgery, in experienced centres these rates are manageable. Furthermore 5 year survival rates show similar outcomes for planned surgery after neoadjuvant treatment and for salvage surgery. As a result the option of more selective surgery needs further investigation with not only the evaluation of surveillance programmes but also to address patient preferences based on careful discussion of all evidence. There is therefore still a definite place of surgery in the treatment of oesophageal SCC. SP-0693 Whole brain irradiation with hippocampal avoidance A. Grosu 1 1 Universitatsklinik Freiburg, Dept. of Radiation Oncology, Freiburg, Germany Abstract text In patients with multiple brain metastases of solid tumors a whole brain radiotherapy (WBRT) is the most widely used treatment option. WBRT is associated with considerable neurotoxicity and may reduce the patients' quality of life. It is known that neural stem cells are located in the hippocampal region, supporting lifelong neurogenesis. The reduction of hippocampal functions like learning and memory as a consequence of WBRT is explained by damage to neural stem cells and by a lower ability for regeneration of neuron populations. Avoidance of neural stem cells in hippocampus may help to reduce the neurotoxicity of WBRT. Several studies have shown that a dose escalation to the brain metastases contribute to better local tumor control and putatively longer overall survival. By the use of new irradiation techniques a WBRT with hippocampal sparing and concomitant boost to the metastases (HA- WBRT) is feasible. The HIPPORAD – NOA 14 project aims to investigate the benefits of HA-WBRT compared to WBRT Symposium: Controversies in the management of brain metastases

Hoeben A, Rekers N, Theys J, Yaromina A, Dubois LJ, Lambin P. Combining radiotherapy with immunotherapy: the past, the present and the future. Br J Radiol. 2017 May 25:20170157.3. Rekers NH, Zegers CM, Germeraad WT, Dubois L, Lambin P. Long-lasting antitumor effects provided by radiotherapy combined with the immunocytokine L19-IL2. Oncoimmunology. 2015 Apr 2;4(8):e1021541.4. Nicolle. H. Rekers, Catharina. M. L. Zegers, Ala Yaromina1, Natasja. G. Lieuwes, Rianne Biemans, Birgit L.M.G. Senden-Gijsbers, Mario Losen, Evert Van Limbergen, Wilfred T.V. Germeraad, Dario Neri, Ludwig Dubois, Philippe Lambin. Combination of radiotherapy with the immunocytokine L19-IL2: additive effect in a NK cell dependent tumour model. Radiother. Oncol. 20155. Rekers NH, Catharina. M. L. Zegers, Ala Yaromina1, Natasja. G. Lieuwes, Rianne Biemans, Birgit L.M.G. Senden-Gijsbers, Mario Losen, Evert Van Limbergen, Wilfred T.V. Germeraad, Dario Neri, Ludwig Dubois, Philippe Lambin. Combination of radiotherapy with the immunocytokine L19-IL2: additive effect in a NK cell dependent tumour model. Radiother. Oncol. 20156. Zegers CM, Rekers NH, Quaden DH, Lieuwes NG, Yaromina A, Germeraad WT, Wieten L, Biessen EA, Boon L, Neri D, Troost EG, Dubois LJ, Lambin P. Radiotherapy combined with the immunocytokine (L19-IL2) provides long-lasting anti-tumor effects. Clin Cancer Res. 2014 Dec 31.

SP-0688 Against the motion: we don't need Costalotamab when we have SBRT M.Joiner 1 1 Karmanos Cancer Institute Wayne State University,Detroit,USA

Abstract not received

Debate: This house believes that patients with squamous cell cancer of the esophagus no longer need surgery

SP-0689 For the motion F.Cellini 1 1 Università Cattolica del Sacro Cuore ,Radiation Oncology Gemelli ART, Rome Italy

Abstract not received

SP-0690 Against the motion B. Wijnhoven 1 1 Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands

Abstract not received

SP-0691 For motion M. Hulshof 1 1 Academic Medical Center, Dept Radiation Oncology, Amsterdam, The Netherlands Abstract text Longterm locoregional recurrences (LR) after definitive CRT in SCC still occurs in about 35% and is significantly worse compared LR rates after pCRT + S (13%). Even in patients with a good initial clinical response LR is in favour of surgery although overall survival is comparable. Treatment morbidity, quality of life and treatment costs are generally considered in favour of dCRT. Thus there is a need for application of more organ sparing treatment. Studies will be discussed that on one hand are trying to improve the outcome of dCRT(dose escalation, endoscopic resection, new drugs) and on the other hand will improve