ESTRO 38 Abstract book

S417 ESTRO 38

Endoluminal Brachytherapy in Ca.Esophagus with Induction Chemotherapy and Definitive Chemoradiation. Material and Methods

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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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Conclusion Endoluminal Brachytherapy with Induction Chemotherapy and Definitive Chemoradiation is a feasible option in the absence of conventional alternatives. PO-0804 Re-irradiation with SBRT for In-field Recurrence of Pancreatic Cancer After Prior SBRT Y. Shen 1 , X. Zhu 1 , X. Ju 1 , Y. Cao 1 , S. Qing 1 , F. Cao 1 , H. Zhang 1 1 Changhai Hospital Affiliated to Second Military Medical University, Department of Radiation Oncology, Shanghai, China Purpose or Objective Stereotactic body radiation therapy (SBRT) is a promising alternative for pancreatic cancer with an excellent local control and acceptable toxicity. However, the safety and efficacy of SBRT for in-field recurrence after the initial SBRT remains unknown. Therefore, the aim of the study was to investigate the feasibility of re-irradiation with SBRT for local recurrent pancreatic cancer after the first SBRT. Material and Methods Twenty-six consecutive patients with pancreatic cancer received re-irradiation with SBRT after prior SBRT in our center between November 2013 and December 2016. One patient was loss to follow-up. Thirteen and twelve patients had limited disease (M0) and distant metastasis (M1) at the time of re-irradiation. Outcomes, including survival, disease control and toxicity, after treatment were evaluated in details. Results The median time between the first and second SBRT was 12.5 months (range, 6-29 months). The median prescription dose of the initial SBRT was 36Gy (range, 32- 45Gy in 5-8 fractions), and of the re-irradiation with SBRT was 32Gy (range, 25-40 Gy in 5-8 fractions). The median OS of patients with M0 was 15 months (range, 9-20 months) from re-irradiation and 25 months (range, 12-42 months) from the first SBRT. Six months after re-irradiation, the percentage of disease control rate(DCR) was 77.3%. Whether patients received chemotherapy or not, CA19-9 levels declined dramatically after re-irradiation ( P =0.002, 0.018). Thirteen of 18 patients (72.2%) had pain relief after re-irradiation. No Grade 4 or 5 toxicity was found during the whole treatment. One patient (4.2%) experienced late Grade 3 upper gastrointestinal hemorrhage.

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 Paclitaxel/Carboplatin. 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 on the Ryles Tube 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. Results