ESTRO 38 Abstract book

S770 ESTRO 38

54.8%, and abdominal discomfort: 64.2%). Median time to symptom progression was 89 days (range: 12-392 days), in which patients with CR+PR at 1 month had more durable control of symptoms than those with SD+PD (median 114 days vs. 55 days, p=0.24). Treatment is well tolerated with only 2 patients (3.8%) developing grade 3 toxicities. (fatigue, n=1; vomiting, n=1). AFP response, radiological response rate, and disease control rate at 3 months were 38.6%, 15.2%, and 54.6% respectively. Table 1. Bar Chart showing proportion of patients with clinical improvement of pain and abdominal discomfort at 1 month (CR+PR, SD, and PD)

Material and Methods Eligible patients for this ethics-approved Phase I trial had symptomatic dysphagia, biopsy-proven carcinoma, PET staged ≤5 metastases, and ECOG PS 0-1. The biological equivalent dose of radiotherapy (RT) was kept at approximately 40Gy, whilst the number of daily fractions was reduced in a stepwise manner from 15 to 10 over four schedules. Patients received weekly concurrent CP (carboplatin (AUC2) and paclitaxel 50mg/m2)) either three (schedules 1-3) or two (schedule 4) times. Subsequent management was at clinician discretion. Dose Limiting Toxicities (DLTs) were radiation pneumonitis or oesophageal rupture. The main measure of efficacy was relief of dysphagia using the Mellow scale, where 4=complete obstruction and 0=normal. Results 16 patients (14 male), median age 68 years (range 42-81) provided informed consent and were recruited. At baseline, 8 patients had severe dysphagia (Mellow 3 or 4). Three patients required admission for management of nausea related to study treatment. No DLTs occurred within a minimum of 6 weeks following the completion of CRT. By 3 months, all patients showed improvement in dysphagia by a median of 2 levels on the Mellow scale. Some responses were profound: one had a Mellow score improve from 4 to 0 and maintained normal swallow for a year, whilst another was dysphagia-free 2 years after completing CRT without any further therapy. Conclusion A short course of CRT with weekly concurrent CP provides good dysphagia relief with manageable toxicity in a well selected group of patients with OesC. Larger studies are required to explore the utility of this treatment. EP-1417 Palliative Liver Radiotherapy (RT) of Advanced Hepatocellular Carcinoma (HCC) in Endemic Population C.L. Chiang 1,2 , C.S. Yeung 3 , N.S. Wong 3 , K.C. Tsang 1 , B.Y. Chan 1 , S.K. Ha 1 , C.H. Ho 3 , F.A. Lee 3 1 The University of Hong Kong, Department of Clinical Oncology, Hong Kong, Hong Kong SAR China ; 2 HKU- Shenzhen Hospital, Department of Clinical Oncology, Shenzhen, China ; 3 Tuen Mun Hospital, Department of Clinical Oncology, Hong Kong, Hong Kong SAR China Purpose or Objective This study aims at evaluating the symptom response, response duration, and toxicity of palliative liver radiotherapy (RT) in advanced HCC patients in endemic area. Material and Methods We reviewed the clinical records of unresectable HCC patients treated with palliative RT (8Gy single fraction) in our institution. Eligible patients were unsuitable or refractory to TACE and SBRT, with an index symptom of pain or abdominal discomfort. Physician reported symptoms [complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD)] were documented monthly at the first 3 months and every 3 months thereafter till death. The primary outcome was the percentage of patients with clinical improvement of index symptom (CR+PR) at 1 month. Secondary outcomes were symptom response duration, toxicities, alpha-feto protein (AFP) response (>20% drop from baseline), and radiological response. Results Fifty-two patients were included in the study. Thirty-eight (73%) were hepatitis B carriers; median size of the largest tumor was 13cm (range 3-24cm); 33 (63.5%) had tumor involvement >50% of total liver volume. Fifty-one (98.1%) were Barcelona Clinic Liver Cancer (BCLC) stage C and twenty-three of them (45.1%) received Sorafenib after radiotherapy. The index symptom was pain in 34 patients, and abdominal discomfort in 18 patients. At 1 month, 57.8% of patients had improvement of symptoms (pain:

Table 2. Symptom response (CR, PR, SD & PD), response duration, and overall survival of patients

Conclusion Substantial patients had improvement of index symptoms after receiving palliative liver RT with median response duration of around 3 months. The treatment is well tolerated with minimal toxicities.