ESTRO 37 Abstract book

ESTRO 37

S402

CR/PR patients was comparable to that of the patients that underwent neoadjuvant chemotherapy plus surgery during the same period in this institution. Radiation pneumonitis of grade 2 or higher occurred in 8 and 6 patients with/without induction chemotherapy, respectively (ns). Predictors of radiation pneumonitis were lung V20 p=0.0055) and age (p=0.0368). Conclusion For the patients with locally advanced esophageal squamous cell carcinoma, induction chemotherapy of TPF followed by CCRT is a feasible and promising treatment, especially in responders to induction chemotherapy.

esophagus in 20pts (71.4%) and the gastroesofageal junction in 6 pts (21.4%). All pts underwent concurrent chemoradiotherapy (CRT), with IMRT technique, consisting of 45 Gy/25 frs to PTV1 (the primary gross tumor volume and the regional nodes), a simultaneous integrated boost ranging from 52.5Gy to 54Gy to PTV2 (gross tumor volume) and weekly concurrent carboplatin (AUC2) and paclitaxel (50mg/m 2 ). Induction CT was administered to 6 pts. All pts completed the RT schedule. The median number of CT cycles was 3 (range 1-5) and 10 pts (36%) received 4 to 5 cycles of CT. Two adverse reactions to paclitaxel were reported. There were no major non-hematological adverse effects, the most common were nausea and vomiting (10%), and dyspagia (7%). Leukopenia was reported in 20 pts (71%), G3 in 2 pts (10%) and G2 in 18 (90%), respectively. G2 anemia occurred in 2 pts while G2 thrombocytopenia was reported in 3 pts (10%). Among the 21 evaluable pts (restaging is ongoing in 7 pts) a clinical complete response (PET, endoscopy and negative biopsy) was observed in 10 pts (47.6%), 6 with adenocarcinom and 4 with squamous cell carcinoma. Partial response was observed in 8 pts (38%) and 4 (19%) showed progressive disease (3 systemic and 1 local). Total esophagectomy with radical lymphadenectomy, performed in 10 pts so far, showed a pathologic complete response in 4 pts (40%). No postoperative complications were reported. Conclusion Preoperative intensified IMRT with concurrent Carbo/Tax CT in pts with LAEC appears safe and effective, with an acceptable toxicity. These promising results need to be confirmed in all pts evaluated in this multimodality program. PO-0778 A study of treatment mode for T4 locally advanced gastric cancer R. Hu 1 , W. Yang 1 , Y. Wang 1 , M. Zhou 1 , G. Li 1 , Z. Zhang 1 1 Fudan University Cancer Hospital, radiation therapy, Shanghai, China Purpose or Objective Surgery is very important for the treatment of gastric cancer. However, many patients are diagnosed with locally advanced stage initially. Some of these patients do not have the possibility to receive radical surgery. Can these patients have the possibility to receive radical surgery after they undergo chemoradiotherapy (CRT) ? Can they have longer survival time? What about the prognosis comparing these patients with who have R0 surgery andadjuvant CRT? Material and Methods Retrospective analysis is performed in this study. Patients in Fudan University Shanghai Cancer Center (FUSCC) from 2005 to 2016 are enrolled. The original diagnosis is T4NxM0. For the patients who were assessed by gastric surgeons of FUSCC that they couldn ’ t receive R0 surgery, they would receive CRT firstly. Then whether they would have surgery depends on tumor regression. Futhermore, we will compare the prognosis of preoperative CRT and adjuvant CRT. Results Eventually 59 patients complete preoperative CRT. Respectively 33 patients receive surgery after CRT and 26 patients do not .Among 59 patients, 32(54.2%) patients have R0 surgery, 6(10.1%) patients have pathologic complete response (pCR), 29(49.2%) patients have descending T stage. The surgery group have better overall survival (OS) than no-surgery group (3-year OS 68.1% vs 16.7%, p<0.05). Comparing the 59 patients with 260 patients who receive R0 D1+ resection and adjuvant CRT, the difference of OS isn’t statistical significant (5- year OS 40.4% vs 44.1%, p>0.05). The adjuvant CRT group has worse OS and PFS (progress free survival) than the

PO-0777 Intensified concurrent chemotherapy for locally advanced esophageal carcinoma. R. Innocente 1 , F. Navarria 1 , E. Palazzari 1 , F. Matrone 1 , G. Boz 1 , M. Gigante 1 , E. Farina 1 , L. Foltran 2 , C. Castoro 3 , P. Ubiali 4 , R. Petri 5 , A. Ruol 6 , G. Franchin 1 , A. De Paoli 1 1 Centro di Riferimento Oncologico IRRCS Aviano, Radiation Oncology, Aviano, Italy 2 S. Maria degli Angeli Hospital, Medical Oncology, Pordenone, Italy 3 Istituto Clinico Humanitas IRCCS, General Surgery, Rozzano MI, Italy 4 S. Maria degli Angeli Hospital, General Surgery, Pordenone, Italy 5 University Hospital Santa Maria della Misericordia of Udine, General Surgery, Udine, Italy 6 University Hospital of Padova, 3rd Surgical Clinic, Padova, Italy Purpose or Objective Evaluate safety, feasibility and efficacy of an intesified preoperative IMRT and concurrent carboplatin and paclitaxel-based chemotherapy (Carbo/Tax CT) in patients (pts) with locally advanced esophageal cancer (LAEC) treated at our Institution. Material and Methods We retrospectively analyzed acute toxicity (according to CTCAE 4.0 scale), compliance and response to treatment in a series of consecutive patients, treated between February 2016 and September 2017, with preoperative intensified radiotherapy (RT) and weekly concurrent carboplatin and paclitaxel-based chemotherapy (CT) according to the CROSS trial. Results Twenty- eight consecutive pts, 25 (89%) males and 3 (11%) females, were evaluable. The median age was 67 yrs (range 52-83) and the ECOG Performance status ranged from 0 to 2. The diagnosis was adenocarcinoma in 15 pts (53%), squamous-cell carcinoma in 12 pts (43%) and undifferentiated carcinoma in 1 pt (3%). Three pts (11%) had a T2 disease, 21 pts (75%) a T3 and 4 pts (14%) a T4 disease, respectively; 4 pts (14%) were N0, 16 pts (57% ) N1 and 8 pts (28%) N2, respectively . Tumor involved the cervical esophagus in 2 pts (7%), the thoracic IMRT with