ESTRO 37 Abstract book

ESTRO 37

S405

(p=0.005). The R0 resection rate was 91 % for NTS pts and 76 % for US pts (p=0.236). With a median follow-up of 25 months, 50 % of NTS pts and 62 % of US pts relapsed (p=0.65), with mainly metastatic recurrence. No local relapse was seen in NTS pts versus 4.7 % for US pts (p=0.39). Median overall survival for the entire population was 46.1 months. There was no significant difference in estimated OS (49.7 versus 36 months (p=0.372)) between NTS and US pts, however there was a trend towards significance in DFS in favor of NTS pts : 34.6 vs 15.6 months (p=0.054).

on the hazard ratio (HR) of OS. The area under curve (AUC) for NLR, dNLR, PLR and LMR were 0.569, 0.492, 0.502 and 0.449. The high NLR group was significantly associated with more lymph node metastasis and poor prognosis. NLR remained an independent prognostic factor for OS (HR = 1.828, 95% CI: 1.091-3.063; p = 0.022) in the multivariate analysis. Conclusion NLR had a linear effect on the HR of OS and is more predictive of OS than other three markers. NLR measurement can provide important prognostic value in patients with LAGC underwent postoperative CRT after curative resection. PO-0784 Contemporary esophageal cancer management by chemo radiation: survey of French radiation oncologists E. Blais 1 , A. Huertas 2 , M. Ozsahin 3 , G. Créhange 4 , F. Huguet 5 , J. Bourhis 3 , P. Maingon 1 , M. Antoine 6 , I. Troussier 1 1 Salpétrière hospital, Radiation oncology, Paris, France 2 Georges Pompidou Hospital, Radiation oncology, Paris, France 3 CHUV, Radiation oncology, Lausanne, Switzerland 4 Georges-Francois Leclerc Center, Radiation oncology, Dijon, France 5 Tenon hospital, Radiation oncology, Paris, France 6 Bergonie Institute, Radiation oncology, Bordeaux, France Purpose or Objective We hypothesized that the unsolved issues concerning the radiotherapy for locally advanced esophageal cancer may be responsible of treatments’ heterogeneities between different centers. The aim of this study was to assess the current state-of-art of radiotherapy for esophageal cancer in France. Material and Methods Seventy-nine French Gastro-intestinal radiation oncologists were invited to answer a survey to evaluate the current management of esophageal cancer by chemo radiation (CRT) in September 2016. Four parameters were evaluated: (1) The preoperative CRT dose prescription; (2) The exclusive CRT dose prescription; (3) The nodal volume delineation: elective-field irradiation (ENI) or involved-field irradiation (IFI); (4) The radiotherapy modality: conformational radiotherapy (3D) or intensity- modulated radiotherapy (IMRT). Results The response rate was 77% as 61 centers participated in our survey. The prescribed dose for pre operative CRT was 40 to 50.4 Gy with a median dose of 45 Gy. Only 25% of radiation oncologists proposed the CROSS protocol treatment scheme (41.4 Gy with weekly concomitant chemotherapy of carboplatin-paclitaxel). The prescribed dose for exclusive CRT was 50 to 68 Gy with a median dose of 55 Gy. Most of centers (66%) proposed to treat with a dose above 50.4 Gy for exclusive CRT. ENI was systematically suggested by 38 centers (62%) whereas 15 centers (25%) proposed IFI. Eight centers (13%) offered either ENI either IFI depending of the disease and patient characteristics. A 3D technique was used in 24 centers (39%) whereas 34 centers (56%) preferred IMRT. Three centers (5%) offered either 3D either IMRT. When proposing a dose above 50.4 Gy for exclusive CRT, most of centers (65%) were using IMRT. Conclusion We observed an important heterogeneity for the management of esophageal cancer by chemo radiation in France. Our study highlights the impact of debated topics on the clinical practice. The results of future phase 3 trials should permit to answer to these remaining issues in order to homogenize the treatment of locally advanced esophageal cancer by chemo radiation.

Conclusion Despite higher rate of mesenteric arterial abutment, neoadjuvant treatment consisting in FOLFIRINOX based CT followed by chemoradiotherapy achieved a similar R0 resection rate than for patients with BR pancreatic cancers treated by upfront surgery. Moreover there was a trend towards a significant better disease-free survival in favor of neoadjuvant treatment. PO-0783 Inflammatory markers in patients receiving R0 resection and chemoradiation for gastric cancer M.L. Zhou 1,2 , W.J. Deng 1,2 , R. Hu 1,2 , W. Yang 1,2 , Y. Wang 1,2 , G.C. Li 1,2 , Z. Zhang 1,2 1 Fudan University Shanghai Cancer Center, Department of Radiation Oncology, Shanghai, China 2 Shanghai Medical College- Fudan University, Department of Oncology, Shanghai, China Purpose or Objective Previous studies have suggested that levels of systemic inflammatory markers are associated with survival in patients with gastric cancer. However, little evidence has defined the role of these markers in patients receiving curative resection and postoperative chemoradiation (CRT) for locally advanced GC (LAGC).The present study sought to evaluate preoperative blood neutrophil-to- lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), derived neutrophil-to-lymphocyte ratio (dNLR) and lymphocyte-to-monocyte ratio (LMR) as prognostic factors in patients receiving CRT after an R0 resection for LAGC. Material and Methods NLR, PLR, dNLR and LMR were explored using restricted cubic splines, piecewise linear model, and categorization. The optimal cut-off levels for the four markers were defined by receiver operating characteristic curve analysis for survival. Patients were dichotomized into the high or low group based on the cut-off value, and the clinical features of these two groups were comparatively analyzed. Univariate and multivariate analyses were performed to examine the impact of these markers on overall survival (OS). Backward stepwise selection using the AIC was applied in Cox proportional hazards regression model. Results From 2005 to 2016, 206 eligible GC patients treated at the Fudan University Shanghai Cancer Center (FUSCC) were included in this study. Only NLR had a linear effect