ESTRO 37 Abstract book

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ESTRO 37

pneumonitis the most common type (17 patients [85%]). Chronic toxicity G3 was observed in 4% of patients. A large variability of pretreatment PFTs was observed: median FEV1, FVC and DLCO c was 1.63L (range 0.48- 3.42), 2.55L (range 0.93-5.52) and 63.71% (range 19.4- 135.5%) respectively. No significant decline in FEV1 or FVC was observed during follow-up. DLCO c worsened significantly from baseline to 1.5-months after SBRT (67.72% vs 62.71%; p=.016) and from baseline to 12- months after SBRT (69.96% vs 62.41%; p=.048) but with no significant changes at 24 and 36-months after SBRT. Conclusion Despite the significant decrease in DLCO c at 1.5-months and 12-months after-SBRT and the downward trend at 24 and 36 months, there was no significant long-term lung toxicity in a population with important basal COPD disease. According to previous reports, lower PFTs were no related to a high rate of respiratory events. SBRT is a well-tolerated and safe treatment even among a population with poor baseline lung function for inoperable patients with comorbid early NSCLC. EP-1410 Comparison of neoadjuvant chemoradiation with carboplatin/paclitaxel or CDDP/5-FU for esophageal SCC S. Münch 1 , S. Pigorsch 1 , M. Feith 2 , J. Slotta-Huspenina 3 , W. Weichert 3 , H. Friess 2 , S. Combs 1 , D. Habermehl 1 1 Klinikum rechts der Isar- Technical University of Munich, Radiation Oncology, Munich, Germany 2 Klinikum rechts der Isar- Technical University of Munich, Surgery, Munich, Germany 3 Klinikum rechts der Isar- Technical University of Munich, Pathology, Munich, Germany Purpose or Objective Neoadjuvant chemoradiation (nCRT) is the treatment of choice for patients with locally advanced squamous cell carcinoma of the esophagus (SCC). Today radiation oncologists can chose between to different therapy regimes including chemoradiation with cisplatin and 5- fluoruracil (CDDP/5FU) and chemoradiation analogue to the CROSS-regime with carboplatin and paclitaxel (Carb/TAX). However, there is a lack of studies comparing these regimes, especially for the subgroup of patients with SCC. In this study, we want to compare nCRT with CDDP/5FU and nCRT with Carb/TAX for patients with locally advanced SCC. Material and Methods We retrospectively compared 20 patients who were scheduled for nCRT with a total dose of 41.4 Gy (daily dose of 1.8 Gy) and weekly chemotherapy with carboplatin (Area under the curve 2) and Paclitaxel (50mg per square meter of body-surface area) according to the CROSS-regime to 31 patients who were scheduled for nCRT with a total radiation dose of 45 Gy (daily dose of 1.8 Gy) and a simultaneous chemotherapy with cisplatin (20mg/m²/d) and 5-fluoruracil (500mg/m²/d) on day 1-5 and 29-33. For the per-protocol analysis, per protocol treatment was defined as either complete radiation with 41.4 Gy and at least three cycles of Carb/TAX and subsequent surgery or complete radiation with 45 Gy and at least one complete cycle of CDDP/5FU with subsequent surgery. Results 51 patients (31 patients treated with CDDP/5FU and 20 patients treated with Carb/TAX) were evaluated for the ITT analysis and 44 patients (26 patients treated with CDDP/5FU and 18 patients treated with Carb/TAX) were evaluated for the PP analysis. No significant differences Electronic Poster: Clinical track: Upper GI (oesophagus, stomach, pancreas, liver)

were seen for baseline and tumor characteristics like age, sex, TNM-stage, grading and tumor extension between patients treated with Carb/TAX and patients treated with CDDP/5FU. The most common tumor regression grade after neoadjuvant treatment was grade I as classified by Becker et al., which was observed in 84% and 79% of patients. No significant differences in tumor regression grades were seen between regimens. Postoperative insufficiency of the anastomosis was seen in 6 patients (33%) who were treated with Carb/TAX and 4 patients (15%) who were treated with CDDP/5FU (p=0.273). Patients treated with CDDP/5FU developed significant more cumulative hematologic III° (CTCAE) toxicities (58% vs 20%; p=0.010) than patients treated with Carb/TAX. In contrast to that, there was no significant difference for OS and DFS between treatment groups. Conclusion While there was no difference for OS and DFS, nCRT with CDDP/5FU is associated with, significant more hematologic III°- toxicities compared nCRT with Carb/TAX. Therefore, nCRT with Carb/TAX should be the current treatment of choice for patients with locally advanced SCC. EP-1411 Comparison between radiochemotherapy, and other modalities in locally advanced esophageal cancer D. Scepanovic 1 , I. Zavacka 1 , A. Masarykova 1 , A. Hanicova 1 , M. Dzongov 1 , M. Pobijakova 1 , Z. Dolinska 1 1 National Cancer Institute, Radiation Oncology, Bratislava, Slovakia Purpose or Objective Background . - Treatment of locally advanced esophageal carcinoma has been changed for the last 15 years. The low cure rates after external beam radiotherapy (EBRT) alone prompted the inclusion of systemic chemotherapy (CT) in multimodality treatment regimens, to control distant micrometastatic disease and enhance local radiation effects. However, it is still a highly lethal malignancy. The aim of our work was to show whether the addition of surgery or intraluminal brachytherapy (ILBT) after radiochemotherapy could improve the overall survival of these patients. Material and Methods Between 2008 and 2015, 70 patients (pts) with locally advanced esophageal cancer received radiation therapy (RT) with/without CT. Thirty one pts had EBRT with/without CT. Nineteen pts had surgery six weeks after completion of RT/CT and 20 pts combined EBRT/CT followed by intraluminal brachytherapy (ILBT). In the neoadjuvant approach total doses that range between 30 and 50Gy with concomitant CT of cisplatin and fluorouracil have been applied. On the average a week after the EBRT a median total dose of 10Gy ILBT was given in 2 fractions. Results During the median follow up of 16 months (range, 4-108) for all pts, 5 pts were alive in group of EBRT with/without CT and 6 pts with neoadjuvant settings. The overall cumulative survival rate was 17% at 3 years for whole group of pts. The 3-year overall survival (OS) rate for EBRT with/without CT group and neoadjuvant group was 16% and 15%, respectively (chi-square statistic=0.0072, p-value=.932256, the result is not significant at p < .05). However, pts who were alive, showed a long-term survival of longer than 3 years in a neoadjuvant group of pts. Conclusion Our analysis suggested, although there was no statistically significant difference between the two groups of our patients in terms OS, patients who had surgery or ILBT after EBRT with / without CT lived longer.