ESTRO 37 Abstract book

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ESTRO 37

(clinical stage T1N1M0 or T2–3N0–1M0, were enrolled in this study. The radiation dose was 50,4Gy/28 fractions with weekly administration of six cycles (intravenous carboplatin AUC 2mg/mL and intravenous paclitaxel 50mg/m 2 ) followed by surgery. Toxicity was prospectively evaluated according to CTCAE criteria and tumour regression grade using Ryan scoring system on surgical specimens (TRG). Results From November 2015 to September 2017, 15 patients were treated by the reported schedule. Median age was 71 years (range 56-84). Stage of cancer were: 33% stage IIB, 33% stage IIIA and 33% stage IIIB. All patients were able to complete the entire neoadjuvant chemoradiotherapy regimen and nine patients has been operated. Preliminary treatment results indicated a tumour downstaging of 78%, including 44% of patients with ypT0(documented T0 at surgery) and 44% with a satisfactory tumour regression grade defined as TRG1. 4 patients (26%) had grade III non-haematological toxicity and 4 patients 26% grade III haematological toxicity. Conclusion Dose-escalated radiation therapy with the CROSS trial scheme followed by surgical resection could be an option to increase complete pathologic responses. EP-1444 Palliative whole-liver radiotherapy for massive liver metastases: a single-institution experience S. Kakinouchi 1 , T. Ohguri 1 , K. Tomura 1 , K. Yahara 1 , S. Nakahara 1 , Y. Korogi 1 1 University of Occupational and Environmental Health, Department of Radiology, Kitakyushu, Japan Purpose or Objective In the subset of patients with end-stage disease, massive liver metastases in which the liver is replaced by metastatic tumors can eventually lead to hepatic failure and death. In such patients, further chemotherapy cannot be administered due to severe hepatic dysfunction or the presence of chemoresistant tumors. Recently, a few clinical reports on palliative whole-liver radiotherapy have demonstrated good palliative effects. However, tolerability and efficacy are not well known. We have also encountered several patients treated with palliative whole-liver radiotherapy. The purpose of this study was to evaluate the efficacy and toxicity of palliative whole-liver radiotherapy in patients with massive liver metastases at our institution. Material and Methods Between April 2015 and December 2016, the data of 12 consecutive patients with massive liver metastases who were treated with palliative whole-liver radiotherapy were retrospectively analyzed. The massive liver metastases were defined as the replacement of over three-quarters of the liver by metastatic tumors. The primary tumors were non-small cell lung cancer (n=3) and others (n=9). All patients underwent external beam irradiation with a linear accelerator using computed tomography-assisted 3-D treatment planning. In all patients, the planned radiation schedule was 21 Gy in seven fractions, which were administered five times per week at a daily dose of 3 Gy. Symptomatic relief, change in liver function, objective tumor response, survival time, and toxicity of radiotherapy were evaluated. Results Two patients could not complete the planned dose due to worsening of the patient’s general condition/ comorbidities, and whole-liver radiotherapy was

terminated at 6 Gy and 9 Gy. Because the worsening of the general condition/comorbidities in the 2 patients was rapidly progressed before the start of the whole-liver radiotherapy, the termination was assumed to have little relation to the radiotherapy. Digestive symptoms, such as a feeling of abdominal bloating, were improved in 6 (55%) of 11 patients. Elevated levels of alkaline phosphatase, aspartate transaminase, and alanine transaminase improved in 9 (100%) of 9 patients, 7 (100%) of 7 patients, and 8 (100%) of 8 patients, respectively, and the median reduction rates of these values were 41%, 53%, and 81%, respectively. Regarding the objective tumor response, a partial response was seen in 3 (50%) of 6 evaluated patients, stable disease in 2 patients, and progressive disease in one patient. The median survival time was 48 days. Only mild toxicity was detected, and toxicities of grades 2–5 were not observed. Conclusion Palliative whole-liver radiotherapy for massive liver metastases is non-toxic and promising for relieving symptoms and improving hepatic dysfunction due to tumor lesions. Further prospective evaluations with detailed protocols are necessary to clarify whether whole-liver radiotherapy could improve the quality of life in end-stage patients with massive liver metastases. EP-1445 Clinical outcome of elderly patients (≥70 years) with esophageal cancer undergoing CRT F. Walter 1 , D. Boeckle 1 , N. Schmidt-Hegemann 1 , R. Koepple 1 , C. Belka 1 , F. Roeder 1 1 Klinik und poliklinik für Strahlentherapie und Radioonkologie, Strahlentherapie, München, Germany Purpose or Objective To analyse the outcome of elderly patients with esophageal cancer treated with curative intent 55 patients (m:f 45:10) with a median age of 75 years (70-85) who received curative intent radio(chemo)- therapy for esophageal cancer between 1999 and 2015 were retrospectively analyzed. Charlson comorbidity score was ≤1 in 40 patients (73%) and >1 in 15 patients (15%). Tumors were located mainly below the bifurcation (69%). Most patients showed locally advanced disease (T3/4: 78%, N+: 58%, M1(supra): 7%). Histologies were SCC in 41 pts (74%) and adenocarcinoma in 14 pts. 48 patients received definitive treatment (median dose 59.4 Gy, range 10.8-66.6 Gy), while 7 patients were treated neoadjuvantly (median dose 45 Gy, range 41.4-50.4 Gy). PET-CT was used for treatment planning in 65%. Usually EBRT was carried out in 3D conformal technique including elective nodal irradiation with a sequential Boost to the primary and involved nodes. Simultaneous chemotherapy was applied in 47 pts (85%), mainly Cisplatin/5-Fu or MMC/5-FU. Results Median follow-up was 11 months (1-68) and 21 months in survivors. RT was completed without interruptions >4 days in 85% of the patients. CHT could be completed to >80% in 77%. Maximum acute toxicity (up to 90 days from start of RT or until surgery) was grade 3 in 24 pts (43%), grade 4 in 6 pts (11%) and grade 5 in 7 pts (13%). Grade 3 toxicity was mainly represented by dysphagia and grade 4 mainly by leukopenia. Grade 5 toxicities were pneumonia (3), sepsis (3) and hemorrhage (1), of whom 3 occurred during hospital admission for R(CH)T and 4 after R(CH)T was finished and patients had been discharged. Locoregional recurrences were observed in 19 patients radio(chemo)therapy. Material and Methods