World Congress of Brachytherapy 10-12 May, 2012 - Estro-events.org

S116 World Congress of Brachytherapy 2012
(8.1%, p=0.02) and R13 was the largest (25.0%, p0.05). They were statistically better than all the
other plans (p10 on their pre treatment PET scan. 60% of
distant metastases occurred in patients with a nodal SUV >4 on pre
treatment PET scan. In patients with 3 month post treatment PET scan
(54%), 75% of patients with a SUV >4 suffered a local recurrence. 30
month estimates for local control, disease free survival, metastasis
free survival, and overall survival using KM curves are 80%, 30%, 42%
and 65% respectively.
: MRI based interstitial brachytherapy for locally advanced
cancers of the cervix and vagina results in a high rate of local control.
Additionally, a HRCTV D90 > 95%, an initial staging PETCT SUV max
>10 and a 3 month posttreatment SUV of >4 correlate well with local
control. A pretreatment PETCT nodal SUV >4 may be a better
predictor for distant metastasis than an SUV >10 of the primary.
Though longer followup is required, MRI based planning appears to
provide initial excellent local control and distant metastasis free
survival.
PO293
OUTCOMES FOR RECURRENT ENDOMETRIAL CANCER WITH HDR
INTERSTITIAL BRACHYTHERAPY UTILIZING MRI BASED PLANNING
M.C. Biagioli 1 , J.M. Freilich 1 , A. Cruz 1 , A.S. Saini 1 , D.C. Hunt 1 , J. Shi 1 ,
D.C. Fernandez 1
1
H. Lee Moffitt Cancer Center, Radiation Oncology, Tampa Florida,
USA
: Recent data has emerged demonstrating
significant advantages to MRI based planning over CT based planning
in the brachytherapy treatment of cancer of the cervix. The purpose
of this study is to evaluate our experience utilizing MRI based
brachytherapy treatment planning for patients with recurrent
endometrial cancers who underwent an interstitial implant as part of
there treatment.
: A retrospective review was conducted of all
endometrial cancer recurrences treated at Moffitt Cancer Center from
20092011 where 1.5 T contrast enhanced MRI based high dose rate
(HDR) interstitial brachytherapy was part of their treatment plan. 12
patients were identified and local recurrence, disease free survival,
metastasis free survival, and overall survival were analyzed in the
whole group and based on prognostic features and treatment plans.
: Mean followup was 10 months (range 216). 92% of patients
had recurrent disease, 17% received chemotherapy and 83% received
external beam radiation therapy with a median dose (range) of 4920
cGy (43205500). Median (range) brachytherapy total dose and dose
per fraction was 2500 cGy (22003500) and 500 cGy (450600),
respectively. Local recurrence rate was 16.7% with estimated mean
time to local recurrence of 13 months. In patients with the CTV D90
greater than 95%, local recurrence was 10% versus 50% if less than or
equal to 95%. Disease free survival was 67% with estimated mean time
to event of 9 months. Metastasis free survival was 80% in patients
without metastatic disease on presentation with estimated mean time
to metastasis of 7 months. Overall survival was 67% with estimated
mean time to death of 9 months. 15 month estimates for local
control, disease free survival, metastasis free survival, and overall
survival using KM curves are 70%, 62%, 62% and 62%, respectively.
: MRI guided interstitial brachytherapy results in a high
level of local control in patients with pelvic recurrences after primary
treatment for endometrial cancer. Though initial followup is short
this local control appears to result in a high level of DFS. Of the 2
local failures there was no pretreatment PET information available.
Additionally, patient number was too small to determine the utility of
3 month posttreatment PET as a predictor for local or distant
failures.
PO294
BRACHYTHERAPY
TURKEY
EXPERIENCE IN GYNAECOLOGICAL TUMORS IN
I. Aslay 1 , B.W.G. Brachytherapy Working Group 2
1
Istanbul University Oncology Institute, Radiation Oncology, Istanbul,
Turkey
2
Oncology Institutes, Radiation Oncology, Istanbul, Turkey
: This study is conducted to evaluate the
brachytherapy experience in gynaecological tumors in Turkey.
: Gynaecological brachytherapy data of 11
medical faculty, one government hospital and two private hospitals
between 19702011 was collected. Ovarian cancer was not included.
Median brachytherapy (BrT) experience of the centers was 12 (141)
years. The total number of the patients (pts) was 297124 and 7% of
them was gynaecological tumor (except ovary). The ratio of the
tumors was %49 in cervix carcinoma (CC), %46 in endometrium
carcinoma (EC), %1 in vagina carcinoma (VaC), %3 in vulvar carcinoma
(VuC).
: For curative treatment of CC concomitant chemotherapy
(CCh) 40mg/m2 weekly was standard procedure in all centers. In
postoperative CC , Cch was given if poor prognostic factors present
such as positive margin, positive lymph node, bulky tumor, positive
parametrium. Adjuvant Ch to radiotherapy was not given in any
center. The incidence of the pts treated with curative intent in EC
and VuC was low. Ch was given in EC pts if advanced stage or poor
hystology was present. In VuC, Ch was given due to comorbidities of
the pts and also BrT was not applicated as a treatment component
except in salvage therapy. VaC was treated mostly with the same
protocol of CC. Salvage treatment was done with external
radiotherapy (ERT) and/or BrT in two centers, with only ERT in 3
centers and with cyberknife in one center. Eight centers have no
salvage treatment experience. ERT technigues were 3D and IMRT in
three centers, 3D in 7 centers, 2D and 3D in 4 centers. Except two
centers with two and one center with 5 BrT machines all the others
have one HDR treatment unit. BrT technigue was 3D in 6 , 2D in 8
centers. Two centers also have LDR experience. ERT, BrT and total
treatment doses are listed in table 1.