Search

• Multicentric cohort of n = 605 patients treated with definitive chemoradiotherapy for anal cancer. • Overall, T-category, N-category, age and KPS were associated with worse DFS. • In early stage disease, T-category, HIV status, age, performance status and elevated platelets were associated with worse DFS. Prognosis after chemoradiotherapy (CRT) for anal squamous cell carcinoma (ASCC) shows marked differences among patients according to TNM subgroups, however individualized risk assessment tools to better stratify patients for treatment (de-) escalation or intensified follow-up are lacking in ASCC. Patients' data from eight sites of the German Cancer Consortium - Radiation Oncology Group (DKTK-ROG), comprising a total of 605 patients with ASCC, treated with standard definitive CRT with 5-FU/Mitomycin C or Capecitabine/Mitomycin C between 2004–2018, were used to evaluate prognostic factors based on Cox regression models for disease-free survival (DFS). Evaluated variables included age, gender, Karnofsky performance score (KPS), HIV-status, T-category, lymph node status and laboratory parameters. Multivariate cox models were separately constructed for the whole cohort and the subset of patients with early-stage (cT1-2 N0M0) tumors. After a median follow-up of 46 months, 3-year DFS for patients with early-stage ASCC was 84.9%, and 67.1% for patients with locally-advanced disease (HR 2.4, p < 0.001). T-category (HR vs. T1: T2 2.02; T3 2.11; T4 3.03), N-category (HR versus N0: 1.8 for N1-3), age (HR 1.02 per year), and KPS (HR 0.8 per step) were significant predictors for DFS in multivariate analysis in the entire cohort. The model performed with a C-index of 0.68. In cT1-2N0 patients, T-category (HR 2.14), HIV status (HR 2.57), age (1.026 per year), KPS (HR 0.7 per step) and elevated platelets (HR 1.3 per 100/nl) were associated with worse DFS (C-index of 0.7). Classical clinicopathologic parameters like T-category, N-category, age and KPS remain to be significant prognostic factors for DFS in patients treated with contemporary CRT for ASCC. HIV and platelets were significantly associated with worse DFS in patients with early stage ASCC. [ABSTRACT FROM AUTHOR]

Poster discussion: CL: Prostate 2 PD-0671: Matched pair analysis of salvage radiotherapy vs observation for post-prostatectomy PSA recurrence T. Wiegel, D. Tilki, F. Preisser, R. Pompe, F. Chun, M. Graefen, H. Huland, A. Siegmann, D. Böhmer, V. Budach, R. Thamm, D. Bartkowiak. [Extracted from the article]

Proffered Papers: Proffered papers 29: Head and neck OC-0570: Validating gene signatures in locally advanced HNSCC patients treated by PORT-C and in xenografts S. Patil, A. Linge, B. Tawk, K. Gurtner, M. Groà er, F. Lohaus, V. Gudziol, A. Nowak, I. Tinhofer, V. Budach, M. Stuschke, P. Balermpas, C. Rödel, H. Schäfer, A. Grosu, A. Abdollahi, J. Debus, C. Belka, S.E. Combs, D. Mönnich, D. Zips, G.B. Baretton, M. Krause, M. Baumann, S. Löck. [Extracted from the article]

Proffered Papers: Proffered papers 28: Gynaecology OC-0564: Randomized trial: Surgical versus clinical staging in cervical cancer patients: Uterus-11-Trial S. Marnitz, A. Tsunoda, P. Martus, R. Affonso, V. Budach, J. Sehouli, H. Hertel, A. Schneider, A. Mustea, C. Köhler. [Extracted from the article]

Abstract: Background: Continuous hyperfractionated accelerated radiotherapy (CHART) counteracts repopulation and may significantly improve outcome of patients with non-small-cell lung cancer (NSCLC). Nevertheless high local failure rates call for radiation dose escalation. We report here the final results of the multicentric CHARTWEL trial (CHART weekend less, ARO 97-1). Patients and methods: Four hundred and six patients with NSCLC were stratified according to stage, histology, neoadjuvant chemotherapy and centre and were randomized to receive 3D-planned radiotherapy to 60Gy/40 fractions/2.5weeks (CHARTWEL) or 66Gy/33 fractions/6.5weeks (conventional fractionation, CF). Results: Overall survival (OS, primary endpoint) at 2, 3 and 5yr was not significantly different after CHARTWEL (31%, 22% and 11%) versus CF (32%, 18% and 7%; HR 0.92, 95% CI 0.75–1.13, p =0.43). Also local tumour control rates and distant metastases did not significantly differ. Acute dysphagia and radiological pneumonitis were more pronounced after CHARTWEL, without differences in clinical signs of pneumopathy. Exploratory analysis revealed a significant trend for improved LC after CHARTWEL versus CF with increasing UICC, T or N stage (p =0.006–0.025) and after neoadjuvant chemotherapy (HR 0.48, 0.26–0.89, p =0.019). Conclusions: Overall, outcome after CHARTWEL or CF was not different. The lower total dose in the CHARTWEL arm was compensated by the shorter overall treatment time, confirming a time factor for NSCLC. The higher efficacy of CHARTWEL versus CF in advanced stages and after chemotherapy provides a basis for further trials on treatment intensification for locally advanced NSCLC. [Copyright &y& Elsevier]