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Poster: Clinical track: CNS PO-0862: Clinical outcome of anaplastic oligodendroglioma treated with adjuvant radiotherapy and temozolomide M. Rastogi, A.K. Gandhi, R. Khurana, R. Hadi, S. Sapru, S.P. Mishra, A.K. Srivastava, A. Bharati, S. Rath, S.S. Nanda, H.B. Singh, S. Kumar, N.P. Singh, N. Husain, M. Husain, D.K. Singh. [Extracted from the article]

Definitive treatment for oral cavity squamous cell carcinoma (OCSCC) is surgery followed by post-operative radiotherapy (PORT) with or without chemotherapy. Risk factors for PORT are T3/T4, node positive, lympho-vascular space invasion (LVI) or perineural invasion (PNI), close margin etc. Depth of invasion (DOI), tumor budding (TB) and worst pattern of invasion (WPOI) and tumor infiltrating lymphocytes (TILS) may have prognostic implications. We aim to report the incidence of these factors and its association with clinical outcome post-operative OCSCC patients treated at our institute. 150 post-operative patients of OCSCC undergoing curative oncological resection were analyzed with median follow up time 18 months from year 2019 to 2021. WPOI (WPOI-5) was defined as tumor dispersion of ≥1mm between tumor satellites. High risk WPOI was defined as (WPOI 4/5). Tumor budding is defined as the presence of single cancer cell or cluster of <5 cancer cells at the invasive front. DOI and staging were used as per AJCC 8th edition. Disease free survival (DFS) and overall survival (OS) were estimated with Kaplan- Meier method. Median age was 50 years with M:F ratio of 135:15. Tumor site was buccal mucosa: tongue:alveolus:others as 84 (56%):49 (32%):13 (8.6%):4 (2.6%). LVI:PNI: close/positive margin: extra nodal extension was seen in 57 (38%):52 (34%):35 (23%):33 (22%) patients respectively. DOI =>10, DOI<10, high risk WPOI, tumor budding and TILS were observed in 79(52.6%), 71(47.3%), 102(72.8%), 97(71.3%) and 30(21.5%) patients respectively. Association of these have been listed in Table 1. AJCC eighth stage was I:II:III:IV as 30 (20%):32 (21.3%):38 (25.3%):50 (33.3%). Median RT Dose was 60 Gray. Sixty-four patients received CTRT (Median 5 cycles). Median Overall Treatment Time (OTT) was 98 (95-120) days. 2-year OS and DFS for the entire cohort was 81% and 67% respectively. 2-year DFS for patient with TILS was 86% vs.64% without TILS (p=0.07). PNI (60% vs. 72%; p=0.06) and bone invasion (47% vs 84%; p=0.04) portended poorer DFS. TB, WPOI and DOI did not statistically impact DFS in our cohort. TB, WPOI and DOI are often associated in post-operative OCSCC with other adverse risk features. Patients with TILS tend to have a better clinical outcome [ABSTRACT FROM AUTHOR]

The paradigm of management of locally advanced rectal (T3/4; T1-4N1-2) cancers (LARC) have been shifting to induction chemotherapy (NACT) with long course neoadjuvant chemo-radiotherapy (NACRT) followed by total mesorectal excision (TME) inching towards total neoadjuvant therapy approach. We aimed to evaluate the outcomes of NACRT alone (Arm A) versus NACT followed by NACRT (Arm B) in LARC treated at our center. Data of 101 patients of LARC (March 2013 – Jan 2021) were retrieved for this retrospective analysis. NACT in Arm B consisted of 2 cycles of CAPOX [oxaliplatin (130 mg/m2 day 1) and capecitabine (1000 mg/m2 twice daily for 14 days) repeated every 3 weeks]. Radiotherapy (RT) in both the arms was 50.4 Gray in 28 fractions with capecitabine 825 mg/m2 twice daily on days of RT. All patients underwent TME. Adjuvant chemotherapy (ACT) consisted of CAPOX regimen. Pathological complete response (pCR) and overall complete response OCR (pCR plus near complete response) were defined as per modified Ryan grading system. Disease-free survival (DFS) and overall survival (OS) were assessed with Kaplan Meier method. Patient characteristics are summarized in Table 1. Median number of NACT cycles in Arm B was two (range 2-4). Median radiotherapy dose was 50.4 Gray. pCR rates were 12.7% in arm B and 7.3% (3/41) in arm A (p=0.516). OCR rates were 28.3% (17/60) in Arm B vs 12.1% (5/41) in Arm A (p=0.044). 2-Year DFS and OS in Arm A versus B were 47.5% vs. 73.9% (p=0.781) and 54.3% vs 67.3% (p= 0.371) respectively. Patients with pCR vs no pCR had better 2-year DFS and OS 88.9% vs 50.1% (p = 0.009) and 83.3% vs 55.4% (p = 0.015) respectively. Patients with OCR vs no OCR had better 2-year DFS and OS 88.5% vs 45.2% (p = 0.009) and 94.4% vs 51% (p = 0.015) respectively. Patients with positive circumferential margin (CRM) and regional node at presentation had poorer DFS 18.6% vs 83.6% (p=0.03) and 42.7% vs 54.9% (p=0.004) respectively. NACT prior to NACTRT leads to higher OCR rates in LARC. pCR and OCR predicted better DFS and OS and positive CRM and node positivity at presentation portended poorer outcome in our cohort of patients. [ABSTRACT FROM AUTHOR]