Hyperthermia with short-course-Radiotherapy in TNT for LARC: Initial outcomes and toxicity
Barbara Gabriela Salas Salas,
Spain
PO-1404
Abstract
Hyperthermia with short-course-Radiotherapy in TNT for LARC: Initial outcomes and toxicity
Authors: Barbara Gabriela Salas Salas1, Laura Ferrera-Alayón2, Rodolfo Chicas-Sett3, Miguel Sanchez- Carrascal4, Celia Madan Rodriguez5, Andrea Kannemann2, Guillermo Potdevin-Stein2, Marta Lloret Sáez-Bravo2
1Hospital Universitario de Gran Canaria Dr. Negrín, Radiation oncology, Las Palmas de GC , Spain; 2Hospital Universitario de Gran Canaria Dr. Negrín, Radiation Oncology, Las Palmas de GC, Spain; 3ASCIRES, Radiation oncology, Las Palmas de G C, Spain; 4Hospital Universitario de Gran Canaria Dr. Negrín, Radiophysics , Las Palmas de GC, Spain; 5Hospital Universitario de Gran Canaria Dr. Negrín, Radiophysics, Las Palmas de GC, Spain
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Purpose or Objective
The new Standard of care in Locally advanced rectal cancer (LARC) included Total neoadjuvant treatment(TNT) intensive neochemotherapy with short course Radiotherapy (scRT) followed by surgery. This new approach achieves the doble (28%) of completed pathological response (pCR) than conventional RTQT schedules.
The aim of this study is to analyze if regional-hyperthermia (RHT) can improve pCR and complete resection rates(R0) without increased toxicity related to oncological treatment.
Material and Methods
We conducted a feasibility study including patients with LARC treated with TNT, scRT and RHT at HUGCDN in March 2020-February 2022. scRT schedule with a total dose of 25 Gy in 5 consecutive fractions (fx), was delivered by VMAT and IGRT with AL Truebeam VARIAN, combined with FOLFOX4 or CAPEOX chemotherapy (CT) 2-3 weeks later. RHT were administered by Deep Hyperthermia SYSTEM _ ALBA 4D, in session 1 and 5, 40 minutes after RT-fx, reaching tumor temperatures between 39-43ºC for 60minutes. Surgery was performed 4-6 weeks after CT. Analysis of the pCR rate was based on histopathological reports. Acute side effects were documented according to CTCAEv4.0.
Results
25 patients were included (5 patients are in course of CT, 1 waiting for surgery), with a mean age 60 (41-80years), Stage II 4% (1/25), Stage III 80% (20/25), and Stage IV 16% (4/25). Most of the patients 76%(19/25) received 2 scheduled RHT-sessions, 76%(19/25) had already undergone surgery. The pCR was 32% (6/19) and R0 rates was 79% (15/19). The prevalence of immediately acute toxicity after scRT(<1month) grade 0 56%(14/25), grade1 28%(7/25), grade2 8%(2/25), grade 3 were 8%(2/25) non≥4.
Conclusion
This initial result shows that the addition of RHT in scRT in TNT schemes in LARC may improve the pCR rates, without increase immediately scRT toxicity. Further studies are needed to confirmed this benefit.