- Email: [email protected]
Interest of radiochemotherapy in the rectal cancer
ABSTRACTS were PIRADS 5. In the extended Tofts model, the mean Ktrans value of PIRADS 3, 4 and 5 lesions were 0.35 min1, 0.55 min1and 0.57 min1, respectively (p value ¼ 0.041). However, in the Tofts & Kermode model, the mean Ktrans value of PIRADS 3, 4 and 5 are 1.0329, 1.0776 and 1.065 min1 (p value ¼ 0.380), respectively. In addition, kep of both models, PE% and SER% were not correlated with PIRADS score, when assessed using a quantitative method rather than shape of the curves. Conclusion: Ktrans using extended Tofts model, positively correlates with the PIRADS scores but other quantitative methods, assessing wash in and out did not correlate with the PIRADS scoring. Further analysis of histopathology and Gleason score is needed to confirm these findings. http://dx.doi.org/10.1016/j.ejso.2016.07.049
82. Rate of cachexia in lung cancer Adele Hug, Iain Phillips, Lindsey Allan, Veni Ezhil Royal Surrey County Hospital, UK Background: Lung cancer is the second most common cancer diagnosed in men and women in the UK with a very poor 5 year survival (10%). There is a lack of robust data on the stage of cachexia in which patients with lung cancer present. The severity of cachexia can influence overall outcome. Refractory (irreversible) cachexia indicates a poor prognosis of usually less than 3 months. Method: We reviewed all patients diagnosed with primary lung cancer that were reviewed by the Macmillan Oncology Dietitians over a 4 year period at the Royal Surrey County Hospital. Reasons for referral commonly included: weight loss, glycaemic control in diabetes, decreased oral intake and food texture modification. Patients were defined as cachectic if weight loss was >5%. Results: 458 patients were reviewed by the dietitian. 43% were female, 57% were male. Mean and median weight loss of total body weight at referrals was 9.5% and 13% respectively. Mean pre-cancer body mass index (BMI) was 26.9 (kg/m2), mean BMI at referral was 23.0 (kg/m2). 359 patients (78%) were treated with palliative intent. 99 were treated with radical/adjuvant intent. 341 (76%) of this cohort had >5% weight loss from their usual body weight prior to diagnosis. Conclusion: This data suggests cachexia is very common in lung cancer. It is known that early symptom control improves survival in lung cancer. It is not known whether early dietetic intervention may improve lung cancer outcomes. Further research is needed. These patients have a BMI within the healthy range of 20e25 kg/m2 before and after their cancer diagnosis in spite of significant weight loss. We are seeking ethical approval to prospectively assess the rate of cachexia in lung cancer and its correlation with other simple nutrition assessment tools. We aim to assess clinical outcomes categorised by % weight loss in advanced lung cancer. http://dx.doi.org/10.1016/j.ejso.2016.07.050
85. Building a weight of evidence to prevent cancer in later life Gillian Rosenberg, Lucie Hooper, Jyotsna Vorhra Policy Research Centre for Cancer Prevention, Cancer Research, UK Background: Obesity is the largest preventable risk factor for cancer after smoking. Being overweight as an adult is linked to 10 cancer types, and overweight children are more likely to become overweight adults. Recent data shows that around one in three children leave primary school overweight or obese, with the most deprived children twice as likely to be so. A comprehensive evidence-based childhood obesity strategy is vital in order to prevent obesity related cancers later in life. Method: A multidisciplinary research strategy was developed at Cancer Research UK to build a body of evidence that can directly influence government policy making in obesity. This included a quantitative study to investigate obesity and cancer awareness in the general population; a
S227 modelling study to predict future obesity related cancer cases; and qualitative studies to explore obesity-linked behaviours in children. Results: Cancer was not at the forefront of people’s minds when thinking about obesity, with only 26% showing an unprompted awareness of the link. However the projected impact of obesity on cancer is high: if current trends continue it will lead to a further 670,000 cases over the next 20 years. When looking specifically at childhood obesity, it was found that junk food marketing was associated with parental pester power and can override nutritional knowledge. Conclusion: These research studies formed an integral part of the current Cancer Research UK campaign on obesity. The first stage addressed the poor knowledge of obesity and cancer in the general population. The modelling results were a key part of this, alongside existing data on the mechanisms behind the causal relationship of obesity and cancer. Following this, during the development of the government’s childhood obesity strategy, the childhood obesity studies demonstrated to policy makers the importance of taking action to limit advertising exposure in children. http://dx.doi.org/10.1016/j.ejso.2016.07.051
92. Interest of radiochemotherapy in the rectal cancer Messaoud Ayad1, Naima Haoui2 1 EHS Centre Anti Cancer, UK 2 Centre Anti Cancer, UK Background: We propose the study of treating patients with locally advanced rectal cancer by radiochemotherapy followed by surgery with TME. The objective is to make inoperable patients, operable after the radio chemotherapy and get a pathologic complete response at the maximum of the patients and decrease the rate of local recurrence and distant. Method: During 2008e2011, we have recruited 80 patients in our radiotherapy oncology department of Blida; age is between 18 and 70 years. Radiotherapy (RT) is made at a dose of 45 Gy in the pelvis; the patient received three courses of CT (FOLFOX) for all the radiation therapy. All patients were assigned to surgeons for surgery (TME). Results: Rectal bleeding was found in 89% of patients. 70% of our patients had a low rectal cancer 98% of our patients are classes T3, T4. 78 % N+, and only 21% N. The RTCT was well tolerated by patients, no side effects Grade 4.77 had surgery 55% of our patients had a conservative surgery. 41% had an abdomino perineal resection. The downstaging affects more 45% of tumors after the RTCT and we have 12% complete pathological response, 61% of objective response. The local recurrence rate is (4%) relapse distance is 22.9%. The average time of relapse was 14 months away. The survival rate at 5 years was 64%. Relapse distance during follow-up of patients operated is 22.9%. Conclusion: Our result of 12% complete response is less than the results of others studies (16% to 21%). Our result of local relapse is similar to international studies. Every patient should have a personalized treatment for all steps (radiochemotherapy, surgery, adjuvant chemotherapy). http://dx.doi.org/10.1016/j.ejso.2016.07.052
93. Breast cancer in woman younger than 35 years Messaoud Ayad1, Naouel Aksil2 1 EHS Centre Anti Cancer, UK 2 Centre Anti Cancer, UK Background: Our aim was to report the epidemiological and clinical characteristics of breast cancer in young women and to evaluate the therapeutic Results in Radiotherapy Oncology department of Blida. Method: We report the Results of a retrospective study including 64 patients less than 35 years old treated for breast cancer between January 2010 and December 2014 in our department.
82. Rate of cachexia in lung cancer Adele Hug, Iain Phillips, Lindsey Allan, Veni Ezhil Royal Surrey County Hospital, UK Background: Lung cancer is the second most common cancer diagnosed in men and women in the UK with a very poor 5 year survival (10%). There is a lack of robust data on the stage of cachexia in which patients with lung cancer present. The severity of cachexia can influence overall outcome. Refractory (irreversible) cachexia indicates a poor prognosis of usually less than 3 months. Method: We reviewed all patients diagnosed with primary lung cancer that were reviewed by the Macmillan Oncology Dietitians over a 4 year period at the Royal Surrey County Hospital. Reasons for referral commonly included: weight loss, glycaemic control in diabetes, decreased oral intake and food texture modification. Patients were defined as cachectic if weight loss was >5%. Results: 458 patients were reviewed by the dietitian. 43% were female, 57% were male. Mean and median weight loss of total body weight at referrals was 9.5% and 13% respectively. Mean pre-cancer body mass index (BMI) was 26.9 (kg/m2), mean BMI at referral was 23.0 (kg/m2). 359 patients (78%) were treated with palliative intent. 99 were treated with radical/adjuvant intent. 341 (76%) of this cohort had >5% weight loss from their usual body weight prior to diagnosis. Conclusion: This data suggests cachexia is very common in lung cancer. It is known that early symptom control improves survival in lung cancer. It is not known whether early dietetic intervention may improve lung cancer outcomes. Further research is needed. These patients have a BMI within the healthy range of 20e25 kg/m2 before and after their cancer diagnosis in spite of significant weight loss. We are seeking ethical approval to prospectively assess the rate of cachexia in lung cancer and its correlation with other simple nutrition assessment tools. We aim to assess clinical outcomes categorised by % weight loss in advanced lung cancer. http://dx.doi.org/10.1016/j.ejso.2016.07.050
85. Building a weight of evidence to prevent cancer in later life Gillian Rosenberg, Lucie Hooper, Jyotsna Vorhra Policy Research Centre for Cancer Prevention, Cancer Research, UK Background: Obesity is the largest preventable risk factor for cancer after smoking. Being overweight as an adult is linked to 10 cancer types, and overweight children are more likely to become overweight adults. Recent data shows that around one in three children leave primary school overweight or obese, with the most deprived children twice as likely to be so. A comprehensive evidence-based childhood obesity strategy is vital in order to prevent obesity related cancers later in life. Method: A multidisciplinary research strategy was developed at Cancer Research UK to build a body of evidence that can directly influence government policy making in obesity. This included a quantitative study to investigate obesity and cancer awareness in the general population; a
S227 modelling study to predict future obesity related cancer cases; and qualitative studies to explore obesity-linked behaviours in children. Results: Cancer was not at the forefront of people’s minds when thinking about obesity, with only 26% showing an unprompted awareness of the link. However the projected impact of obesity on cancer is high: if current trends continue it will lead to a further 670,000 cases over the next 20 years. When looking specifically at childhood obesity, it was found that junk food marketing was associated with parental pester power and can override nutritional knowledge. Conclusion: These research studies formed an integral part of the current Cancer Research UK campaign on obesity. The first stage addressed the poor knowledge of obesity and cancer in the general population. The modelling results were a key part of this, alongside existing data on the mechanisms behind the causal relationship of obesity and cancer. Following this, during the development of the government’s childhood obesity strategy, the childhood obesity studies demonstrated to policy makers the importance of taking action to limit advertising exposure in children. http://dx.doi.org/10.1016/j.ejso.2016.07.051
92. Interest of radiochemotherapy in the rectal cancer Messaoud Ayad1, Naima Haoui2 1 EHS Centre Anti Cancer, UK 2 Centre Anti Cancer, UK Background: We propose the study of treating patients with locally advanced rectal cancer by radiochemotherapy followed by surgery with TME. The objective is to make inoperable patients, operable after the radio chemotherapy and get a pathologic complete response at the maximum of the patients and decrease the rate of local recurrence and distant. Method: During 2008e2011, we have recruited 80 patients in our radiotherapy oncology department of Blida; age is between 18 and 70 years. Radiotherapy (RT) is made at a dose of 45 Gy in the pelvis; the patient received three courses of CT (FOLFOX) for all the radiation therapy. All patients were assigned to surgeons for surgery (TME). Results: Rectal bleeding was found in 89% of patients. 70% of our patients had a low rectal cancer 98% of our patients are classes T3, T4. 78 % N+, and only 21% N. The RTCT was well tolerated by patients, no side effects Grade 4.77 had surgery 55% of our patients had a conservative surgery. 41% had an abdomino perineal resection. The downstaging affects more 45% of tumors after the RTCT and we have 12% complete pathological response, 61% of objective response. The local recurrence rate is (4%) relapse distance is 22.9%. The average time of relapse was 14 months away. The survival rate at 5 years was 64%. Relapse distance during follow-up of patients operated is 22.9%. Conclusion: Our result of 12% complete response is less than the results of others studies (16% to 21%). Our result of local relapse is similar to international studies. Every patient should have a personalized treatment for all steps (radiochemotherapy, surgery, adjuvant chemotherapy). http://dx.doi.org/10.1016/j.ejso.2016.07.052
93. Breast cancer in woman younger than 35 years Messaoud Ayad1, Naouel Aksil2 1 EHS Centre Anti Cancer, UK 2 Centre Anti Cancer, UK Background: Our aim was to report the epidemiological and clinical characteristics of breast cancer in young women and to evaluate the therapeutic Results in Radiotherapy Oncology department of Blida. Method: We report the Results of a retrospective study including 64 patients less than 35 years old treated for breast cancer between January 2010 and December 2014 in our department.