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PO-369 COMPARISON OF 60 GY AND 54 GY IN HIGH-DOSE-RATE INTERSTITIAL BRACHYTHERAPY FOR EARLY ORAL TONGUE CANCER
S148 necessary to be managed by respirator transiently for one patient. Five patients (28%) showed soft tissue necrosis or mandible complication as moderate to severe late severe complication. One of 5 patients received partial sequestrectomy and the other symptoms were improved by drug and/or hyperbaric oxygen. Conclusions: Our treatment result of HDR-ISBT as a monotherapy of 54 Gy in 9 fractions for anterior mobile tongue cancer is feasible. Technical improvement should be investigated to prevent local recurrence by technical error. PO-367 THE DIFFERENT BIOLOGICAL EFFECTS OF SINGLE, FRACTIONED AND CLDR IRRADIATION IN CL187 COLORECTAL CANCER CELLS H. Wang1, J. Wang1 1 Peking University Third Hospital, Cancer Center, Beijing, China Purpose/Objective: To identify the different effectiveness of single, fractioned and continuous low dose rate irradiation on the human colorectal cancer cell line CL187 in vitro and explore the relevant molecular mechanisms. Materials and Methods: The CL187 cells were exposed to radiation of 6 MV X-ray at high dose rate of 4Gy/min and 125I seed at low dose rate of 2.77 cGy/h. There were three groups: single dose radiation group (SDR), fractioned dose radiation group (FDR) by 2Gy/f and continuous low dose rate radiation group (CLDR). The radiation doses were 0, 2, 4 and 8Gy, respectively. Radiation responses to radiation of tumor cells were evaluated by colony-forming assay. Cell cycle arrests were detected by flow cytometry after propidium iodide (PI) staining. Apoptosis was detected by Annexin and PI staining. The expressions of DNA-PKcs, Ku70 and Ku80 were determined by Western blotting. Results: The relative biological effect (RBE) for 125I seeds compared with 6 MV X-ray was 1.41. At 48h after 0, 2, 4 and 8 Gy irradiation, the percentage of G2/M phase of CLDR group were 4.92±0.02%, 13.67±1.67%, 16.41±2.19% and 23.81±1.61%, respectively. Irradiated by 4Gy, the percentage of the G2/M phase cell cycle arrest of CLDR group increased significantly(CLDR vs. SDR, t=-6.03, p=0.026; CLDR vs. FDR, t=-13.98, p=0.005). After 0, 2, 4 and 8 Gy irradiation, early apoptosis rates of CLDR group at 48h were 1.28±0.25%, 1.87±0.06%, 6.54±0.88% and 7.62±0.39%, respectively. The percentage of early apoptosis of 4Gy in CLDR group increased significantly(CLDR vs. SDR, t=-31.22, p=0.001; CLDR vs. FDR, t=-7.01, p=0.02). At 48h after 0, 2, 4 and 8 Gy irradiation, late apoptosis rates of CLDR group were 1.19±0.05%, 7.86±0.08%, 9.72±0.85% and 5.76±0.63%, respectively. The percentage of late apoptosis of 4Gy in CLDR group increased significantly(CLDR vs. SDR, t=-15.08, p=0.004; CLDR vs. FDR, t=-11.99, p=0.007). DNA-PKcs and Ku70 expression level of CLDR group decreased compared with SDR and FDR groups. Conclusions: 125I seeds continuous low dose rate irradiation showed more effective inhibition than that of 6 MV X-ray high dose rate irradiation on CL187 cells. Apoptosis and G2/M phase cell cycle arrest were the main mechanism of cell-killing effects under low dose rate irradiation. 125I seeds continuous low dose rate irradiation could influence the DNA repair of cells via DNA-PKcs and Ku70 pathways. PO-368 ULTRASOUND-GUIDED PERCUTANEOUS IODINE-125 SEED IMPLANTATION FOR TREATING LIVER MALIGNANCIES S.Q. Ttian1, J.J. Wang1, Y.L. Jiang1, W.J. Jiang1, P. Jiang1, W.Q. Ran1, N. Meng1 1 Peking University Third Hospital, Department of Radiation Oncology Cancer Center, Beijing, China Purpose/Objective: To investigate the therapeutic efficacy of ultrasound-guided 125I seed implantation for treatment of liver cancer. Materials and Methods: A total of 18 patients (84 male, 13 female; mean age 53.4 years, range 24–74 years) with liver cancer were included in this study. The diagnosis of each case was verified by CT, MRI and biopsy. A median number of 28 125I seeds (rang, 8-56) per patient were implanted into liver cancer by ultrasound-guided needle puncture. The specific activity of 125I ranged from 0.60 to 0.80 mCi per seed and the median D90 was 120 Gy (rang, 90-140 Gy). Patients were followed-up by examination and by contrast-enhanced computed tomography (CT) to evaluate treatment responses. Survival was analyzed using the Kaplan–Meier method.
World Congress of Brachytherapy 2012 Results: During a median follow-up period was 24 months (range: 4– 37months), the response rate of tumor was 83.0%. Overall median control time was 11.0 months (95% CI, 8.4–14.3). The local control rate was 59.9% at 1 year and 20.5% at 2 years. The overall median survival was 15 months (95% CI, 9.6–20.3), while the overall 1-, 2- year survival rates were 61.9%, 27.1%, respectively. No serious complications were observed postoperatively and during the follow-up period Conclusions: Ultrasound-guided brachytherapy using 125I seed implantation was a safe and effective therapeutic technique for treating liver cancer. PO-369 COMPARISON OF 60 GY AND 54 GY IN HIGH-DOSE-RATE INTERSTITIAL BRACHYTHERAPY FOR EARLY ORAL TONGUE CANCER H. Akiyama1, K. Yoshida2, K. Shimizutani1, H. Yamazaki3, M. Koizumi4, Y. Yoshioka4, N. Kakimoto5, S. Murakami5, S. Furukawa5, K. Ogawa4 1 Osaka Dental University, Department of Oral Radiology, Osaka, Japan 2 National Hospital Organization Osaka National Hospital, Department of Radiation Oncology, Osaka, Japan 3 Graduate School of Medical Science Kyoto Prefectural University of Medicine, Department of Radiology, Kyoto, Japan 4 Osaka University Graduate School of Medicine, Department of Radiation Oncology, Osaka, Japan 5 Osaka University Graduate School of Densitry, Department of Maxillo-Facial Radiology, Osaka, Japan Purpose/Objective: To compare the results between total dose 60 Gy/ 10 fractions (bid) and 54 Gy/ 9 fractions of High-dose-rate interstitial brachytherapy (HDR-ISBT) for early oral tongue cancer. Materials and Methods: We made a matched-pair analysis of early oral tongue cancer (T1-2N0M0) patient treated by 60 Gy and 54Gy between 1996 and 2004 at Osaka University Hospital. 17 patients treated by 54Gy and 34 matched pair control arm treated by 60Gy were extracted and analyzed. Results: Local recurrence occurred in two patients treated with 54 Gy arm and five in 60 Gy arm. Two and 5-year local control rates were both 88% for 54 Gy arm and 88% and 84% for 60Gy arm (n.s.). Nodal metastases occurred in 13 and 9 patients for 60 Gy and 54 Gy arms Five-year overall survival rates of 60 Gy and 54 Gy arm were 84% and 66%, respectively. One and 2-year actuarial complication free rates in the 60 Gy arm were 97 and 91%, respectively, and those in the 54 Gy arm was both 83% (n.s.). There were no significant associations between the total dose and local control rate and late complications. Conclusions: A dose of 54 Gy in 9 fractions showed compatible outcome to 60 Gy/ 10 fractions for early oral tongue cancer. PO-370 PERCUTANEOUS ULTRASOUND-GUIDED IODINE-125 IMPLANTATION AS A SALVAGE THERAPY FOR RECURRENT LYMPH NODE METASTASES J.J. Wang1, L.E.I. Lin1, Y. Jiang1, N.A. Meng1, W. Ran1, S. Tian1, R. Yang1, Y.A.N. Yu2 1 Peking University Third Hospital, Department of Radiation Oncology, Beijing, China 2 Thomas Jefferson University, Department of Radiation Oncology, Beijing, USA Purpose/Objective: Esophageal cancer is generally associated with a poor prognosis, particularly in the recurrent cervical lymph node metastases after radial therapy. This study aimed to assess the efficacy and feasibility of percutaneous 125I seed implantation for the management of recurrent lymph node metastases in esophageal carcinoma. Materials and Methods: 27 lesions in 16 patients with cervical lymph node metastases who had undergone ultrasound-guided 125I seed implantation were reviewed. The local control and survival rates were evaluated by the Kaplan-Meier method Results: Prior to seed implantation, all patients had undergone surgery, EBRT with/without chemotherapy: one patient had previously undergone cervical lymph nodes dissection and EBRT twice; two patients had undergone surgery once; 13 patients had received EBRT (9 patients received EBRT once, 4 received EBRT twice). The total cumulative doses of EBRT were 47-143 Gy, with a median of 64 Gy.
World Congress of Brachytherapy 2012 Results: During a median follow-up period was 24 months (range: 4– 37months), the response rate of tumor was 83.0%. Overall median control time was 11.0 months (95% CI, 8.4–14.3). The local control rate was 59.9% at 1 year and 20.5% at 2 years. The overall median survival was 15 months (95% CI, 9.6–20.3), while the overall 1-, 2- year survival rates were 61.9%, 27.1%, respectively. No serious complications were observed postoperatively and during the follow-up period Conclusions: Ultrasound-guided brachytherapy using 125I seed implantation was a safe and effective therapeutic technique for treating liver cancer. PO-369 COMPARISON OF 60 GY AND 54 GY IN HIGH-DOSE-RATE INTERSTITIAL BRACHYTHERAPY FOR EARLY ORAL TONGUE CANCER H. Akiyama1, K. Yoshida2, K. Shimizutani1, H. Yamazaki3, M. Koizumi4, Y. Yoshioka4, N. Kakimoto5, S. Murakami5, S. Furukawa5, K. Ogawa4 1 Osaka Dental University, Department of Oral Radiology, Osaka, Japan 2 National Hospital Organization Osaka National Hospital, Department of Radiation Oncology, Osaka, Japan 3 Graduate School of Medical Science Kyoto Prefectural University of Medicine, Department of Radiology, Kyoto, Japan 4 Osaka University Graduate School of Medicine, Department of Radiation Oncology, Osaka, Japan 5 Osaka University Graduate School of Densitry, Department of Maxillo-Facial Radiology, Osaka, Japan Purpose/Objective: To compare the results between total dose 60 Gy/ 10 fractions (bid) and 54 Gy/ 9 fractions of High-dose-rate interstitial brachytherapy (HDR-ISBT) for early oral tongue cancer. Materials and Methods: We made a matched-pair analysis of early oral tongue cancer (T1-2N0M0) patient treated by 60 Gy and 54Gy between 1996 and 2004 at Osaka University Hospital. 17 patients treated by 54Gy and 34 matched pair control arm treated by 60Gy were extracted and analyzed. Results: Local recurrence occurred in two patients treated with 54 Gy arm and five in 60 Gy arm. Two and 5-year local control rates were both 88% for 54 Gy arm and 88% and 84% for 60Gy arm (n.s.). Nodal metastases occurred in 13 and 9 patients for 60 Gy and 54 Gy arms Five-year overall survival rates of 60 Gy and 54 Gy arm were 84% and 66%, respectively. One and 2-year actuarial complication free rates in the 60 Gy arm were 97 and 91%, respectively, and those in the 54 Gy arm was both 83% (n.s.). There were no significant associations between the total dose and local control rate and late complications. Conclusions: A dose of 54 Gy in 9 fractions showed compatible outcome to 60 Gy/ 10 fractions for early oral tongue cancer. PO-370 PERCUTANEOUS ULTRASOUND-GUIDED IODINE-125 IMPLANTATION AS A SALVAGE THERAPY FOR RECURRENT LYMPH NODE METASTASES J.J. Wang1, L.E.I. Lin1, Y. Jiang1, N.A. Meng1, W. Ran1, S. Tian1, R. Yang1, Y.A.N. Yu2 1 Peking University Third Hospital, Department of Radiation Oncology, Beijing, China 2 Thomas Jefferson University, Department of Radiation Oncology, Beijing, USA Purpose/Objective: Esophageal cancer is generally associated with a poor prognosis, particularly in the recurrent cervical lymph node metastases after radial therapy. This study aimed to assess the efficacy and feasibility of percutaneous 125I seed implantation for the management of recurrent lymph node metastases in esophageal carcinoma. Materials and Methods: 27 lesions in 16 patients with cervical lymph node metastases who had undergone ultrasound-guided 125I seed implantation were reviewed. The local control and survival rates were evaluated by the Kaplan-Meier method Results: Prior to seed implantation, all patients had undergone surgery, EBRT with/without chemotherapy: one patient had previously undergone cervical lymph nodes dissection and EBRT twice; two patients had undergone surgery once; 13 patients had received EBRT (9 patients received EBRT once, 4 received EBRT twice). The total cumulative doses of EBRT were 47-143 Gy, with a median of 64 Gy.