S216 Tuesday 23 October 2001 Poster Sessions patients were delayed with 1-2 courses ChT. Clinical target volume (CTV) of the patients includes the preserved breast with the underlying thoracic wall of the patients with N- and N+ up to 3 positive lymph nodes. For all patients three-CT transversal scans were made for precise outlining of the CTV and the organs of risk. The target volume were irradiated with two tangential field (60 Co) without boost for the tumour bed to the prescribed total dose of 5OGy in 25 fraction for 5 weeks When the supraclaviculary fosse was included, it was treated with a total dose of a 44Gy by adding a ‘third’ field. The adjuvant system treatment includes VI courses chemotherapy and Tam in patients, with SR+. Results: 5 year local control in 96,0% of patients, excellent 51,6% and good 41,0% cosmetic results, were accomplished, as in only 1,6% postra- diothempy pulmofiircrsis was diagnosticised This method is accessible and feasible to all patients. It allows homogenous inadiation of CTV and sparing the organs of risk. The combination of unfavourable factors of the tumour in a group with high risk essentially reduces the local control and the overall survival. The aesthetC results depend only on the volume of the removed tissues and on the type of surgical incisions for the primary tumour and the axillary dissection. BCT proved a better local control versus M, but the 5 years overall survival was not significantly different in the two treatment methods - 95,6% versus 92,5% Ccmcluslons: The individualised CT planning and the applying of a 5OGy dose without ‘boost’ in the tumour bad. leads to better treatment, cosmetic results and minimal late complications This imposes the BCT as a successful alternative of the modified radical mastectomy. 791 POSTER A study of 40 patients with nasopharyngeal cancer (stage 1 to 4) treated with radiation therapy using CT simulation with a single isocentre technique and 3 dlmensional planning M.I.A. Wahid’, A.Z. Bustam2, F. Hayat2, P. Rassiah2, A. Bustam3, U. Prasad4. 1 Pantai Medical Cm-We. Radiotheraov and Oncoloov Kuala Lumpui, Malaysia; 2 Universify Of Malaya Medic~iCentre, C/ink% Onwiogg Kuala Lumpur, Malaysia; 3 University Of Cambridge Medical School, Medicine, Cambridgk, England; 4 University Of Malaya Medical Cenrre, EM; Kuala Lpmpur, Malaysia Purpose: Nasopharyngeal Cancer(NPC)is a very common cancer affecting mainly the Chinese ethnic group in Malaysia.The inddence is approxi- mately 25 per 1OOOOO population. Treatment simulator is the main planning tool for radiation treatment of NPC.At the University of Malaya Medical Center(UMMC),CT Simulation using a single isocentre and 3 dimensional planning was used in a pilot study to plan NPC.ln this paper we analysed the treatment outcome using the planning technique,which we designed. Materials: From 1998 to 1999,40 patients with NPC were planned at UMtvlC using CT simulation.30% of the patients were stage 1 and 2,70% v&e stage 3 and 4 diiase.The patients were planned \kith their neck extdnded and immobilized in a beam directing shell.4mm to 5 mm scans slices were performed to indude the head and upper chest.8 single isocen- tar was chosen in the neck and marked on the patient Critical structures and turnour volume were butlined oneach CT slices on the CT simulation plan- ning console.3~beams were used to treat the post nasal space and a single anterior beam for the neck using a half beam block technique.Shieldin~ of structures were ‘drawn’ on the digital reconstructed radiograph (DRR) and the planned ‘volume checked by scrolling through the axial,saggital arX’c@ronal c&s on the CT simulation console.The plan was exported to a 3D treatment planning system for flh’al dosimetry.Each field was verified on electronic portal image and compared with the planned digital reconstructed radiographs prior treatment. ;Results: CT simulation was useful in defining the anatomy,outline of critical structures,fumor and target volume with a higher degree of accuracy compared to conv~ntic+simulation.Of the 40 patients in the study group,1 defaulted treatment.lOO% of the 39 patients who completed treatment achieved complete, or major response at the end of radiation treatment21 patient died early following adjuvant chemotherapy.The local control rate at 24 months was ImOO%. patients had systemic relapse at 12.5 and 118 months of follow up and treated with salvage chemotherapy.The survival rate at 2 years was 95%. ~Conclt+orl! CT ‘simulation provides a superior anatomical and tumor definition in three dimensions compared to conventional simulation.The initial findings IrtdicCate that is highly effective ‘in controlling early as well as advanced stages of NPC.ln UMMC;CT Simulation has now replaced the conirentional planning method of using a treatment simulator. Genitourinary cancer 792 POSTER Comblnation Studies with the Farnesyttransferase Inhibitor R115777 and Chemotherapy Agents A. Adiei, L. Bruzek, C. Ettichman, R. Marks, G. Croghan, J. Sloan, J. Reid, H. Plot, R. Goldberg, L. Hanson. Mayo Clinic, Rochester, USA Famesyltransferase (FT), an enzyme that catalyzes the first step in the post- translational modification of ras and other important polypeptides involved in cell proliferation, has emerged as an important target for cancer therapy. R115777, one of the first FT inhibitors to undergo clinical testing, has shown promising activity in leukemia and breast cancer. Phase Ill studies have been completed with this compound. We examined the effect of combining RI15777 with several classes of antineoplastic drugs in various human tumor cell lines. Colony forming assays were utilized to examine the effect of treating cells with cisplatin (CDDP.), melphalan. gemcitabine (GEM) or 5-FU in combination with RI15777 in a number of cell lines, including the A549 NSCLC line as well as TQ8G glioblastoma, MCF-7 breast, BxPCb3 pancreatic and HCT-116 wlon carcinoma cell lines. The combination of RI15777 and CDDP exhibited synergy that is dependent on sequence of administration and on the model system utilized. The combination of RI15777 and GEM was additive, while the combinations with melphalan and 5-FU were less than additive. Based on these findings, we undertook a phase I trial to define the MTD. toxicities, PK, and clinical activii of the combination of Rl15777 (po BID dl-14), GEM (dl, d8), and CDDP (dl). on a Pl-day cycle in patients (pts) with advanced cancers. To date, 25 pts have received 68 cycles of treatment through 5 dose levels. The most wmmon and dose-limiting toxicity is neutropenia. Thrombocytopenia (10 grade 3, lgrade 4), rash (2 grade 3), nausea (8 grade 2, 1 grade 3). and fatigue (1 grade 2). Six objective responses (5 PRs, 1CR) have been documented in 18 evaluable patients. PK and in vivo wrrelates of Ff’ inhibition at the MTD (R115777 300 mg po BID, GEM 1000 mg/m2, CDDP 75 mg/m2) will be presented. Supported by grants from NIH (CA77112, RROO585) ‘and Janssen Research Foundation. 793 POSTER Results of exclusive brachytherapy In the treatment of carcinoma of the penis K. Kanfir’, C. Haie-Meder’, M. Albano’, B. Court’, P. Wibault’, C. Breton-Callu’, R. de Crevoisier’, A. Gerbaulet’ ‘Department of Radiation Onwlogy; *Department of Urology; lnstitut Gustave-Roussy, 94805 Vilieju% France Purpose: To assess the role of exclusive brachytherapy (BT) as a wnser- vative approach in the treatment of penis carcinoma. Methods: Between 1973 and 1995, 145 patients (pts) with penis carci- noma were treated with a conservative approach consisting of exclusive BT. The median age was 58 years (20-83). A history of phymosis was found in 27% of the pts, and precancerous lesions were observed in 30% of the pts. Stage distribution was: Tl in 107 pts (74%), T2 in 18 pts (12%), T3 ih 11 pts (8%) and impossible to assess in 9 pts. lnguinal nodes were present in 17 pts (12%). One patient presented with metastases. One hundred and twenty pts (83%) had circumcision prior to BT, the 25 remaining pts had already a history of previous circumcision: BT was performed using the hypodermic needles technique. The mean radioactive line number was 6 (2-18) in a mean number of 2 planes (l-5). The mean radioactive length was 26 cm (4-108). The mean delivered dose according to the Paris system rules was 67 Gy (20-60). The mean treated volume was 28 cm3 (5-137). Treatment of dinically present inguinal node consisted of node dissection completed by external irradiation, depending on pathologic findings. Results: Of the population, 22 (15%) printed a local relapse, 14 of them (64%) being controlled by either a partial amputation (10 pts), a total amputation (2 pts) or a new BT (2 pts). Twenty-five pts (17%) presented an inguinal lymph node relapse. Eleven of the 25 pts (44%) were controlled by either lymphadenectomy or external irradiation or both. Eighteen pts (12%) presented metastases. A total of 79 late wmplimtions (all grade) ~(54%) were recorded. Urethral stricture and necrosis were the two most wmmon complications. In 29 cases (20%) complications required surgery, consisting of partial amputation. Wiih a median follow-up of 120 months, 79 pts (55%) are alive. Twenty-two pts died of tumor. Conclusion: BT gives good local control in the conservative approach of penis cancer. The major carcinologic event was represented by inguinal lymph node relapse, showing the need for a more systematic surgical approach with inguinal dissection.