ESTRO 2020 Abstract book

S639 ESTRO 2020

Margaret Cancer Centre- University Health Network, Department of Radiation Oncology- University of Toronto, Toronto, Canada Purpose or Objective Sexual health is an important, yet often neglected, survivorship issue for cervical cancer patients. The objective of this study was to assess patient-reported sexual toxicity in the era of MR-guided brachytherapy and to correlate with dosimetry and physician-reported toxicity. Material and Methods Cervical cancer patients treated with definitive chemo- radiation and MR-guided HDR brachytherapy who were disease-free for a minimum of 3 months and attending routine follow-up were eligible. Consenting patients were asked to complete the validated Female Sexual Distress Scale-Revised (FSDS-R; cut-off for distress ≥11)), Female Sexual Function Index (FSFI; cut-off for risk of sexual dysfunction score ≤26), and EuroQol Group EQ-5D-3L (index value range: 0 (death) to 1 (perfect health)), as well as a socio-demographics questionnaire. Oncologists were asked to score vaginal/sexual toxicity using the CTCAE v4.0. Patient, treatment and dosimetric characteristics were collected and summarized using descriptive statistics. The association between FSDS-R/FSFI scores (both dichotomized) and dosimetric characteristics (ICRU recto-vaginal point dose and vaginal D2cc) were assessed using Wilcoxon rank test. The association between patient and physician reported (cut-off of grade ≥2) toxicities were assessed using Fisher’s exact test. All tests were two- sided. Results were considered statistically significant if the p-value was ≤0.05. Results Between August 2018 and May 2019, 42 patients were approached, 35 (83%) consented and 31 (89%) were eligible for analysis. Median age at diagnosis was 46 (range: 27-73), 47% were FIGO stage 2B, 52% were lymph node positive and 42% had vaginal involvement. Eighty-three percent of patients were partnered and 23% were not sexually active. None were currently receiving treatment/intervention for sexual concerns, although 85% had used a vaginal dilator post-treatment. The median HRCTV D90 was 92.8 Gy (81- 106.4), ICRU recto-vaginal point was 63 Gy (53.8-77.2) and median vaginal D2cc was 79.9 Gy (54.5-118.5). Median score for the FSDS-R was 14, with 18 (62%) meeting criteria for sexual distress. The median score for FSFI was 19.4, with 20 (83%) meeting criteria for sexual dysfunction. The median EQ5D-3L index value was 0.8 (0.6-1). FSDS-R had a significant positive correlation with the ICRU recto-vaginal point (p= 0.017). Total FSFI score and EQ5D-3L score were negatively correlated with the ICRU recto-vaginal dose, but did not reach statistical significance. There was no significant correlation between patient-reported sexual toxicity and physician-assessed vaginal/sexual toxicity. Conclusion Cervical cancer survivors self-report high rates of sexual dysfunction and distress. Sexual distress was positively correlated with the ICRU recto-vaginal point. Vaginal dose de-escalation is recommended, when feasible, to decrease the risk of sexual toxicity. PO-1120 Exploring Brachytherapy Educational Needs of Cervical Cancer Patients C. Jennifer 1 , A. Julius 2 , J. Manhertz 3 , C. Heck 4 , K. Chan 5 , K. Lawrie 6 , N.K. Quartey 6 , J. Papadakos 6 1 Radiation Medicine Program- Princess Margaret Cancer Centre- University Health Network, Department of Radiation Oncology- University of Toronto, Toronto, Canada ; 2 Collaborative Academic Practice-University Health Network, Department of Nursing- Princess Margaret Cancer Centre, Toronto, Canada ; 3 Collaborative Academic Practice- University Health Network, Department of Nursing- Princess Margaret Cancer Centre, Toronto, Canada ; 4 Collaborative

Academic Practice, University Health Network, Toronto, Canada ; 5 Radiation Medicine Program- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada ; 6 Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Canada Purpose or Objective Brachytherapy plays an important curative role in the management of women with cervical cancers. Despite this, standardized patient education materials are lacking. The objective of this study were to determine the brachytherapy education needs of cervical cancer patients from the perspectives of both patients and health care A mixed methods, cross-sectional survey design was used. A literature review yielded no pre-existing validated, relevant questionnaires. Patient and HCP surveys were developed in-house by content and instrument development experts and then pilot-tested for validity, feedback and revisions. English-speaking women >18 years with cervix cancer treated with definitive chemo— radiotherapy, including brachytherapy, were eligible to participate. Patients were approached during their brachytherapy and consenting patients completed the survey during their first follow-up post-treatment. All radiation oncologists, brachytherapists, and nurses involved in brachytherapy were invited to participate via email and through an educational in-service. Descriptive statistics were used to analyze the results, including participant demographics, frequencies, percentages, and means as appropriate. Content analysis was used to analyze open-ended questions to identify themes. Results Between April 2017 and May 2018, 20 patients and 52 HCPs consented to participate and completed the survey. Median patient age was 60 years (range, 34-94), with 61% completing post-secondary education. The majority of HCPs were nurses (70%); all GYN radiation oncologists participated (n=4). The top informational needs identified by patients were vaginal stenosis prevention (“very important,” 89%), management of bleeding post- treatment (84%) and vaginal dilator use (74%). The majority of patients (85-90%) preferred to receive this information via pamphlets or one-on-one by their HCP. Content analysis revealed that patients desire a follow-up telephone call, with the majority preferring it within 2 weeks post-treatment. Only 44% of HCPs believed patients were “very satisfied” with their current brachytherapy education. The majority agreed that patients culture (96%) and age (90%) impacted how education is provided. Although one third of HCPs indicated uncertainty in providing brachytherapy education, the majority indicated they were comfortable (63%) and knowledgeable (53%) in providing patient education. Conclusion Evaluating brachytherapy education needs from the perspectives of cervix cancer patients and HCPs informed current practices and identified current gaps. Patients identified vaginal stenosis prevention and dilator use as the most important educational needs. These results will be used to facilitate the development of standardized patient education materials for both patients and HCPs that will be implemented and evaluated. PO-1121 Outcomes of post - radiation recurrent Gyn Cancers treated with Advanced Brachytherapy Treatments N. Lavanya 1 , R. Mittal 2 , G. Mulye 2 , D. Aravindaksham 3 , L. Scaria 3 , S. Kohle 4 , S. Kadam 3 , S. Chopra 5 , U. Mahantshetty 2 1 Tata Memorial Hospital, Radiation Oncolgy, Mumbai, India ; 2 Tata Memorial Hospital, Radiation Oncology, Mumbai, India ; 3 Tata Memorial Hospital, Medical Physics, Mumbai, India ; 4 Tata Memorial Hospital, professionals (HCPs). Material and Methods