Abstract Book

S823

ESTRO 37

(all patients underwent prior external beam radiation and weekly cisplatin treatment). The images have been taken and analyzed using the FLIR software (FLIR Tools), which calculated the maximal, minimal temperature and the delta between the max and the min temperature. Results A reduction in the delta temp of the cervix occurred in all patients during treatment, between the first and the last sessions. There was a rise in temperature at the middle of treatment probably due to inflammation process of the cervix tissue as a result of radiation. All patients had a complete clinical response and are free of disease with median follow-up of 14 months. Conclusion We report a new method for monitoring cervix brachytherapy efficacy, by measuring the physiological response of the tissue. Also, thermography provides information about the inflammatory process that occurs in the tumor area. Assessment of the response may promote changes in the treatment regimen, radiation dose, fields and the need for chemotherapy, therefore contributing to individualized treatment schedules for optimal treatment effectiveness. EP-1519 Eosinophil-to-Lymphocyte Ratio (ELR) as a novel prognostic biomarker for cervical cancer. K. Holub 1 , A. Biete 1 1 Hospital Clínic de Barcelona- Universitat de Barcelona, Radiation Oncology Department, Barcelona, Spain Purpose or Objective To analyse the influence of the Eosinophilia and the Eosinophil-to-Lymphocyte Ratio (ELR) detected in the pre-treatment blood analysis, on the prognosis of patients with cervical carcinoma (CC). Material and Methods A retrospective cohort of 140 patients (p) diagnosed with CC and treated with radiotherapy (RDT) in our institution between July 2009 and January 2017 was evaluated. Median age at diagnosis: 50 years (range 25-92). All patients underwent biopsy, being squamous histology prevalent: non-keratinizing in 98p (70%) and keratinizing in 9p (6.4%). FIGO stage (2009): IA1-1p (0.7%), IA2-1p (0.7%), IB1-26p (18.6%), IB2-10p (7.1%), IIA1-5p (3.6%), IIA2-2p (1.4%), IIB-46p (32.9%), IIIA-5p (3.6%), IIIB-34p (24.3%), IVA-5p (3.6%), IVB-5p (3.6%). Bulky disease was diagnosed in 94p (67.1%). Lymphadenectomy was performed in 86p (61.4%), and in 11p sentinel lymph node procedure was used. Treatment based on a combination of the External Beam Radiotherapy (EBRT) and chemotherapy with High Dose Rate Brachytherapy (HDR- BT) was applied in 85p (60.7%), and EBRT+HDR-BT in 14p (10%). The mean dose of EBRT was 41.4Gy (median 45Gy, range 12-60Gy) and an additional boost was applied in 23p (16.4%); 129p (92.1%) were treated with HDR-BT (mean dose 18Gy, median 20Gy, range 6-30Gy). The most applied chemotherapy was cisplatin (75p).After the initial treatment, 103p (73.6%) presented complete response (CR), 21p (15%) partial response, 13p (9.3%) disease progression and 1p stable disease. Afterwards, 46p in the group of CR presented disease relapse. After a median follow-up of 34.3 months (range 6-83months), 33p (23.6%) suffered cancer-related deaths. We analysed the prognostic value of an absolute eosinophil count (Eos) in the pre-treatment blood test, and the Eosinophil-to- Lymphocyte ratio (ELR) was calculated as follows: absolute eosinophil count/absolute lymphocyte count, reagarding the Overall Survival ans the Time to

Progression. Statistics: Chi2, Kaplan-Meier test (SPSS v.23). Results Using the most discriminative cut-off value of 0.2 for Eos and 0.1 for ELR (according to the ROC curve) better Overall Survival was observed in patients with Eos ≥ 0.2 (LogRank test: Chi2 4.35, p=.037) and in patients with ELR ≥0.1 (Log Rank test: Chi2 4.32, p=.038). We examined also the influence of ELR on the Time to Progression (TTP). Using ROC curve cut-off value of 0.05 for ELR, larger TTP was observed in patients with ELR ≥0.05 (10.5 months) than in patients with ELR<0.05 (5.0 months), Log Rank test: Chi2 4.45, p=.035. Conclusion Increased values of Eos and ELR are related with better Overall Survival and ELR with longer TTP in cervical carcinoma. These results could help identifying patients with higher risk of progression, with the additional benefit that both the eosinophils count and the ELR are inexpensive parameters easy to get from the pre- treatment analysis. However, the consistency and the magnitude of the prognostic impact of these biomarkers remain to be confirmed in the prospective studies. EP-1520 The Utility Of Lymohopenia In Cervical Carcinoma Patients Treated With Definitive Chemoradiotherapy C. Onal 1 , B. Akkus Yildirim 1 , H. Mertsolylu 2 1 Baskent Universitesi Tip Fakultesi- Adana Hastanes, Department of Radiation Oncology, Adana, Turkey 2 Baskent Universitesi Tip Fakultesi- Adana Hastanes, Department of Medical Oncology, Adana, Turkey Purpose or Objective To investigate the prognostic significance pre- and post- treatment lymphopenia in locally advanced squamous cell carcinoma (SCC) cervical cancer patients treated with definitive chemoradiotherapy (ChRT). Material and Methods A total of 95 patents with cervical cancer was retrospectively analyzed. The relationships between pre- [total lymphocyte count (TLC) < 1000 cells/mm 3 ) or post- treatment lymphopenia (TLC was < 500 cells/mm 3 ) and patient or tumor characteristics were assessed. The association of pre- and post-treatment lymphopenia with overall survival (OS) and disease-free survival (DFS) were evaluated. Results Median follow-up times for entire cohort and survivors were 68 months (range, 3 – 133 months) and 88 months (range, 22 – 133 months), respectively. Pre-treatment lymphopenia was seen in 10 patients (11%), while post- treatment lymhopenia was observed in 58 patients (61%). The median pretreatment TLC decreased from 2029 cells/mm 3 (Figure 1A) to 506 cells/mm 3 two months after initiating ChRT ( p <0.001). Patients with pre-treatment lymphopenia had significantly less complete response after definitive ChRT than those without. Patients with post-treatment lymphopenia had significantly higher rates of lymph node metastasis ( p = 0.001) and less post- treatment CR rates ( p = 0.01) compared with patients without post-treatment lymphopenia. In univariate analysis, besides pre- and post-treatment lymphopenia, FIGO stage, tumor size, lymph node metastasis and treatment response were significant prognostic factors for OS and DFS. In multivariate analysis, pre-treatment lymphopenia, lymph node metastasis and treatment response emerged as significant independent predictors of both OS and DFS. Patient’s age was also significantly