Abstract Book

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Purpose or Objective The aim of this study was to present early results of treatment of patients with locally advanced cervical cancer with synchronous cancers. Material and Methods The group encompassed 200 women with locally advanced cervical cancer (stage IIB-IIIB) who underwent PET-CT with the aim of optimization of radiotherapy treatment planning. Results Four patients (2%) from our group were diagnosed with synchronous cancers. Two of the cases were found to have cancers from head and neck region - laryngeal and hypopharyngeal cancer. Malignancies diagnosed in the other two patients were breast cancers. Each women underwent radical radiochemotherapy of cervical cancer and other treatment of synchronous cancer – surgery, radiotherapy or chemotherapy. The optimal therapeutic path was chosen due to histopathology and stage of synchronous cancer. According to treatment results, women diagnosed with hypopharyngeal cancer and breast cancer reached complete remission of both primary and secondary malignancy. Patient diagnosed with laryngeal cancer, reached complete remission of cervical cancer, but ended radiotherapy of the laryngeal cancer at a palliative dose. Conclusion PET-CT is a helpful method of optimization of radiotherapy treatment planning before radical radiochemotherapy in patients with locally advanced cervical cancer. The increasing accessibility of PET-CT will escalate the number of diagnosed synchronous cancers. Second primary tumours are often detected at an early stage, where radical treatment can be performed. It helps to personalized and individualised treatment for both primary and secondary tumor in every patients. However, management of such difficult and complex clinical cases as synchronous cancers should be carried out by multidisciplinary teams. EP-1525 Nodal and distant metastases in cervical cancer pts FIGO IIB&IIIB in pretreatment (18)F-FDG- PET/CT A. Wilk 1 1 Greater Poland Cancer Centre, Radiotherapy and Gynecology Ward, Poznan, Poland Purpose or Objective The aim of this study was to evaluate the incidence of nodal and distant metastases (non-nodal) in FIGO IIB and FIGO IIIB cervical cancer patients.Clinical staging in cervical cancer is based on gynecological examination (FIGO 2009). (18)F-fluorodeoxyglucose positon emission tomography combined with CT ((18)F-FDG-PET/CT) is known for its high sensitivity and specificity in evaluation of nodal metastases in this disease. The incidence of nodal and distant metastases based on FDG-18 PET/CT was analyzed. Material and Methods All cervical cancer patients gynecologically examined as FIGO stage IIB and IIIB underwent (18)F-FDG-PET/CT before the treatment (radio-/radiochemotherapy). The machine used was Philips PET/CT. 72 patients were treated between 02. 2012 and 05.2013. Results The number of patients with nodal metastases based on (18)F-FDG-PET/CT in particular FIGO stages were as follow: IIB – 16 of 26 patients (61,5%), in this group metastases to paraaortic nodes were found in 5 patients,

EP-1523 Testing the efficacy of trimodal therapy in locally advanced cervical cancer: a phase II study R. Autorino 1 , A. Nardangeli 1 , M. Campitelli 1 , B. Gui 2 , E. Rodolfino 2 , E. Foti 3 , F. Mascillini 3 , G. Ferrandina 3 , M. Gambacorta 1 1 Polyclinic University A. Gemelli- Catholic University, Radiation Oncology Area- Gemelli-ART- Catholic University of the Sacred Heart- Rome- Italy., Rome, Italy 2 Institute of Radiology- Agostino Gemelli Hospital- Rome- Italy., Diagnostic Area- Catholic University of the Sacred Heart, Roma, Italy 3 Institute of Obstetrics/Gynecology- Catholic University- Rome- Rome- Italy., Gynecologic Oncology Unit- Fondazione "Policlinico Universitario A. Gemelli", Rome, Italy Purpose or Objective To analyze the efficacy of neoadjuvant chemotherapy followed by radiochemotherapy and surgery in locally advanced cervical cancer. Material and Methods A phase II, prospective, non-randomized trial was conducted in our institution. Locally advanced cervical cancer patients (Ib2-IVa) were treated with neoadjuvant paclitaxel 80 mg/mq and carboplatinum area under the curve 2.0 D1-D8-D15, for 2 cycles. Then, they received intensity-modulated extended-field chemoradiation plus simultaneous integrated boost (SIB- IMRT): a dose of 39.6 Gy, 1.8 Gy/fraction, was delivered to the pelvis plus a radiation dose to the primary tumor delivered with SIB-IMRT strategy for a total of 50.6 Gy, 2.3 Gy/fraction in 25 fractions. Cisplatin based chemotherapy was delivered associated to radiotherapy. Radical hysterectomy plus pelvic with or without aortic lymphadenectomy was performed within 6 to 8 weeks from CRT. Response rate (RR) and toxicity were the primary endpoints. Overall survival (OS) and Disease Free Survival (DFS) were secondary endpoints. Results Fouty-five patients were enrolled. Median age was 46 years old (range: 30-74 years of age). Twenty-five patients (55%) were FIGO stage IIB, whereas 9 cases (20%) had stage IB2/IIA disease, 9 (20%) and 2 (5%) cases had stage III and IVA, respectively. At staging workup, pelvic lymph node involvement was documented in 38 patients (84.4%). Clinical complete and partial response to treatment were documented in 18 (45%) and 22 (55%) patients, respectively. The treatment was well tolerated. Grade 3 leukopenia and neutropenia were reported in 6 patients (14.6%). Gastrointestinal toxicity was grade 1 or 2; only 1 patient had GI inferior tract grade 3 toxicity. The 2-year DFS and OS in the whole series were 68.0 % and 83.0%, respectively Conclusion In our phase II trial, in the patients with a high risk of extrapelvic relapse the addition of neoadjuvant chemotherapy to chemoradiation therapy followed by surgery achieved a good survival and was feasible with an acceptable rate and profile of toxicity. EP-1524 Synchronous cancers in PET-CT in cervical cancer patients treated with radiochemotherapy. M. Płachta 1 , W. Cholewiński 2 , E. Burchardt 1 , P. Cegła 2 , B. Urbański 1 , Z. Wareńczak-Florczak 1 , A. Roszak 1 1 Greater Poland Cancer Centre, Radiotherapy and Gynecologic Oncology Department, Poznan, Poland 2 Greater Poland Cancer Centre, Department of Nuclear Medicine, Poznan, Poland