ESTRO 2020 Abstract Book

S594 ESTRO 2020

1 Ospedale Mariano Santo, U.O. Radioterapia, Cosenza, Italy Purpose or Objective Patients after pelvic RT have DS. Normally, self-tests are performed by the patient at home, with a response rate of 43-68%. In the PORTEC-2 (500 pts.) the rate is 65% after RT, for sexually active it rises to 81%. There is difficulty in facing such an intimate topic. The objective of the study: a psychological approach to overcome these limits in patients with and without pharmaceutical supportive therapy. Also evaluating how the correct therapy and information improve the quality of life. Material and Methods Based on the tests already used, the psychologist created ten questions to be included in an individual interview with the patient to assess the quality of life and the impact on sexual activity after brachytherapy (BRT). Some with answers of choice multiple (intended as a change of emotions: nothing, a little, very, very much) other direct answers (yes or no). Results 2 groups of CBRT and Subrt patients (control therapy vs. supportive therapy). Areas have been defined: 1) social relationships and personal emotions, 2) intimacy and sexuality of a couple, 3) impact of treatment on sexuality, 4) doctor-patient relationship before the BRT. We have compared the questions. Results 199 pts. in 7 years; median follow-up of 44 months (range 8-93). Psychological evaluation performed 142 pts. (61 years, range 44-71) remaining 57 not interested because they are not sexually active. Two groups: 69 CBRT vs 73 pts. Subrt. The change in social activity recorded as "very, very much" 33% CBRT vs 22% SuBRT, and in the emotional state 42% CBRT vs 29% SuBRT. Couple intimacy 71 vs 49% declared a change; with repercussions on the intimacy of 49 vs 32%, moreover 81 vs 48% reported a reduction in sexual desire (CBRT vs Subrt). Impact on sexuality: has the BRT changed your sex life? 46 vs 21% "very, very much". With painful sexual intercourse for 73 vs. 48% of respondents. "Are sexual relations satisfactory?" 91 vs 60% of respondents answered "NO" (CBRT vs Subrt). We asked "Have you been informed that the BRT could have an impact on sexuality?" 58 vs. 80% of pts. answered "YES" and to the question "Did they advise you to have sex with your partner?" 71% against 81 of women received these indications (CBRT vs Subrt). Unexpectedly, 13 CBRT vs 1% SuBRT required psychological support. 71% of the women interviewed answered the questions, 100% of sexually active women. The introduction of supportive therapy during treatment allowed a 30% improvement vs. the control group. Conclusion A dedicated psychologist is better than a self-assessment test. The psychological approach has allowed us to understand how much suffering exists despite the recovery and above all it has allowed us to detect those patients who needed help. The introduction of supportive therapy during treatment allowed a 30% improvement vs. the control group. A better doctor-patient relationship reduces the impact on quality of life. PO-1126 Clinical experience of pelvic radiotherapy for postoperative uterine cervical cancer using VMAT T. Yamamoto 1 , R. Umezawa 1 , M. Kubozono 1 , H. Tokunaga 2 , H. Matsushita 1 , Y. Ishikawa 1 , Y. Katagiri 1 , K. Takeda 1 , S. Tasaka 1 , Y. Suzuki 1 , N. Yaegashi 2 , K. Jingu 1 1 Tohoku University Hospital, Radiation Oncology, Sendai, Japan ; 2 Tohoku University Hospital, Obstetrics and Gynecology, Sendai, Japan Purpose or Objective The purpose of this study was to reveal treatment outcomes and toxicities after pelvic radiotherapy or chemoradiotherapy for postoperative uterine cervical cancer using the VMAT technique. Radiotherapy is not

complications. A comprehensive approach is needed for those reporting the severest symptoms to rapidly avert complications, and to support those who suffer the harrowing effects once they have developed it. PO-1124 Impact of lymph node dissection on adjuvant radiotherapy in endometrial cancer. E. Doyle 1 , L. Akyol 1 , M. Zahra 1 1 Edinburgh Cancer Centre- Western General Hospital, Oncology, Edinburgh, United Kingdom Purpose or Objective Pelvic lymph node dissection has not been shown to improve survival in endometrial cancer, but knowledge of the nodal status can help in tailoring adjuvant radiotherapy with the aim of trying to minimize the toxicity associated with EBRT in patients who might be suitable to be treated with vaginal vault brachytherapy. The likelihood of lymph node metastases can be estimated from histological subtype, grading, presence of lymphovascular invasion and myometrial invasion. Following the establishment of routine pelvic nodal dissections for patients with endometrial cancer fulfilling the risk criteria, a retrospective audit was performed to assess the impact on the cohort treated in the first two years following the change in practice. Material and Methods Based on the biopsy findings and the pre-operative staging MRI, patients are considered for nodal dissections if the tumour is >2cm or there is evidence of deep myometrial invasion, or if the tumour is a grade 2 or 3 or non- endometroid histology. Data was obtained from online hospital records for the first cohort of patients treated between April 2016 and April 2018. Results A total of 179 patients were included with a median age of 70 (range 41-93) and 78% had a diagnosis of endometroid adenocarcinoma. 97 patients underwent nodal dissection, of which only 8 had nodal metastases and all these had suspicious nodes on pre-operative imaging. Due to suspicious nodes on the staging scans, six patients had para-aortic LN sampling and three were found to have metastases. The subgroups in whom nodal status can reduce the need for EBRT are FIGO IA and IB grade 1or 2 and LVI +ve, and also FIGO II grade 1 or 2 and LVI –ve. There were a total of 26 patients in these categories but only 14 of these patients (54%) underwent pelvic nodal dissection and all had no nodal metastases and were treated with vaginal brachytherapy. The remaining 12 patients did not have nodal dissections due to high BMI (3), co-morbidities (3), depth of myometrial invasion under staged on MRI (3), pre- operative MRI not done (1) and undocumented reasons (2). Of note with the criteria for nodal dissection used, 27% of patients with Figo 1A,Grade 1 LVI –ve (low risk) disease had pelvic lymph node dissection, mainly due tumour size of >2cm on MRI. All nodal dissections in this cohort were negative. Conclusion Nodal dissections have the potential to significantly reduce the need for EBRT in this patient cohort by up to 14.5% with a subsequent reduction in EBRT related toxicities. Unfortunately a major barrier to nodal dissection appears to be the patients’ elevated BMI and other associated co- morbidities that can make nodal dissection more hazardous. Possibly a more systematic pre-operative assessment and referral to a centre with experience in dealing with bariatric patients could increase the number of nodal dissections safely. PO-1125 Qol records filled by patient or psychologist? Ns. experience in sexual dysfunction (DS) after RT. F. Piro 1 , D. Cosentino 1 , A. Massenzo 1 , A. Martilotta 1 , U. Piro 1 , L. Marafioti 1