ESTRO 2020 Abstract Book

S597 ESTRO 2020

combination, whereas radiotherapy is mainly used as adjuvant therapy. However, as shown with this experience, in particular conditions as in elderly women, HDR-BT can represent an interesting alternative treatment that produces local tumor control and low morbidity. PO-1131 Adjuvant Concurrent Chemoradiation and Chemotherapy for High Risk Non-Metastatic Endometrial Cancer R. Rajan 1 , D.B. Kunheri 2 , D.T. Tatineni 2 1 Amrita Institute of Medical Sciences, Department of Radiation Oncology, Kochi, India ; 2 Amrita Institute of Medical Sciences, Department of Radiation Oncology, Kochin, India Although women with endometrial cancer generally have a favourable prognosis, those with high-risk disease features are at increased risk of recurrence. The PORTEC- 3 trial was initiated to investigate the benefit of concurrent chemoradiation therapy followed by adjuvant chemotherapy for women with high-risk endometrial cancer, and found to be well tolerated and beneficial in stage III endometriod and serous histology irrespective of the stage .We have initiated a study to evaluate the tolerance and toxicity of the treatment in our patients belonging to the Asian Subset . Aim: To assess the toxicity and tolerance of adjuvant concurrent chemoradiation followed by chemotherapy for high risk non metastatic endometrial cancer (HREC) Secondary endpoints are failure free survival and overall survival. Material and Methods 25 patients were enrolled into the study so far , and 20 patients who had completed the entire course of treatment were analyzed for the acute toxicities and tolerance during CTRT and adjuvant chemotherapy from December 2016 to August 2019 . The patients were treated with radiotherapy to a dose between 45 to 48.6Gy in 1.8Gy/fraction over 25 to 28 days, 5 days per week. Chemotherapy during radiation was two cycles of cisplatin 50mg/m2 (week 1 and week 5), followed by 4 cycles of adjuvant chemotherapy – carboplatin AUC 5 & paclitaxel 175mg/m2 . The primary endpoint being Toxicity analysis. Results This is an interim analysis for acute toxicity and tolerance to CTRT and adjuvant chemotherapy. The median age of our patients was 62yrs range (47 to 74 years). Acute Toxicity analysis showed that all the patients developed grade 1 & 2 toxicity during various stages of concurrent chemoradiation and adjuvant chemotherapy. During CTRT the major haematological toxicity was grade II Anemia (81%).Grade I Vomiting was seen in all patients undergoing CTRT and only very few patients had grade III vomiting(<5%). It was noted that 18(90%) of the patients developed grade 1 & 2 Gastrointestinal toxicity during CTRT.The most common complaint was diarrhoea . The toxicities of CTRT resolved after completion of treatment without any persistence of acute side effects thereafter. During adjuvant chemotherapy , grade II neutropenia(69.6%) was a significant haematological toxicity observed. Treatment limiting peripheral neuropathy was seen in 2 patients ,and hence could not take 4 th cycle of adjuvant chemotherapy.All other patients completed the proposed treatment. Conclusion Tolerance to CTRT and adjuvant chemotherapy in our subset of patients has been good and none of the patients had unforeseen treatment breaks due to toxicity during CTRT. Purpose or Objective Background:

This is concordant with the results of PORTEC III data of acute toxicity analysis. Long term follow up is required to assess the chronic toxicity and survival. PO-1132 Magnetic resonance imaging (mri) based image-guided adaptive brachytherapy in cervical cancer. M.F. Ropero Carmona 1 , J. Quirós Rivero 1 , J.L. Muñoz Garcia 1 , J. Cabrera Rodriguez 1 , Y. Ríos Kavadoy 1 , V. Vera Barragán 1 , P. Simón silva 1 , B. Ortiz Sierra 1 , B. Baños Pérez 1 , C. Corral Fernandez 1 1 Complejo Hospitalario Universitario Badajoz, Oncologia Radioterápica, Badajoz, Spain Purpose or Objective To report our experience in patients with cervical cancer treated with External Beam Radiotherapy (EBRT) and High- Dose-Rate Intracavitary Brachytherapy (HDR-BT) MRI based IGABT (Image Guided Adaptive Brachytherapy). The standard treatment for locally advanced cervical cancer is currently radio-chemotherapy consisting of EBRT plus concomitant chemotherapy with Cisplatin weekly and intracavitary BT. GEC ESTRO recommends the use image-based brachytherapy and Retro-EMBRACE and EMBRACE, which will establish MRI-guided brachytherapy as a gold standard. Material and Methods From October 2015 to May 2019 forty four patients with cervical cancerstages I-IV, underwent definitive treatment. Patients were subjected to MRI based brachytherapy post EBRT using GEC ESTRO working group guidelines. Median age was 55 years (29-80). Histology was squamous cell carcinoma 66% and adenocarcinoma 34%. The clinical stage was: IB2 7%, II 57%, III 27%, IV A 2%, IVB 7%. The median tumor size 45 mm (7-70).All patients received EBRT plus intracavitary brachytherapy whit UTRECHT applicator, except a patient who treated with DOME applicator by the impossibility cervical dilation. Median dose EBRT 50.4 (45- 60), median dose BT 28 (19.5-28), median dose EQD2 total (α/β=10) (EBRT+BT) was 88 Gy (76-96), median dose HR-CVTD90 (α/β=10) 90.5 Gy ( 70-114) and IR-CVTD90 68Gy (56-80). The median dose organs at risk (OAR) D2cc EQD2 (α/β=3): bladder 74Gy (50-91), rectum 65Gy (48-77) and sigma 63 Gy. The overall treatment time was ≥8 weeks in 98% of the patients with a median overall treatment time of 82 days (55-129). Toxicity were evaluated by CTCAE v4.0. Local Control (LC), Disease Free Survival (DFS) and Overall Survival (OS) were estimated using the Kaplan-Meier method. All statistical analyses were performed using IBM SPSS Statistics version 21.0. Results Complete response confirmed by MRI in 82% of the patients. With a median follow-up of 28 months local control was 95.5%, 75 % patients didn't have a relapse. The first relapse was Local recurrence 2%, Pelvic recurrence 2%, Local and regional recurrence 4.5% and distant metastasis 16%. The 3-year LC, DFS and OS rates were 97%, 72% and 88% respectively and the 3-year LC rates by stages rates was I- IIB 100%, III 91%, DFS was 67% in IB, 100% IIA, 83% IIB, 74% III and IV 67%; and OS by stages rates was I- IIB 100%, III 74%, IV 66%. Prevalence rates of acute toxicity intestinal were G1 16%; rectal acute toxicity was G1 20%, G2 7%, G3 2% (1 patient) and bladder acute toxicity was G1 11%. Prevalence rates of chronic toxicity intestinal were G1 2%, bladder chronic toxicity G1