ESTRO 2020 Abstract book

S642 ESTRO 2020

transposition. The pathology was squamous cell carcinoma in 44 patients, adenocarcinoma in 11 patients and other pathology in 7 patients. Thirty-four patients had high-risk prognostic factors: parametrial invasion in 15 patients, positive pelvic lymph nodes in 28 patients and positive surgical margins at the virginal cuff in 2 patients. Twenty- seven patients had only intermediate-risk factors. The prescribed radiation doses were 50 Gy in 25 fractions for 58 patients and 50.4 Gy in 28 fractions for 4 patients. Only one patient received a virginal cuff boost using intracavitary brachytherapy with 12 Gy in 2 fractions. Chemotherapy (typically weekly cisplatin at 40 mg/m2) were administered in 36 patients. The median follow-up period was 50.9 months and one patient died of primary disease. There was no loco- regional failure. Six patients in the high-risk group relapsed, but none of the patients in the intermediate-risk group relapsed (p=0.02). The 3-year OS and RFS rates were 98.2% and 90.9%, respectively, and the 5-year OS and RFS rates were 98.2% and 87.7%, respectively. Prognostic factors of RFS were squamous cell carcinoma pathology (HR: 0.080, p=0.02), multiple pelvic lymph node metastases (HR: 14.8, p=0.02) and positive surgical margin (HR: 230, p<0.01). Grade 3 or more toxicity occurred in 6 patients. Four patients had obstruction of the intestine and 2 patients had stenosis of the urinary tract. Ovarian function was maintained in 8 of 19 patients who received ovarian transposition. Conclusion In clinical practice, pelvic radiotherapy for postoperative uterine cervical cancer using the VMAT technique showed perfect loco-regional control and a good RFS rate with a relatively low rate of severe toxicity. The maintenance of ovarian function needs further investigation. PO-1127 Acute and late toxicity report of post- operative IG-IMRT for gynecological malignancies M. La Vecchia 1 , F. Cuccia 1 , G. Ferrera 2 , G. Mortellaro 2 , D. Cespuglio 2 , L. Ognibene 3 , G. De Gregorio 1 , N. Luca 1 , G. Trapani 1 , E. Quartuccio 1 , A. Gioia 1 , A. Palmeri 1 , G. Terranova 1 , G. Napoli 1 , A. Sanfratello 1 , C. Lotà 1 , M. Torchia 1 , V. Venuti 1 , V. Valenti 1 , A. Tripoli 1 , G. Evangelista 2 , A. Lo Casto 4 1 University of Palermo, Radiation Oncology School, Palermo, Italy ; 2 ARNAS Civico Hospital, Radiation Oncology Unit, Palermo, Italy ; 3 San Gaetano Radiotherapy and Nuclear Medicine Center, Radiotherapy Unit, Bagheria- Palermo, Italy ; 4 University of Palermo, Radiation Oncology School- Section of Radiology - Di.Bi.Med., Palermo, Italy Purpose or Objective To retrospectively investigate acute and late toxicity of post-operative image-guided/intensity modulated radiotherapy (IG-IMRT) for the treatment of endometrial From April 2014 to May 2019 63 patients were treated with post-operative IMRT for gynecological neoplasms. 44 had endometrial carcinoma (EC), with the following FIGO Staging: IB in 20, II in7, IIIC in 14, 21 patients had cervical cancer (CC); according to FIGO staging they were: IB2 in 9 cases, IIB in 6, IIIC in 6 cases. The most frequent histological subtypes were for EC: adenocarcinoma in 42, serous cells carcinoma in 1 and carcinosarcoma in 1; for CC squamous cell was detected in 13, while adenocarcinoma in 8. A median total dose of 50 Gy (range, 45-50.4 Gy) was delivered with IG-IMRT (VMAT or Helical Tomotherapy), including the para-aortic field in 6 patients (respectively 3 EC and 3 CC). Platinum-based chemotherapy was sequentially administered in 15 EC cases, and concurrently in 18 CC patients. Acute and late toxicity was assessed using CTCAE v4.0, time-to-event data was analysed using Kaplan-Meier and log-rank test. and cervical cancer. Material and Methods

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 performed for such cases in almost half of the institutes in Japan because of rare severe toxicities. Therefore, this study was meaningful, although it was a retrospective single institute experience. Material and Methods Consecutive patients who were treated with pelvic radiotherapy using VMAT for postoperative uterine cervical cancer in our institute were enrolled in this study. Patients treated with cervical conization or patients who had already relapsed before radiotherapy were not regarded as patients in a postoperative setting. Time to an event was calculated from the day of surgery. Relapse-free survival (RFS) and overall survival (OS) were calculated using the Kaplan–Meier estimator and Cox proportional hazard model was used to evaluate prognostic factors. Results Sixty-two patients were identified. Fifty-eight patients received radical hysterectomy, 4 patients received total hysterectomy and 19 patients received ovarian