ESTRO 2020 Abstract book

S644 ESTRO 2020

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. 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

Conclusion An individualized approach can cover the target volume using a smaller PTV without increasing the overlapping bowel bag volume. We recommend an ITV margin of 10 mm for this individual approach. PO-1130 High-Dose-Rate Brachytherapy for primary vaginal melanoma treatment: a case report B. Pappalardi 1 , C.T. Delle Curti 2 , F. Piccolo 1 , C. Tenconi 3 , T. Giandini 3 , M. Carrara 3 , A. Cerrotta 1 1 Fondazione IRCCS Istituto Nazionale dei Tumori, Radiotherapy 2, Milan, Italy ; 2 University Milano-Bicocca, Radiotherapy, Milan, Italy ; 3 Fondazione IRCCS Istituto Nazionale dei Tumori, Medical physics, Milan, Italy Purpose or Objective Malignant melanoma of the vagina is a rare, aggressive malignancy with poor prognosis. The incidence is higher in post-menopausal women, ranging between 2.08/100,000 for 60- to 69-year-old women and 4.43/100,000 for 80- to 89-year-old women. We present a clinical case report of primary malignant vaginal melanoma in a 90 years old woman successfully treated with High-Dose-Rate Brachytherapy (HDR-BT). Material and Methods A 90-year-old woman referred post-menopausal vaginal bleeding. On gynecological examination, two raised lesions, were seen on the right third-inferior of vaginal wall, each one easily bleeding on contact; melanosis of right vaginal fornix was also observed. The lesions were biopsied and diagnosed as vaginal melanoma with a maximum tumor thickness of 3 mm. Staging by PET/CT did not show lymphadenopathy nor distant metastases. Considering the age and the anaesthesiological risk, patient was not suitable for surgery and has been candidate for HDR-BT. A vaginal multichannel applicator was used and treatment planning was performed on CT images acquired for each treatment fraction. The prescription dose was 25 Gy in 5 fractions to whole vagina, followed by a boost of 10 Gy in 2 fractions to the third- inferior of vaginal wall. The treatment was delivered at our Institution with an HDR remote after loading device provided with an Iridium-192 source. Results Patient completed the treatment with no interruptions. After the second treatment fraction (10 Gy) we clinically observed a dimensional reduction of the two lesions. After five fractions there was no bleeding. At the end of treatment, G1 vaginal sub-stenosis and dysuria were the main adverse effects. 18 months after the end of treatment, the patient has a local absence of disease. Conclusion The current treatment approach for primary vaginal melanoma includes wide local excision (WLE), radical surgery, chemotherapy and immunotherapy, alone or in 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

Purpose or Objective Background:

Although women with endometrial cancer generally have a favourable prognosis, those with high-risk disease features are at increased risk of recurrence. The PORTEC-