ESTRO 2020 Abstract book

S647 ESTRO 2020

external radiotherapy and 3D-VB (2x5.5Gy). The effects of pathologic stage and grading on loco-regional relapse (LRR), metastases, and tumor-related death were investigated. EORTC QLQ-C30 and QLQ-EN24 questionnaires were used to evaluate vaginal toxicity and QoL. Statistical analysis: Kaplan-Meier method, Logrank test and Chi-square test. Results After median follow-up of 49 months (7-93), 5-year disease-free survival (DFS), local relapse-free survival (LRFS) and pelvic relapse-free survival (PRFS) 80%, 100% and 91.2%, respectively. PRFS was lower in grade 3 tumors compared to grade 1-2 (83% vs 95%, p=NS). No patients had G3-4 toxicity. Vaginal chronic toxicity (Grade 1-2) was seen in 44% of patients. Patients reported excellent QoL in the C30 questionnaire which showed functional scores above 70% and symptoms scores below 30%. The global health status and QoL scale was 75%, which should be considered as “good” or “very good”. In the EN24 questionnaire the worse scores were sexual enjoyment and pain problems (MS 0% and 40%, respectively). Conclusion In this series 3D adyuvant VB in EC-I achieved good local control rates with good results in QoL. PO-1139 Intrathecal dexmedetomidine vs fentanyl for intracavitary brachytherapy analgesia in cancer cervix. M. Gupta 1 , R. Chawla 1 , S. Mitra 2 1 rajiv gandhi cancer institute and research centre, department of anaesthesiology, delhi, India ; 2 rajiv gandhi cancer institute and research centre, department of radiation oncology, delhi, India Purpose or Objective Intracavitary brachytherapy for cancer cervix is a day care procedure of 6-8 hours. Most patients experience discomfort and pain during brachytherapy resulting in improper applicator placement, inadequate dose distribution, adverse effects on local control, and/or an increased risk of morbidities. Anaesthesia (general or regional) reduces pain during brachytherapy and provides the ideal condition for the procedure. The present study compared the efficacy of perioperative pain relief of intrathecal dexmedetomidine (selective α-2 adrenoreceptor agonist) and intrathecal fentanyl (synthetic opioid agonist) when used as adjuvants to bupivacaine in the spinal anaesthesia in patients of cervical cancer for intracavitary brachytherapy. The primary objective was to compare the perioperative analgesia and duration of pain relief [time interval between the time of subarachnoid block and first rescue analgesia (VAS for pain > 3)]. Secondary objectives were the onset of sensory block, maximum sensory. block achieved, Time to reach maximum sensory block, haemodynamic variability, regression characteristics, sedation characteristics, and side effects. Material and Methods In this prospective, randomized, 3 arms, cross-over, comparative trial, 30 patients (ASA grade I-II patients aged 18-75 years with BMI <30 Kg/m2) of cervical cancer scheduled for Intracavitary brachytherapy/ Intracavitary radiation therapy under spinal anaesthesia were randomly allocated to three groups, either receiving 9mg hyperbaric bupivacaine, or 9mg hyperbaric bupivacaine plus 10μg dexmedetomidine, or 9mg hyperbaric bupivacaine plus 25 μg fentanyl. Results The results of the study revealed that the duration of perioperative pain relief with intrathecal dexmedetomidine was much more (322.67 ± 41.25 minutes) than intrathecal fentanyl (202.33 ± 21.04 minutes) or plain bupivacaine (133.33 ± 19.31 minutes). The mean onset time of sensory block (T10 level) for the dexmedetomidine group (4.2 ± 1.10 minutes) was much less than the fentanyl group (5.6 ± 1.43 minutes). It was

PO-1137 Preoperative18FDG PETCT SUV correlation to CD8+ CD4+FOXP3+TLymphocytes in Cervical Cancer Milieu H.A. Zagloul 1 1 Clinical Oncology Department Alexanderia University Egypt, Clinical Oncology Department Alexandria Egypt, alexandria, Egypt Purpose or Objective Purpose: To scrutinize on the competence of preoperative18F-FDG (PET/CT) Maximum Standardized Uptake Value (SUV Max ) of cervical cancer primaries and immune-modulating T lymphocytes (CD8 + , CD4 + , FOXP3 + ) within tumor milieu in forecasting the outcome following Methods: The preoperative PET-CT SUV max and intensities of CD8 + ,CD4 + ,FOXP3 + T lymphocytes permeating the tumor milieu in radical hysterectomies were interrelated with emphasis on their influence on clinical- pathological characteristics. Additionally, their aptitude in survival outcome predilections was explored using Log rank and Cox regression Results Results: We evaluated 35 patients had who radical hysterectomies. Reduced median levels of primary tumor SUV Max were substantially interrelated with limited intensities of FOXP3 + and accentuated CD8 + /CD4 + ratio (OR 2.3 , 95% CI 1.6-6.1 , OR 2.2, 95%CI 1.5- 7.5),respectively. The decreased primary cervical SUV alongside the enhanced intensities of CD8 + , CD8 + /CD4 + and limited FOXP3 + cells permeating tumor milieu were attributed to node negativity, early stage, absence of lympho-vascular incursion and adjuvant radiation. The multivariate regression revealed that the enhanced primary SUV Max along with nodal dissemination were independently correlated with dismal outcomes with hazard ratio (HR 2.86 (95% confidence interval [CI], 2.35- 6.34), 3.23 (95% CI, 2.24-6.22) for overall survival(OS) and (HR 5.21 (95% CI, 3.21-12.23) and 4.32 (95% CI, 2.83-9.42) for disease free survival (DFS),respectively . Additionally , FOXP3 + ≥ 19 and CD8 + /CD4 + < 2 were considerably attributed to worsened OS (HR 3.82 ( 95% CI ,2.98-10.27) , 2.56 (95%CI ,2.38-7.42) and abysmal DFS (HR 2.91 ( 95% CI ,2.58-7.42) , 3.52(95%CI ,3.73- 8.52),respectively . Conclusion Conclusion: The preoperative PET-CT SUV max, CD8 + , FOXP3 + and C8/CD4 + T-lymphocytes permeating tumor milieu were substantial interrelated and linked to different clinical-pathological factors in surgically treated cervical cancer patients. Additionally, they may be considered as competent authorized forecasters of clinical outcomes. PO-1138 Quality of life in vaginal brachytherapy for endometrial carcinoma IN THE ELDERLY. R. Rubiato Aragon 1 , S. Cordoba 2 , M. Gaztañaga 2 , M.G. Vázquez 2 , G. Marquina 2 , U.A. Corro 1 , J. Romero 1 , J. Velasco 1 1 Hospital Universitario Puerta de Hierro, Oncology Radiotherapy, Majadahonda - Madrid, Spain ; 2 Hospital Universitario Clinico San Carlos, Oncology Radiotherapy, Madrid, Spain Purpose or Objective To evaluate clinical outcomes and quality of life (QoL) of patients receiving adjuvant vaginal brachytherapy (VB) for stage I endometrial carcinoma (EC-I) in the elderly. Material and Methods Between 2011-2016, 32p with pathological EC-I were treated by VB in our department. Mean age: 79y(74- 91). Stage/grade: IA/G1-2:7p; IA/G3:4p; IB/G1-2:16p; IBG3:5p. Twenty patients were treated with 3D-VB to a total dose of 21Gy at 5mm depth from applicator surface, in 3 weekly fractions (3x7Gy), and 11p were treated with radical hysterectomy. Material and Methods