ESTRO 2021 Abstract Book

S1056

ESTRO 2021

constraint. At present, we are performing a longer follow-up in a larger number of patients to confirm our results.

PO-1280 Albumin-to-alkaline phosphatase ratio is not a predictor of survival in cervical cancer patients C. Onal 1 , M. Gultekin 2 , G. Yavas 3 , E. Oymak 4 , S. Yuce Sari 2 , O.C. Guler 1 , E. Yigit 2 , F. Yildiz 2 1 Baskent University Faculty of Medicine, Department of Radiation Oncology, Adana, Turkey; 2 Hacettepe University Faculty of Medicine, Department of Radiation Oncology, Ankara, Turkey; 3 Baskent University Faculty of Medicine, Department of Radiaiton Oncology, Ankara, Turkey; 4 Iskenderun Gelisim Hospital, Division of Radiation Oncology, Hatay, Turkey Purpose or Objective The albumin-to-alkaline phosphatase ratio (AAPR), which was proposed as an indicator for assessing the nutritional status and immune response, was recently found to be a prognostic predictor for different cancer types. However, its value in cervical cancer has not yet been determined. We analyzed the prognostic significance of serum albumin, alkaline phosphatase (ALP), and AAPR and other prognostic factors affecting the overall survival (OS) and progression-free survival (PFS) in cervical cancer patients treated with definitive chemoradiotherapy (CRT). Materials and Methods The clinical data of 200 patients that were treated with definitive CRT was retrospectively analyzed. The inclusion criteria were cervical cancer patients treated for curative intent who were receiving concurrent CRT and intracavitary BRT. Patients with diseases that could affect the albumin or ALP levels, such as liver or bone disease, patients with distant metastasis or other malignancies, and patients who were undergoing a hysterectomy were excluded. The prognostic factors for OS and DFS, in addition to the predictive factors of albumin, ALP, and AAPR, were investigated according to cut-off values determined by receiver operating curve analyses. Results At a median follow-up time of 48.2 months (range, 3.7–171.8 months), the 5-year OS and PFS rates were 57.9% and 53%, respectively. Median pretreatment serum albumin level, ALP level, and AAPR were 4.03 g/dL (range, 2.38–4.93 g/dL), 76.5 U/L (range, 39.0–424.0 U/L), and 0.52 (range, 0.10–1.14), respectively. The optimal cut off points were 4.03 g/dL for albumin with area under the curve (AUC) of 0.606 [95% confidence interval (CI), 0.535–0.674; p = 0.008], 74 U/L for ALP with AUC of 0.656 (95% CI, 0.585–0.721, p < 0.001), and 0.51 for AAPR with AUC of 0.674 (95% CI, 0.604–0.738; p < 0.001). In univariate analysis, age, tumor size, stage, lymph node metastasis, serum albumin, ALP levels, and AAPR were significant prognostic factors for OS and PFS. An older age, lymph node metastasis, non-complete response (CR) to treatment, and low serum albumin levels emerged as predictors of poor OS and PFS in multivariate analysis. There were no significant differences in clinicopathological factors between patients with low and high AAPR, except for lymph node metastasis, where lymph node metastasis rate was significantly higher in patients with a low AAPR compared to those with a high AAPR. Patients with CR to definitive CRT had a significantly higher serum albumin level and AAPR compared to patients without CR. Conclusion We did not find that a low AAPR was predictive of poor survival in cervical cancer patients that were given definitive CRT. The pretreatment serum albumin level proved to be independently predictive of survival; therefore, it could be a suitable biomarker to guide systemic therapy and predict patient outcomes. PO-1281 The prognostic significance of the albumin and globulin levels in cervical cancer patients C. Onal 1 , E. Oymak 2 , O.C. Guler 1 1 Baskent University Faculty of Medicine, Department of Radiation Oncology, Adana, Turkey; 2 Iskenderun Gelisim Hospital, Division of Radiation Oncology, Hatay, Turkey Purpose or Objective Albumin and globulin are the two major serum proteins involved in the systemic inflammatory process. Retrospective studies demonstrated that using a combination of albumin and globulin (i.e., the albumin- globulin ratio [AGR] and albumin-globulin score [AGS]) was an effective predictor of survival in a variety of cancers. However, there has been little research on the prognostic value of the AGR and AGS in cervical cancer. The aim of this study was to evaluate whether pretreatment albumin and globulin levels and the AGR and AGS can be used to predict treatment outcomes in cervical cancer patients treated with definitive chemoradiotherapy (CRT). Materials and Methods Clinical data on 140 cervical cancer patients treated with definitive CRT for histologically proven cervical cancer were retrospectively analyzed . The AGR was measured by dividing the serum albumin level by the serum globulin level. An AGS of 2 was defined as a low serum albumin level and high serum globulin level, and an AGS of 1 was defined as either a low serum albumin or a high serum gloublin level. An AGS of 0 denoted normal serum albumin and globulin levels. Results In most cases, the tumors were squamous cell carcinomas (SCC), and the disease stage was advanced (≥ IIB). Lymph node metastasis was observed in 79 (58.5%) patients. The optimal cut-off points were 4.02 g/dL for albumin, with an area under the curve (AUC) of 0.629 (95% CI, 0.544–0.709; P = 0.006), 3.07 g/dL for globulin, with an AUC of 0.657 (95% CI, 0.572–0.735, P = 0.001), and 1.31 for AGR, with an AUC of 0.678 (95% CI, 0.594– 0.754; P < 0.001). At a median follow-up time of 78.5 months (range, 0.7–171.8 months), the 5-y OS and PFS rates were 55.0% and 49.1%, respectively. In the univariate analysis, serum albumin and globulin levels and the AGR and AGS were significantly predictive of OS, as were the patient’s age, FIGO stage, tumor size, lymph node metastasis, and treatment. Similarly, serum albumin and globulin levels, AGRs and AGSs, age, tumor size, FIGO stage, lymph node metastasis, and treatment response were significant predictors of PFS. In the