ESTRO 2021 Abstract Book

S1072

ESTRO 2021

detected and grade 1-2 nephrotoxicity rate was 22%. Grade ≥ 3 acute hepatotoxicity was reported for 2 (1%) patients. Hypocalsemia insidence was increased in diabetic patients (p=0.027; [OR], 5.607 ;95% CI: 1.324 to 23.738). Elderly patients (≥65 years) had increased risk of hyponatremia (p=0.043; [OR], 2.655 ;95% CI: 1.022 to 6.895) and nephrotoxicity (p=0.001; [OR], 3.387 ;95% CI: 1.164 to 6.998),however no association was found between age and the risk of hematotoxicity and hepatotoxicity. Conclusion Leucopenia and hypomagnesemia were the most common acute hematological and metabolical side effects during the treatment of CRT for inoperabl cervical cancer. Patients with initial low hemoglobin levels should be carefully monitored for development of neutropenic fever and grade 3-4 hematotoxicity, moreover prophylactic granulocyte colony stimulating factor administration may be useful for this subgroup of patient to avoid treatment breaks due to hematotoxicity. Physicians should be aware of increased risk of acute hyponatremia and nephrotoxicity for elderly patients. PO-1305 Radiation Therapy for Stage IVB Uterine Cervical Cancer with Supraclavicular Lymph Nodes Metastases Y. Mukai 1 1 Yokohama City University Graduate School of Medicine, Radiation Oncology, Yokohama, Japan Purpose or Objective Radiation therapy (RT) has an important role in treating uterine cervical cancer (UCC), especially when at an advanced stage without distant metastases. However, for cases with distant metastases, RT of para-aortic lymph nodes (PALNs) has an impact on survival and has been strongly recommended. In the latest International Federation of Gynecology and Obstetrics (FIGO) Cancer Report 2018, patients with PALN metastases are categorized as stage IIIC2 (previously, they were categorized as stage IVB in the FIGO Cancer Report 2008). The pattern of lymphatic metastatic spread has been demonstrated to be stepwise, from the pelvic LNs to the PALNs, left supraclavicular LNs (SCLNs), and finally the mediastinal LNs. The aim of this study was to determine the role of radiation therapy (RT) for patients with distant lymph node (LN) metastases, without organ metastases, from stage IVB uterine cervical cancer (UCC ). Materials and Methods Between 2004 and 2018, 26 consecutive UCC patients with distant LN metastases received RT of the pelvis and distant LN metastases. The distant LN metastases overlapped sites, irradiated sites, and mean prescription dose were as follows: supraclavicular LNs (SCLNs, n=19/14/50 Gy), inguinal site (n=9/8/54.9 Gy), axillary site (n=4/1/50 Gy), and other sites (n=3/0/0 Gy). All patients had histopathological diagnosis of UCC and received three-dimensional RT ± high-dose-rate intracavitary brachytherapy (HDR-ICBT). The median total dose of 63 (48.4–72.4) Gy in the 2 Gy per fraction equivalent dose (EQD2) was delivered to primary cervical tumors. Sixteen patients received simultaneous chemotherapy. Results The median follow-up time was 18.5 (4–85) months. The 2-year overall survival (OS), cause-specific survival (CSS), progression-free survival (PFS), and local control of primary tumor (LC) rates were 51.3%, 51.3%, 46.9%, and 67.9%, respectively. Inguinal LN metastases were considered to be controlled by RT in seven of eight patients. All irradiated SCLN metastases were considered to be controlled. In univariate analysis, EQD2 greater than the median value was significantly associated with OS (p=0.037) and LC (p=0.034), and SCLN metastases were significantly associated with OS (p=0.031), CSS (p=0.011), and PFS (p=0.007). In multivariate analysis, performance status (PS)≥1 (p=0.007), para-aortic LN (PALN) metastases (p=0.001), and no HDR-ICBT (p=0.033) were significantly associated with poor OS. PS≥1 (p=0.004), and PALN metastases (p=0.014) were significantly associated with poor CSS. SCLN metastases were also significantly associated with poor survival (OS, p=0.018; CSS, p=0.011; and PFS, p=0.049). Conclusion This study demonstrated favorable local control in patients with stage IVB UCC with distant LN metastases. SCLN metastasis was a prognostic factor for poor survival. PO-1306 apatinib plus capecitabine in patients of recurrent/metastatic and persistent cervical cancer J. Li 1 , W. Mao 1 , F. Li 1 , L. Ran 1 , J. Chang 1 , F. Mei 1 , L. Hu 1 , Y. Du 1 , X. Tian 1 , L. Shan 1 , M. Liu 1 , Y. Chen 1 , J. Mu 1 , Y. Qin 1 , S. Yin 1 , N. Liang 1 1 Affiliated Hospital of Guizhou Medical University, Oncology, Guiyang, China Purpose or Objective Surgery, radiotherapy and chemotherapy are the main treatment methods for cervical cancer. However, there are also some patients with treatment failure, such as residual tumors, recurrence or metastasis within a short period of time after the initial treatment. Apatinib is a targeted drug for a small molecule vascular endothelial growth factor receptor-2 (VEGFR-2) tyrosine kinase inhibitor. We aimed to assess the efficacy and safety of apatinib plus capecitabine in patients with recurrent/metastatic and persistent cervical cancer after radiochemotherapy Materials and Methods This clinical trial was conducted at Guizhou Cancer Hospital in China, which is a phase II, prospective study (ChiCTR1800017291), eligible patients were aged 18–70 years, had an ECOG performance status of 0 or 1, progressed after at least one line of radiochemotherapy for metastatic, recurrent and persistent cervical cancer, and had measurable lesions. Patients received capecitabine 2000mg/m2 divided into morning and evening every day and apatinib 250mg once daily. Treatment continued until disease progression, unacceptable toxicity, and withdrawal of consent. The primary endpoint was the objective response rate (ORR) assessed by RECIST version 1.1 and Progression-free survival(PFS),Disease control rate (DCR), overall survival (OS),1-year survival rate and safety were the second endpoints.