ESTRO 2021 Abstract Book

S1075

ESTRO 2021

A randomized study is needed to confirm toxicity reduction with SIB.

PO-1309 IMRT in vulvar cancer: dismal outcomes from a retrospective single-center analysis. M. Ferioli 1,2 , A.M. Perrone 3 , A. Galuppi 1 , L. Strigari 4 , F. Romani 4 , M. Buwenge 1,2 , A. Arcelli 1,2 , D. Vallerossa 5,2 , S. Bisello 1,2 , M. Boriani 1 , G. Macchia 6 , F. Deodato 6,10 , S. Cilla 7 , D. Pezzulla 6 , V. Panni 8 , P. De Iaco 3,9 , A.G. Morganti 1,2 , S. Cammelli 1,2 1 Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 2 Department of Experimental, Diagnostic and Specialty Medicine – DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy; 3 Division of Oncologic Gynaecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 4 Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 5 Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 6 Radiation Oncology Unit, Gemelli Molise Hospital – Università Cattolica del Sacro Cuore, Campobasso, Italy; 7 Medical Physics Unit, Gemelli Molise Hospital – Università Cattolica del Sacro Cuore, Campobasso, Italy; 8 Department of Oncology and Radiotherapy, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy; 9 Department Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy; 10 Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italy Purpose or Objective Radiotherapy (RT) is a therapeutic option in vulvar cancer (VC) both in advanced tumors and in the adjuvant setting. Intensity Modulated RT (IMRT) enables precisely conformed dose distribution, with high dose to the target and low dose to the organs at risk. We retrospectively analyzed clinical outcomes and toxicity in VC patients treated with IMRT in our center. Materials and Methods Patients who underwent adjuvant or definitive IMRT for VC were included in the analysis. Toxicity, local control (LC), progression free survival (PFS), and overall survival (OS) were evaluated. Results Twenty-nine patients were included in the analysis. Median age was 79 years (range: 45-93). All patients were treated with IMRT. The disease was confined to the vulva/surgical bed in 55.2% of patients, while 44.8% had metastatic pelvic/inguinal lymph nodes. Among included patients, 51.7% (15 patients) were treated for recurrent VC, and three of them had locally recurrent VC plus nodal relapse. Adjuvant RT was delivered in 41.4% patients and definitive RT in 58.6% of them. Including patients who had RT definitive interruption, RT dose to vulva and surgical bed ranged between 39.6 and 65.0 Gy and between 45.0 and 65.0 Gy in the two settings, respectively. RT dose to positive nodes ranged between 32.4 and 66.0 Gy. Prophylactic nodal irradiation was delivered in all patients (median dose 45.0 Gy; range 32.4-50.4). Concurrent chemotherapy was administered only to nine patients (31%), due to age and/or comorbidities. Most patients showed grade 2 (27.6%) or 3 (69.0%) acute skin toxicity. Treatment interruptions due to toxicity were required in nine patients and RT was not completed in 6.9% of patients. Low grade (G1-2) gastro-intestinal and/or genitourinary toxicity affected 11 patients (37.9%). One- and two-year LC was 63.8% and 43.1%, respectively, with better results in the adjuvant setting (two-year LC: 77.8%). Two-year OS was 42.3 and 32.4% in the adjuvant and definitive settings, respectively. Conclusion Despite the use of IMRT, the recorded results are disappointing in terms of high rate of skin toxicity, frequent RT temporary or definitive interruptions, and low LC and OS rates. Advanced age in most patients may explain this finding. Therefore, further optimizations are needed and the possibility of treatment tailoring, especially in older patients, should be considered. PO-1310 Salvage (re)radiation in oligo-recurrent and oligo-metastatic cervical cancer S. Chopra 1 , B. Kalra 2 , J. Mulani 2 , J. Swamidas 3 , J. Jain 1 , L. Gurram 2 , J. Ghosh 4 , S. Rath 4 , S. Gulia 5 , P. Mittal 2 , U. Mahantshetty 2 , S. Gupta 4 1 ACTREC, Tata Memorial Centre, Radiation Oncology, Navi Mumbai, India; 2 Tata Memorial Hospital, Radiation Oncology, Mumbai, India; 3 ACTREC,Tata Memorial Centre, Radiation Oncology, Navi Mumbai, India; 4 ACTREC, Tata Memorial Centre, Medical Oncology, Navi Mumbai, India; 5 Tata Memorial Hospital, Medical Oncology, Mumbai, India Purpose or Objective Visceral and nodal metastasis presently represents the most common form of relapse in patients with cervix cancer. Modest survival outcomes of 9-17 months are reported with systemic chemotherapy +/- targetted agents and/or immunotherapy. Additon of (re) radiation to systemic chemotherapy may lead to improved survival in patients with oligo metastatic and oligorecurrent disease. The purpose of this audit was to report outcomes of radiation in this setting. Materials and Methods Consecutive patients treated with radiation+/- systemic chemotherapy for either oligometastatic or oligorecurrent disease between Jan 2017 -February 2020 were included. Patients eligible for brachytherapy or surgical salvage or with isolated paraaortic relapse were excluded. All patients received systemic chemotherapy consultation and were additionally considered for consolidation radiation to relapsed or metastatic sites. Progression free survival (PFS) after relapse was defined as the period between diagnosis of relapse and last progression of disease. Overall survival (OS) was defined as the time between date of diagnosis of relapse or metastasis and until last follow up or death. Survival distributions for PFS and OS were estimated using the Kaplan-Meier method. Results Forty patients were treated. The median age was 48 years (30-77 years) and median time to first relapse 14 months (6.25- 22.5 months). The median number of sites at time of relapse were 1 (1-6 ). Overall 26/40 patients had nodal and/or visceral oligo-recurrence (infield =46.2%, out of field 19.2% and both infield and out