ESTRO 2022 - Abstract Book

S387

Abstract book

ESTRO 2022

A. Rovirosa 1 , Y. Zhang 2 , C. Chargari 3 , E. Van der Steen-Banasik 4 , P. Wojcieszek 5 , M. Stankiewicz 6 , D. Najjari 7 , P. Hoskin 8 , K. Han 9 , B. Segedin 10 , R. Potter 11 , K. Tanderup 12 , E. Van Limbergen 13 1 Faculty of Medicine, Universitat de Barcelona, Fonaments Clinics Dpt., Barcelona, Spain; 2 Henan Provincial People’s Hospital, Cancer Center, Zhengzhou, China; 3 Institut Gustave Roussy, Radiation Oncology Dpt., Villejuif, France; 4 Radiotherapie Groep/Arnhem, , Radiation Oncology Dpt. , Arnhem, The Netherlands; 5 Centrum Onkologii-Instytutim. MariiSk ł odowskiej-Curie ., Radiation Oncology Dpt., Warsaw, Poland; 6 Centrum Onkologii-Instytutim. MariiSk ł odowskiej- Curie, Radiation Oncology Dpt., Warsaw, Poland; 7 Institut Català d'Oncologia, Radiation Oncology, Hospitalet de Llobregat, Spain; 8 Mount Vernon Cancer Centre, Clinical Oncology Dpt., Northwood,, United Kingdom; 9 Princess Margaret Cancer Center, Radiation Oncology, Toronto, Canada; 10 Institute of Oncology of Ljubljana, Radiation Oncology, Ljubljana, Slovenia; 11 Medical University of Vienna, Department of Radiation Oncology, Vienna, Austria; 12 Aarhus University Hospital, Department of Oncology, Aarhus, Denmark; 13 University Hospital Gasthuisberg, Radiation Oncology Dpt., Leuven , Belgium Purpose or Objective Analyse the outcomes of stage I-III inoperable endometrial cancer (EC) patients treated with 3D-image-guided brachytherapy (IGBT) and external beam irradiation (EBRT) hypothesising that this treatment provides good results. Materials and Methods Medical records of EC patients treated in 8 European centres and one from Canada from 2003-2019 with EBRT + IGBT were examined, including: EBRT pelvic +/- paraaortic and lymph node boost doses; anaesthetic procedure, applicator type, BT- planning imaging, clinical target volume (CTV), BT schedule, overall daily dose equivalent to 2Gy fractions (EQD2 ( α / β =4,5 or 3) ) to the CTV ( α / β =4,5) and D 2cm3( α / β =3) for organs at risk. Complications were evaluated using CTCAEv4 scores. Survival probability by stages at 2 and 5 years was estimated (cancer-specific survival [CSS], disease-free survival [DFS], local relapse-free survival [LRFS], loco-regional relapse-free survival [LRRFS] and distant metastasis-free survival [DMFS]). Statistics: Survival analysis included descriptive analysis and the Kaplan-Meier method. Results 103 patients staged I (44), II (14) and III (44) were included. Median follow-up: 38 months (6-170). All patients received pelvic +/- para-aortic EBRT and nodal boost when necessary. General anaesthesia (43%) followed by spinal anaesthesia (18%) were most common. Y-Shaped Rotte was the most common (24%) followed by tandem + mould (21%). The median D90 EQD2 ( α / β =4.5) to the CTV was 73.3 (44.6-132.7) in stage I, 69.9 (15-87.9) in Stage II and 75.2 (55.1-97) in stage III. Thirty-four patients presented relapse: uterine in 24 (7 in Stage 1, 3 in II and 14 in stage III), nodal in 15 and distant in 23 (most common in stage III). Six of eight patients with uterine tumour relapse/persistence alone were rescued by surgery and they are alive at present. At 2 and 5 years, CSS was 88.7% and 71.2%, (stages I, II and III were 92.4% and 82.6%, 90.9% and 79.5%, 84.6% and 56.7%, respectively), DFS 71.7% and 55.5%, LRFS was 75.6% and 59%, LRRFS was 75.7% and 59.1% and DMFS was 81.3% and 64.4% respectively. Late G3-G4 complications appeared in 1% in the small bowel, 2% in rectum and 3% in bladder. Conclusion In stages I-III inoperable EC IGBT + EBRT offers good CSS results of 88.7% and 71.2% at 2 and 5 years, respectively with the best outcome in stages I and II. 3D-IGBT provides effective treatment for inoperable patients and prospective studies should help to determine how to obtain better outcomes. S. van Vliet - Perez 1 , R. van Paassen 2 , L. Wauben 3 , R. Straathof 3 , N. van de Berg 4 , J. Dankelman 3 , B. Heijmen 1 , I. Kolkman- Deurloo 1 , R. Nout 1 1 Erasmus MC Cancer Institute, Radiation Oncology, Rotterdam, The Netherlands; 2 Erasmus MC, General Practice, Rotterdam, The Netherlands; 3 Delft University of Technology, BioMechanical Engineering, Delft, The Netherlands; 4 Erasmus MC Cancer Institute, Gynaecological Oncology, Rotterdam, The Netherlands Purpose or Objective Brachytherapy (BT) is an important component of the curative treatment for locally advanced cervical cancer. It consists of several steps, but the impact of these steps on patient experience in terms of pain and anxiety is still scarcely reported. The step durations can potentially influence patient experience, but this is also not well described. The aims of this study are to perform a time-action analysis and to determine the patient experience during each step of the workflow. Materials and Methods Patients treated with EBRT and 3 or 4 fractions of HDR BT with an intracavitary/interstitial applicator were included in a prospective study. For the time-action analysis, the involved staff reported the time needed for each step on a standardised form which included start and end time of each step. For the patient experience analysis, an EQ-5D questionnaire was used to calculate the health state index (0= equivalent to dead, 1= full health), and EQ VAS score (0= worst imaginable health, 1= best imaginable health) at the beginning of the day to establish a base line health status. Pain, anxiety and duration experience for each treatment step were assessed with a numeric rating scale questionnaire (0= the perfect situation, 10= worst possible situation). The median and interquartile range was provided for all parameters. Results A total of 30 patients (69 fractions) were included for the time-action analysis of which 13 patients (28 fractions) were also included for the analysis of the patient experience. The total procedure time, expressed in hours:minutes, from arrival at OC-0444 Patient experience and time-action analysis during cervical cancer brachytherapy