ESTRO 2023 - Abstract Book

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ESTRO 2023

Brachytherapy for gynaecological cancer causes varying levels of pain, anxiety and discomfort in low-dose brachytherapy. To improve women's experiences there needs to be better pain management, patient information and the development of non-pharmacological interventions. Future recommendations are to develop clinical support guidelines, audit the quality of services and develop effective interventions to improve women's experiences of brachytherapy for locally advanced cervical cancer.

PO-2159 Clinical outcomes and toxicities of cervical cancer patients treated with HDR-BT after CCRT

M. dayyani 1 , L. Rafat-Motavalli 2 , E. Hoseinian-Azghadi 3 , H. Miri-Hakimabad 2 , F. Varshoee-Tabrizi 1 , F. Homaee-Shandiz 4

1 Reza Radiotherapy and Oncology Center, Radiation Oncology Department, Mashhad, Iran Islamic Republic of; 2 Ferdowsi University of Mashhad, Physics Department, Faculty of Science, Mashhad, Iran Islamic Republic of; 3 Reza Radiotherapy and Oncology Center, Research and Education Department, Mashhad, Iran Islamic Republic of; 4 Mashhad University of Medical Sciences, Radiation Oncology Cancer Research Center, Mashhad, Iran Islamic Republic of Purpose or Objective This study reported outcomes and toxicities of cervical cancer patients who were treated with external beam radiation therapy (EBRT) and 3-dimensional (3D) image-guided adapted brachytherapy (EBRT/3D-IGABT) in Reza Radiotherapy and Oncology Center (RROC), Mashhad, Iran. Materials and Methods 180 patients with newly diagnosed cervical cancer who were treated with curative-intent in RROC from 2017 to 2021. Patterns of recurrence, cancer-specific survival (CSS), and overall survival (OS) were evaluated. Late gastrointestinal, urinary and vaginal toxicity were scored with National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. Results The median follow-up for patients at the time of last follow-up was 38.9 months (range, 24.0-62.6 months). According to the International Federation of Gynecology and Obstetrics, 10% of tumors were stage IB1 to IB2, 74.5% were stage IIA to IIB, and 15.7% were stage IIIA to IVA. The results after 2 years showed that freedom from relapse (FFR) was 71.4%, CSS was 85.7%, and OS was 74.3% (P < 0.05). Cumulatively, 4.8% of patients had grade ≥ 2 late bowel/bladder toxicities and 22.2% of patients had grade ≥ 2 late vaginal toxicity. Conclusion Comparable FFR, CSS and OS were observed for IB, IIA, IIB and IIIA-IVA patients treated with HDR BT in our center vs. similar previous studies. However, the higher frequencies of grades ≥ 2 vaginal toxicities observed for our patients, which highlights the need for refining the educational approach regarding the late genital-associated toxicities including management of vaginal stenosis. S. Santana Jimenez 1 , S. Córdoba Largo 1 , B. Gil Haro 1 , J. Romero Fernández 1 , C. De La Fuente Alonso 1 , J. Velasco Jiménez 1 , Á. Perales Molina 2 , P. Sarrión Rubio de La Torre 1 , U.A. Corro Verde 3 , R. Benlloch Rodríguez 1 , M. López Valcárcel 1 , M. Hernández Miguel 1 1 Puerta de Hierro Majadahonda University Hospital, Radiation Oncology, Madrid, Spain; 2 Puerta de Hierro Majadahonda University Hospital, Medical Physics, Madrid, Spain; 3 Marqués de Valdecilla University Hospital, Radiation Oncology, Santander, Spain Purpose or Objective Current FIGO and TMN staging in cervical cancer allow adequate staging but do not provide sufficient prognostic information. Findings based on magnetic resonance imaging (MRI) of patients with locally advanced cervical cancer (LACC) may provide prognostic information. Purpose: To investigate the application of a simple but comprehensive tumor score (T-score) in LACC. Purpose or objective: To investigate the application of a simple but comprehensive tumor score (T-score) in locally advanced cervical cancer (LACC). Materials and Methods Twenty-six patients diagnosed of LACC treated between Dec 2019 and Feb 2022 with chemoradiotherapy and image- guided adaptive brachytherapy (IGABT), were analyzed. FIGO stage: IB 11.5%, IIA 11.5%, IIB 11.5%, IIIA 3.8% and IIIC 61.6%. The involvement of 8 anatomical locations (cervix, left parametrium, right parametrium, vagina, bladder, ureter, rectum and uterine body) was scored according to an ordinal scale from 0 to 3 points. The total sum of points constituted the T-score. Statistics: T-test, chi- square, Kaplan-Meier and log-Rank test. Results Median follow-up: 8.5 months (1-28). Median volume HRCV: 32,9cc (12-51.3), median D90: 91,30Gy (80-94.90) and median T-score: 4 (2-9). T-score >4 correlated with larger IGABT target volume (HRCTV) (35cc vs 32cc for T-score ≤ 4; p= 0.053), and the use of interstitials needles (61% vs 15% for T-score ≤ 4; p=0.041). Two-y overall survival was 76%. There were a non- significant trend toward worse 2-y distant metastasis-free survival and pelvic relapse-free survival for T-score >4 (60% vs 75%, p=0.1; and 75% vs 100%, p=0.07, respectively) PO-2160 T-score evaluation as prognostic factor in locally advanced cervical cancer