ESTRO 2023 - Abstract Book

S314

Sunday 14 May 2023

ESTRO 2023

and 107/126 patients G0-G1. In the univariate analysis CTV ≤ 9cm3 (p=0.036), use of dilators <9 months (p=0.015), and total EQD2 received by 2cm3 of the most exposed to the dose CTV ≥ 68Gy (p=0.039) were associated with G2 late vaginal toxicity. Multivariate analysis showed the use of vaginal dilators >9 months as the only independent prognostic factor for reducing G2-late vaginal toxicity (OR=8.59;95% CI: 1.59-159.9 and p=0.043,). Conclusion The present cohort study showed the use of vaginal dilators >9 months to be an independent prognostic factor in reducing G2-late vaginal toxicity in multivariate analysis. The use of vaginal dilators >9 months should be better analysed in the future and considered in studies analysing brachytherapy related vaginal toxicity. PD-0413 Sexual health and vaginal toxicity after chemo-radiation and brachytherapy in cervical cancer J. Conway 1,3 , J. Hanuschak 2 , L. Conroy 3,2 , K. Han 2,3 , M. Milosevic 2,4 , J. Lukovic 2,3 , S. Ferguson 5,6 , A. Salman 7 , A. Santiago 8 , A. Rink 9,3 , J. Croke 2,3 1 Simcoe Muskoka Regional Cancer Centre, Radiation Oncology, Barrie, Canada; 2 Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Canada; 3 University of Toronto, Department of Radiation Oncology, Toronto, Canada; 4 University of toronto, Department of Radiation Oncology, Toronto, Canada; 5 University Health Network/Sinai Health System, Department of Obstetrics and Gynecology, Toronto, Canada; 6 University of Toronto, Division of Gynecologic Oncology, Toronto, Canada; 7 University Health Network/Sinai Health System and Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Toronto, Canada; 8 Princess Margaret Cancer Centre, Department of Biostatistics, Toronto, Canada; 9 University of Toronto, Department of Medical Biophysics, Toronto, Canada Purpose or Objective Vaginal and sexual function is an important, yet often neglected, survivorship issue for cervical cancer patients. Our objective was to evaluate patient-reported sexual outcomes (PROs) and physician-assessed vaginal toxicity (VT) after chemo-radiation (CRT) and brachytherapy (BT) for locally advanced cervical cancer. Materials and Methods This was a single-centre prospective cross-sectional study. Stage IB-IVA cervical cancer patients treated with definitive CRT and MR-guided BT who were disease-free for >3 months were eligible. Consenting patients completed the following validated PRO measures: Female Sexual Distress Scale-Revised (FSDS-R; cut-off for distress ≥ 11)), Female Sexual Function Index (FSFI; cut-off for risk of sexual dysfunction ≤ 26), EuroQol Group EQ-5D (index value range: 0 (death) to 1 (perfect health)), and Menopause Rating Scale (MRS; 0 (asymptomatic) to 44 (highest symptoms)), as well as a socio-demographics questionnaire. During the clinical encounter, physicians assessed VT using the CTCAE v4.0. Sociodemographic, PROs, VT, and clinical data were summarized using descriptive statistics. Univariate associations of PROs with VT (grouped 0/1 vs 2+) were explored using the Wilcoxon-rank sum (Mann-Whitney) test for continuous PRO variables and Fisher’s exact test for categorical PRO variables. Results Between August 2018 and April 2022, 74 patients were eligible for analysis. Median age at diagnosis was 49.5 (range: 25- 81), 51% were FIGO cT2b, 61% had vaginal involvement at diagnosis, 77% were partnered and 87% reported using a vaginal dilator post-treatment. Median time from treatment was 19.8 months (3.3-57.1). Median CTVHR D90% was 92.1Gy (81- 106.4), ICRU recto-vaginal (RV) point was 63.1Gy (52.6-85.8) and vaginal D2cm3 was 76.3Gy (54.5-133). Median FSDS-R score was 12.5 (0-52) with 55% meeting criteria for sexual distress, median FSFI score was 12.6 (0-33.6) with 85% meeting criteria for sexual dysfunction, median EQ-5D index value was 0.8 (0.4-1), and median MRS score was 13 (0-44). Grade 2+ VT was documented in 31.1% (23/74) of patients. Younger age (<50 years old, p<0.001) and marital status (being partnered, p=0.004) were associated with higher rates of sexual distress, whereas there were no associations for sexual orientation, ethnicity, or religion. Vaginal dilator use was associated with less sexual dysfunction (p=0.04). Patient-reported sexual distress and menopausal symptoms were associated with physician-reported VT for dryness (p=0.01 FSDS-R, p-0.02 MRS), dyspareunia (p=0.01 FSDS-R, p=0.01 MRS) and vaginismus (p=0.004 FSDS-R, p=0.005 MRS). Conclusion Cervical cancer patients self-report high rates of sexual distress, sexual dysfunction and menopausal symptoms after CRT and BT. Clinical identification of VT should prompt physicians to discuss sexual health and to assess the downstream impact on functioning and quality of life. PD-0414 ERAS pathway for gynecologic cancer patients receiving brachytherapy: A prospective clinical trial L. Andring 1 , K. Corrigan 1 , N. Bailard 2 , M. Rooney 1 , M. Domingo 1 , J. Varkey 1 , T. Foster-Mills 1 , B. Fellman 3 , L. Lin 1 , A. Jhingran 1 , L. Colbert 1 , P. Eifel 1 , A. Klopp 1 , M. Joyner 1 1 UT MD Anderson Cancer Center, Radiation Oncology, Houston, USA; 2 UT MD Anderson Cancer Center, Anesthesiology, Houston, USA; 3 UT MD Anderson Cancer Center, Biostatistics, Houston, USA Purpose or Objective Women with gynecologic malignancies who receive chemoradiation (CRT) and brachytherapy (BT) have significant functional recovery needs. Enhanced recovery pathways (ERPs) have been adopted by many surgical specialties and have shown improved outcomes. No data exists examining the role of an ERP in patients receiving CRT or BT. Here, we review baseline patient reported outcomes (PROs) from a prospective clinical trial. Materials and Methods A single-institution, prospective trial evaluating the outcomes of gyn cancer patients undergoing BT before (n=33) and after (n=33) the implementation of an ERP. The ERP will include interventions that span the prehabilitation, peri-operative and survivorship phases of care. Questionnaires to assess PROs before CRT, post-BT, and 60-day follow-up (FU) were collected, using EORTC QLQ-C30, and EORTC QLQ-CX24 validated metrics. Higher scores for functional scales and global health status are favorable and higher scores for a symptom item are unfavorable. Mean scores were compared to an EORTC reference population of females with any cancer diagnosis using Welch’s t-test. Simple linear regression models were used to assess the relationship between quantitative variables.