ESTRO 2023 - Abstract Book

S1155

Digital Posters

ESTRO 2023

PO-1427 Risk factors for unplanned acute care visits in gynecologic oncology patients receiving radiotherapy

J. Croke 1 , A. Dou 1 , M. Doherty 1 , G. Bouchard-Fortier 2 , K. Han 1 , M. Milosevic 1 , J. Lukovic 1 , S. L’heureux 3

1 Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Canada; 2 Princess Margaret Hospital Cancer Centre, Department of Gynecologic Oncology, Toronto , Canada; 3 Princess Margaret Cancer Centre, Department of Medical Oncology and Hematology, Toronto, Canada Purpose or Objective Unplanned acute care utilization during cancer treatment can negatively impact patient quality of life, healthcare costs and clinical outcomes. Our objective was to evaluate risk factors for unplanned ambulatory acute care clinic (AACC) utilization in gynecological oncology patients receiving radiotherapy (RT). Materials and Methods This was a retrospective review of gynecological cancer patients treated at our institution between August 1, 2021, and January 31, 2022. Patients were divided into 2 cohorts: those receiving concurrent chemoradiation regimens (CCR) and those receiving RT alone. Baseline socio-demographic data, as well as clinical and treatment characteristics, were extracted from medical records. Data pertaining to unplanned visits to our AACC were also collected, including number of visits during treatment, chief complaint, and interventions performed. Descriptive statistics summarized the study population. Student's t-test and chi-squared test were used for comparisons of continuous and categorical variables, respectively. Results RT was delivered to 180 gynecological cancer patients within the time period, of which 42 received CCR (23.3%) and 138 (76.7%) received RT alone. PORTEC-3 for endometrial cancer was the most common CCR regimen (59.5%), followed by weekly cisplatin/RT for cervix cancer (33.3%). CCR patients had higher rates of unplanned AACC utilization compared to those receiving RT alone (54.8% vs. 18.8%, p<0.001) and visited more frequently during treatment (3.1 visits/patient vs. 1.4 visits/patient; p=0.005). CCR patients most commonly presented with dehydration requiring an intervention with IV fluids (33.6% of visits), whereas RT only patients presented with questions surrounding symptom management requiring patient education (21.4% of visits). CCR patients who visited the AACC had higher rates of Psychosocial Oncology referrals (60.9% vs. 5.3%; p<0.001) and were more likely to be single (43.5% vs. 10.5%; p=0.019) compared to CCR patients who did not visit the AACC. CCR patients with unplanned AACC utilization had significantly more treatment interruptions (52.2%) compared to those who did not visit the AACC (15.8%, p=0.014) and compared to RT alone patients who did present to the AACC (7.7%, p<0.001). There were no associations between disease site, age, nor distance to the cancer centre and unplanned AACC utilization. Conclusion Gynecological oncology patients undergoing CCR are at increased risk for unplanned acute care utilization. Psychosocial referrals, being single and treatment interruptions were significantly higher in CCR patients utilizing the AACC. Targeted strategies to better meet the supportive care and psychosocial needs of this population are required. 1 Post Graduate Institute of Medical Education and Research, Radiotherapy and Oncology, Chandigarh, India; 2 Post Graduate Institute of Medical Education and Research, Gynae-pathology, Chandigarh, India; 3 Post Graduate Institute of Medical Education and Research, Obstretics and Gynaecology, Chandigarh, India Purpose or Objective To evaluate clinicopathologic characteristics and prognostic factors of uterine Sarcomas and to assess the patterns of relapse and survival. Materials and Methods It is a single-institution retrospective analysis of histopathologically confirmed uterine sarcoma, including Leiomyosarcoma (LMS) & endometrial stromal sarcoma (ESS) treated in our institute from 2015-2021. A total of 81 patients were included. Kaplan Meier and log-rank tests were used for survival analysis. The Cox regression model was used to determine prognostic factors. Results The most common histopathological type was ESS (49/81, 60.4%), followed by LMS (32/81, 39.6%). The median age at diagnosis was 50 years for LMS and 41 years for ESS. A total of 80 (98.7%) patients (31 for LMS and 49 for ESS) underwent surgery. Eighteen (56.2%) patients were early stage (FIGO stage 1& 2), 14 (43.75%) were advanced stage (3 & 4) for LMS. Thirty (61.1%) patients were early stage & 14 (28.6%) were in the advanced stage of ESS. Twelve patients (37.5%) for LMS and 9 (18.3) for ESS had positive surgical margins. In the case of LMS, ten patients (31.3%) received adjuvant External Beam Radiation (EBRT), and 17 (53%) received chemotherapy (Table1). In the case of ESS, 20 patients (40.8%) received pelvic EBRT, and 14 (28.5%) received chemotherapy. The most common pattern of failure for LMS was distant relapse (21, 65.6%) followed by local relapse (8, 25%), and for ESS, eight patients (16.3%) had a distant relapse, and 7 (14.2%) had a loco regional relapse. Median overall survival (OS) was 19 months, progression-free survival (PFS) was 11 months, 2-year OS was 45.9%, and 2-year PFS was 34.6% for LMS. In the case of ESS, 2-year OS was 83%, and 2-year PFS was 76% (Figure1). The tumor stage (p=0.02), size of the tumor (p=0.02) for LMS and Low grade (p=0.03), and positive margins (p=0.01) for ESS were significantly associated with PFS. Table1: Patient and Treatment characteristics of Uterine Sarcomas PO-1428 Treatment outcomes in Uterine Sarcomas: A Real-world experience S. GY 1 , B. Rai 1 , T. Dey 1 , R. Srinivasan 2 , V. Jain 3 , V. Suri 3 , R. Bagga 3 , S. Ghoshal 1